Endocrine Abstracts

Haematopoietic stem cell transplantation (HSCT), also known as bone marrow transplantation, is a potentially curative therapy mainly indicated in malignant and non-malignant bone marrow disorders. It has resulted in improved survival for patients at the cost of long-term complications. Endocrine and metabolic disorders are the most prevalent sequelae following bone marrow transplantation, primarily caused by powerful conditioning chemotherapy associated with total body irradia...

Pituitary hyperplasia is a relatively common condition that occurs in both physiological and pathological states. Pregnancy is the most common condition associated with physiological pituitary enlargement, associated primarily with lactotroph hyperplasia. Pathological hyperplasia has been shown to be associated with end organ insufficiency from primary gonadal insufficiency, primary adrenal insufficiency, and primary hypothyroidism. We present the case of a 33-year-old male wi...

Introduction: Survivors of childhood, adolescent or young adult cancers are at risk of endocrine dysfunction from their tumours, surgery, chemotherapy and/or radiotherapy treatment. The hypothalamic pituitary axes and gonads are at risk of dysfunction depending on a number of risk factors. Endocrine dysfunction can occur from before diagnosis of cancer, soon after but mostly a number of years later, even after survivors have been discharged from oncology follow-up. We aim to e...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

Introduction: Congenital Adrenal Hyperplasia (CAH) is a rare genetic disorder characterised by deficiency of cortisol and/or mineralocorticoid hormones with over production of sex steroids. 21-hydroxylase deficiency is the commonest cause of CAH accounting for 95% of cases. Severe form of classic CAH occurs in 1 in 15 000 live births.Case report: A 30 year old women with CAH diagnosed at birth was on replacement with hydrocortisone and fludrocortisone. S...

Introduction: Primary testicular lymphoma is very rare and constitutes about 2% of all extra nodal lymphomas, mostly in men above the age of 60. Bilateral adrenal masses could be due to metastatic disease, congenital adrenal hyperplasia, bilateral macro-nodular hyperplasia, adrenal adenomas, lymphomas, infiltrative diseases, amyloidosis and infections like tuberculosis. Metastasis occurs most commonly from lung, bowel, breast and pancreatic cancer. Metastasis from lymphomas is...

IntroductionCurrent guidelines recommend a single elevated prolactin measurement drawn without excessive venepuncture stress as sufficient for diagnosing hyperprolactinaemia. However, previous studies have demonstrated that the cannulated prolactin test is more reliable at eliminating stress-induced hyperprolactinaemia, thus avoiding unnecessary additional investigations. We routinely perform morning serial prolactin sampling immediately after brachial v...

BackgroundSomatostatin receptor ligands (SRL) are commonly used in patients with acromegaly to control insulin growth factor 1 (IGF1) concentrations. Biliary sludge or gallstone formation are well-recognised biliary adverse events (BAE) from SRL therapy. Our current practice is to routinely monitor patients with acromegaly on SRL with ultrasound scanning (USS). Once BAE are detected, ursodeoxycholic acid (UDCA) therapy is initiated.<p class="abstext"...

Background: Enzalutamide is a next-generation androgen receptor (AR) antagonist, used as a daily oral agent, in the treatment of castration-resistant prostate cancer. Its suppression of 11β-hydroxysteroid dehydrogenase-2 enzyme has been reported in the literature, leading to hypertension through a relative increase in cortisol concentration at the level of the mineralocorticoid receptors. Enzalutamide is also known to be a potent inducer of drug metabolising enzymes (cyto...

Background: Diagnostic work-up for Cushing ’s syndrome (CS) can be challenging, with variable performance characteristics on screening tests. We were recently referred a young female patient with Cushing’s disease (CD) due to a microadenoma. She presented with a seizure and initial biochemical work-up included a Synacthen stimulation test (SST). Her peak cortisol rose to over 1,000 nmol/l. Exaggerated response during SST is expected in hyperestrogenic states due to e...