Endocrine Abstracts

Background: The European Society of Endocrinology (ESE) published guidelines to standardise intravenous hypertonic saline (HTS) for severe symptomatic hyponatraemia in 2014. Two 150 mL boluses of 3.0% HTS are proposed, one after the other, to achieve an initial sodium rise of 5 mmol/l without waiting for an interval sodium result. ESE guidelines were adopted by our University Hospital in 2017. However, high rates of sodium overcorrection were observed, and the guidelines lacke...

Introduction: Carcinoid heart disease can occur in up to 20 % of patients with carcinoid syndrome. It is a regarded as a rare complication and associated with high morbidity and mortality as a sequela of vasoactive peptides resulting in plaque formation on the valve leaflets classically tricuspid and pulmonary valves and causing right heart failure. Definitive treatment is surgical valve replacement, but percutaneous valve management is an attractive alternative for those deem...

Introduction: The COVID-19 pandemic has affected patient care and experience. We assessed the evolution of NET patient perceptions during and peri-pandemic via a bespoke patient satisfaction survey.Methods: In February 2022, questionnaires with a pre-paid return envelope were posted out to 87 randomly selected NET patients, treated between January and December 2021. This consisted of 29 questions covering: initial contact, physician care and support, ill...

Introduction: Established guidelines recommend carefully selected patients with Carcinoid Heart Disease (CHD) may undergo surgical valve replacement as definitive management. Right sided heart valve involvement is classical, occurring as result of plaque deposition on valve leaflets as a consequence of vasoactive peptides secreted by the NET because of carcinoid syndrome. Tricuspid and Pulmonary valve involvement leads to right heart failure (RHF) increasing mortality and morb...

Case history: A 59-year-old male presented to gastroenterology with a two years of high volume persistent watery diarrhoea. He gave a past medical history of poorly controlled, insulin treated diabetes mellitus present for 8 years. He reported abdominal pain and diarrhoea that persisted despite fasting. A colonoscopy with biopsy were reported as normal. Diarrhoea, malaise, fatigue and weight loss persisted.Investigations: Stool culture and faecal elastas...

Pancreatic neuroendocrine tumours are rare with an incidence of 5 per million. Of these tumours, 75% maybe hormonally functioning. They carry a better prognosis than adenocarcinoma of the pancreas. Parathyroid Hormone related peptide hypersecretion in PNETs is uncommon and is solely associated with metastatic PNETs. 31 cases are reported of PTH-rPoma in the literature. Here we describe a novel case presenting with cough. A previously well 56-year-old female presented to the ac...

Introduction: Pregnancy in women with pre-existing Type 1 diabetes (T1DM) is known to carry a 3–5 times increased frequency of severe hypoglycaemia (SH) in the first compared to the third trimester. The main predictors are: pre-gestational SH, HbA1C <6.5%/48 mmol/mol, duration of diabetes and higher total daily insulin doses. Freestyle Libre or flash monitoring utilizes a 14 day tiny glucose sensor which is applied to the back of the arm and scanned with a reader, to ...

Splenunculi or accessory spleens are congenital foci of normal splenic tissue that are separate from the main body of the spleen. They are common, with a prevalence of 16% on contrast-enhanced abdominal CT, and present in 10–30% of post mortem examinations. They are benign, and important to recognise to avoid unnecessary investigations and surgery for suspected malignancies.Splenunculi are usually asymptomatic and found incidentally. Typically on CT...

: The orally administered targeted therapies, Sunitinib and Everolimus lengthen progression free survival in pancreatic neuroendocrine tumours (pNETs). Choice of therapy has traditionally been on avoidance of deterioration in established co-morbidities. Sunitinib has been recognised to induce hypocalcaemia and the subsequent need for calcium supplementation has been reported. However, little has been documented about the utility and therapeutic significance of this effect....

Background: Evidence suggests associations between vitamin D deficiency and cardiovascular risk factors, including hypertension and excessive cortisol levels. Also, vitamin D levels may be associated with exercise performance. Thus, we aimed to investigate the effects of vitamin D intake on cardiovascular risk factors, free urinary cortisol and exercise performance.Methods: A randomised placebo controlled single-blinded parallel trial was conducted in he...