Endocrine Abstracts

Case History: A 46 year old lady presented to A&E with a 4 day history of headache, vomiting, abdominal pain and fever. On further questioning, she admitted to having had experienced occasional episodes of palpitations, hot flushes and headaches over the past few months. She had history of appendectomy when she was young and acoustic neuroma removal few years ago. She wasn’t on any regular medications. On clinical examination, she looked visibly unwell and was hypoxic...

Introduction: Primary hyperparathyroidism (PHPT), as a state of chronic hypercalcemia, can be manifested by non-typical symptoms which can delay the proper diagnosis for many years and lead to serious preventable complications affecting the patient’s quality of life.Case report: A 52-year-old woman with hypertension, thyroid nodular goiter treated with radioactive iodine and a 20-year history of gastric and duodenal ulcerative disease, complicated b...

Introduction: Pituitary apoplexy (PA) is a rare but potentially life-threatening complication that may occur in pituitary neuroendocrine tumors (PitNETs). Non-functioning PitNETs (NF-PitNETs), specifically macroadenomas, seem to have a higher risk of apoplexy. Case description: A 45-year-old male presented to the emergency unit with a one-week history of binocular visual deterioration (blurred vision, diplopia, visual field defect) with left-side predomi...

Introduction: Visfatin belongs to adipokines, i.e. hormones produced mainly by adipose tissue; its expression and role have been described in many organs, where it regulates energy metabolism, insulin resistance and inflammatory reactions. Moreover, the level of visfatin changes during pregnancy and in obese women and those with obesity related pregnancy pathologies: preeclampsia (PE), gestational diabetes (GDM) or intrauterine growth restriction (IUGR) its level increases. Th...

Background: Bilateral adrenalectomy (BLA) is a treatment option for patients suffering from endogenous Cushing syndrome (CS). It consists of the surgical removal of both adrenal glands. Even though BLA offers immediate control of cortisol excess, given the risk of adrenal insufficiency, it requires life-long glucocorticoid and mineral corticoid replacement. It may lead to perioperative and long-term complications which affect patients’ quality of life (QoL). Health state ...

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

Introduction: Asprosin, a novel adipokine, is a circulating hormone mainly secreted by white adipose tissue. Asprosin is encoded by the penultimate 2 exons of the fibrillin 1 (FBN1) gene. Protein product of FBN1 is profibrillin-1, which undergoes a proteolytic cleavage by furin enzyme to produce mature fibrillin-1 and asprosin. Literature data indicated that asprosin is involved in the development of diabetes, obesity, cardiomyopathy, cancer, and polycystic o...

Introduction: Pancreatic neuroendocrine neoplasms (Pan-NENs) account for 1-2% of all pancreatic tumors. Adrenocorticotropic hormone (ACTH)-producing PanNEN is an extremely rare neuroendocrine tumor that accounts for approximately 4-16% of ectopic ACTH-dependent Cushing’s syndrome.Clinical case : A 58-year-old female with arterial hypertension and type 2 diabetes was referred to the Endocrinology Department due to abdominal pain, muscle weakness, and...

Background: Many patients require IV insulin during their critical illness. Maintenance of insulin in St James’s Hospital ICU is governed by a local protocol. At the time of ICU discharge, IV insulin therapy is often stopped. Transitioning from IV to subcutaneous insulin is often done with endocrinology input. If this is unavailable inappropriate insulin dosing may increase the risk of hypo-/hyperglycaemia.Aims: To reduce the number of episodes of h...

Background: Etomidate is mainly used in general anesthesia. In some rare cases it can also be helpful in treating life-thretening severe hypercortisolaemia (in much lower doses) in patients who are not able to take oral medications or when oral drugs are not available.Case Presentation: Fifty-seven-year-old woman with symptoms of virilization, hypokalemia and muscle weekness for 6 months was admitted to Department of Endocrinology. On admission cortisol ...