Endocrine Abstracts

The usual management at our centre for patients awaiting phaeochromocytoma surgery involves pre-operative titration of alpha blockade with frequent clinic visits for blood pressure (BP) and heart rate (HR) monitoring. The COVID-19 pandemic restricted our ability to consult with patients frequently. To reduce infection risk, we incorporated virtual BP monitoring using a Microsoft Excel template coupled with regular remote consultations. We present a clinical case highlighting o...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Insulinomas are neuro-endocrine tumours of the pancreas with an incidence of 0.7-4 cases per 1,000,000 population per year. Type 1 diabetes has an incidence of >20 cases per 100,000 per population per year. Cases of insulinoma with diabetes are lower than in the general population with a type 2 preponderance. This report is the seventh of insulinoma with type 1 diabetes suggesting the latter inhibits the development of the former. A 31 year old female with a 20 year histor...

Case history: A 53-year-old male with melanoma who had a previous surgical excision of his skin lesion in December 2018 was being treated with adjuvant pembrolizumab. In June 2019 his treatment changed to combination immune checkpoint inhibitor therapy (ICPi) with ipilimumab and nivolumab due to radiological recurrence.Investigations: There were no pre-ICPi endocrine investigations available. In July 2019, thyroid function tests (TFTs) showed thyroid-sti...

Case History: A 53 year old woman presented with a 12-month history of progressive hirsutism and deepening of her voice. Her symptoms coincided with the onset of the menopause. On clinical examination she had evidence of virilisation with muscle hypertrophy.Investigations: Biochemical tests revealed a serum testosterone (serT) of 30 nmol/l, a DHEA-Sulphate of 1.5 umol/l (1.0–12.0), an androstenedione of 3.2 nmol/l (0.0–6.0), a post-overnight de...

Introduction: Late-night salivary cortisol assessment is an important element when investigating suspected Cushing’s syndrome (CS). The goal of medical therapy is achieving a mean (of 5 samples during a single day) serum cortisol (serumF) of 150–300 nmol/l (Cushing Day Curve [CDC]). Metyrapone is an 11β-hydroxylase inhibitor elevating levels of 11-deoxycortisol causing conventional immunoassay (IA) to overestimate SerumF; a problem obviated by LC–MS/MS. We ...

Background: The UK Acromegaly Register contains data for 2700 patients. IGF-1 and random growth hormone (GH) measurements are used for disease monitoring. The registry reference laboratory (RRL) uses the Immunodiagnostic systems (IDS)-iSYS immunoassay platform for GH and IGF-1. The RRL uses age- and sex-specific reference ranges for IGF-1. We compared IGF-1 and GH results fromlocal laboratories to those of the RRL (pre-defined as the Gold standard) to determine the extent of d...

Introduction: Cancers that metastasise to the pituitary gland are unusual. The clinical manifestations of these can be varied making the diagnosis challenging. The most common cancers that metastasise to the pituitary are breast and lung which together account for more than two-thirds of cases. There have been reports of other types of cancers metastasising to the pituitary but these are rare. Case An 86 year old female with a previous history of a laparotomy for Duke’s C...

Objective: This study aimed to characterise the relationship between immune checkpoint inhibitors (ICIs), which are commonly used to treat cancer, and thyroid dysfunction in terms of the proportions affected, timing of onset, sequalae and risk factors.Design: Retrospective cohort studyMethods: Patients with normal baseline thyroid function who received an ICI were included. Proport...