Endocrine Abstracts

Introduction: Primary hyperaldosteronism (PA) can affect up to 10% of patients with hypertension. Adrenal vein sampling (AVS) is used to distinguish between unilateral and bilateral aldosterone production. However, it is invasive, technically challenging and is only performed in a limited number of centres. This audit aimed to evaluate the effectiveness of AVS in informing the management of PA in a large teaching hospital.Methods: A retrospective audit o...

We report the case of a 52 year old gentleman who presented to Primary Care with a short history of gynaecomastia, loss of libido and erectile dysfunction. He was normally fit and well, with no past medical history and no regular medications. Initial blood tests showed low testosterone (0.7 nmol/l (normal 11–28)) with inappropriately low gonadotrophins (LH 1.2iU/l (1.5–9.3), FSH <0.1 iU/l (1.4–18.1)). Other blood tests were unremarkable (TFTs, prolactin, FBC...

Background: Primary hyperparathyroidism (PHPT) is a common cause of hypercalcaemia seen in outpatient endocrinology clinic. Diagnosis is based on biochemistry and exclusion of other conditions, such as familial hypocalciuric hypercalcaemia. Symptomatic patients should usually be referred for parathyroidectomy. For asymptomatic patients there are clear guidelines for surgical referral, based on the Fourth International Workshop (2014) recommendations. This study evaluates curre...

Objectives: Craniopharyngioma is a benign tumour of the suprasellar region that is associated with increased morbidity and mortality in comparison to other causes of hypopituitarism. We aimed to establish the mode of presentation, investigations, treatment outcomes, mortality and subjective improvement in patients with craniopharyngioma in a single institution over 10 years.Design: Retrospective case notes review of patients with Craniopharyngioma on end...

Background: Lithium-associated hyperparathyroidism (HPT) is an under-recognised side effect of chronic lithium therapy. Cessation of lithium may precipitate relapse of psychiatric illness. Potential treatment with cinacalcet has been described in two case series recently.Aim: We present two cases of HPT secondary to lithium therapy used for bipolar affective disorder, which were successfully managed with cinacalcet.Results: Patient...

Background: Primary hyperparathyroidism (PHPT) and concomitant medullary thyroid disease is well described in literature as part of multiple endocrine neoplasia. However, coexistence of PHPT and papillary thyroid cancer (PTC) has only been scarcely documented in sporadic case reports and some surgical series.We present two unusual cases of PHPT associated with synchronous multifocal PTC.Cases: A 62-year-old woman with sporadic PHPT...

Cushing’s syndrome (CS) associated with dilated cardiomyopathy without LVH is rare but important to recognise as treatment of CS can lead to total recovery of heart function.A 30-year-old previously fit and well Turkish man presented with chest pain and was diagnosed with NSTEMI and CCF. An MRI of the heart and CT coronary angiogram showed normal coronary arteries but a large right adrenal tumour of 11.5 cm with extension into IVC. The transthoracic...

A 70-year-old female presented with general lethargy and a two day history of painful muscle twitching and paraesthesia in her right hand. No other symptoms were reported. Past medical history included hypertension, hypothyroidism and she had recently been diagnosed with Type 2 diabetes. Examination was unremarkable.The overall biochemical picture was that of a hypokalaemic alkalosis with hypocalcaemia and hyperglycaemia: Na+140 mmol/l, K...

Background: Mild autonomous cortisol secretion (MACS) is a common finding in patients who have an adrenal incidentaloma (AI). Evidence suggests patients with MACS are at risk of cardiovascular morbidity, but there is not yet a consensus on the management of this cohort. Our study assesses the cardiovascular risk of patients with MACS, compared to patients with non-functioning AIs.Methods: Data were collected retrospectiv...

We report the case of a 63-year-old lady with refractory hypocalcaemia due to surgical hypoparathyroidism, decompensated by malabsorption following gastric bypass, successfully treated with recombinant human parathyroid hormone 1-84 (rhPTH), Natpar. She initially presented with medullary thyroid cancer aged 33 and was found to have MEN2A. She underwent thyroidectomy and developed post-surgical hypoparathyroidism. She was managed for over 20 years with alfacalcidol and oral cal...