Endocrine Abstracts

Rapid diagnosis and treatment of Cushing’s syndrome (CS) is essential for good outcomes. Current standards for appropriate timelines for referral are under review by NHSE. Data are required to substantiate standard setting. Knowledge of current referral pathways/processes are required to explore delays in accessing definitive surgical treatment. An audit of referral processes at Queen Elizabeth Hospital Birmingham was undertaken and further expanded to 4 additional tertia...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

Introduction: Herein we provide clinical, biochemical, histological and radiological evidence of a rare case of a male patient who was diagnosed with pituitary macroadenoma (prolactinoma), phaeochromocytoma and a lung typical-carcinoid tumour on a background of SDH gene mutation encoding the succinate dehydrogenase enzyme.Presentation of case: A 42 year old male individual, was initially diagnosed with a pi...

We report a case of 43 year old gentleman who had surgery in 1998 for left glomus typanicum, leaving him with complete left lower facial nerve palsy. Incidentally he was noted to have had labile blood pressure during this surgery. He had gradual growth of residual tumour which required fractionated radiotherapy in 2012. He has had ongoing problems with headaches with profuse left-sided rhinorrhoea and intermittent episodes of sweating. In...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

Introduction: Herein we provide clinical, biochemical, histological and radiological evidence of a rare case of a male patient who was diagnosed with pituitary macroadenoma (prolactinoma), phaeochromocytoma and a lung typical-carcinoid tumour on a background of SDH gene mutation encoding the succinate dehydrogenase enzyme.Presentation of case: A 42 year old male individual, was initially diagnosed with a pi...

We report a case of 43 year old gentleman who had surgery in 1998 for left glomus typanicum, leaving him with complete left lower facial nerve palsy. Incidentally he was noted to have had labile blood pressure during this surgery. He had gradual growth of residual tumour which required fractionated radiotherapy in 2012. He has had ongoing problems with headaches with profuse left-sided rhinorrhoea and intermittent episodes of sweating. In...

Patients with adrenal insufficiency (AI) should be informed about ‘sick day rules’ and risk of a life-threatening adrenal crisis if corticosteroids are abruptly stopped or if the steroid dose is inadequate.Aims and Methods: To assess current practice with regard to steroid advice given across medical specialties at Oxford University Hospital Trust. To assess patient knowledge both in a specialist Endocrine department and in a medical specialty ...