Searchable abstracts of presentations at key conferences in endocrinology

ea0021p48 | Clinical practice/governance and case reports | SFEBES2009

Forensic endocrinology: a case report of factitious hypoglycaemia

Cheah Yee Seun , Etok Atim , Gough Andrew , Kane Pauline , Aylwin Simon , Schulte Klaus-Martin , Gilbert Jackie

A 51-year-old female presented with a 9 month history of symptoms suggestive of hypoglycaemia and associated episodes of unconsciousness, which were prevented by frequent food intake but with subsequent weight gain. She reported a history of lactose-induced anaphylaxis and the use of lactose-free subcutaneous prednisolone since sustaining a traumatic cardiac injury in 1987.Two supervised prolonged fasts demonstrated hypoglycaemia with elevated insulin le...

ea0021p225 | Endocrine tumours and neoplasia | SFEBES2009

Mitotane treatment has profound effects on cortisol catabolism

Ghataore Lea , Abraha Hagosa , Chakraborti Indrani , Taylor Norman , Aylwin Simon , Schulte K-M

Mitotane (o,p’DDD) is an effective oral adrenolytic agent for treatment of advanced adrenocortical carcinoma (ACC). Inhibition of cortisol biosynthesis has been described. Cortisol metabolic clearance rate is unchanged, but decreased cortisol biovailability is indicated by increased dose requirement for hydrocortisone replacement during mitotane treatment. Urinary excretion of common cortisol metabolites (CM) has been reported to be normal but with increase of 6β-hyd...

ea0021p282 | Pituitary | SFEBES2009

Cortisol but not GH responses are dependent on symptoms during the glucagon stimulation test

Cheah Yee Seun , Lau Kristy , Gilbert Jackie , McGregor Alan , Aylwin Simon

The glucagon stimulation test is commonly used to assess the hypothalamic–pituitary axis when the insulin stress test (IST) is contraindicated. The mechanism behind glucagon induced secretion of GH and cortisol is unclear. To determine whether these responses are dependent on symptoms during the glucagon test, a retrospective case note study of glucagon tests performed over 3 years in patients with pituitary disease was undertaken.Methods: Fifty-six...

ea0021p407 | Thyroid | SFEBES2009

Should the cytological finding of Thy 3 mandate surgical excision?

Chakraborti Indrani , Aylwin Simon , McGregor Alan , Schulte Klaus Martin , Diaz-Cano Salvador , Gilbert Jackie

Introduction: Current guidelines recommend that thyroid nodules classified as Thy 3 following fine needle aspiration (FNA) should be managed surgically. This results in over-treatment of benign disease. The purpose of this study was to review multi-disciplinary team (MDT) management of Thy 3 FNAs at our institution.Patients and methods: A total of 109 FNAs were performed between April 2008 and October 2009; 31 were reported as Thy 3. The management of al...

ea0015oc20 | Tumours, diabetes, bone | SFEBES2008

Serum 18 hydroxycortisol identifies aldosteronoma in the differential diagnosis of primary aldosteronism

Narasimhan Sowmya , McGregor Alan , Miell John , Chambers Susan Mary , Abraha (Daines) Hagosa Demoz , Aylwin Simon

Introduction: 18-hydroxycortisol (18-OHF) is known to be elevated in glucocorticoid remediable aldosteronism but there are few data relating to 18-OHF in the differential diagnosis of primary aldosteronism.Aim: We evaluated the usefulness of lying and standing 18-OHF in patients with primary aldosteronism in differentiating between aldosteronoma, bilateral adrenal hyperplasia (BAH) and normality.Methods: Patients (n=27) with...

ea0013p106 | Clinical practice/governance and case reports | SFEBES2007

Adult growth hormone replacement using a fixed graded initiation phase followed by an individualised titration phase: a single centre experience

Lecka Agnieszka , Prague Julia , Oguntolu Victor , Miell John , McGregor Alan , Aylwin Simon

Most authorities recognise adult growth hormone deficiency (AGHD) as a distinct endocrine disorder, although determining an appropriate strategy for optimising replacement remains controversial.We reviewed the outcome of a cohort of patients treated with a fixed graded initiation phase followed by an individualised titration phase. Patients were initiated on a starting dose of 0.3 mg recombinant human growth hormone (rhGH) for one month, with increases t...

ea0055oc3 | National Clinical Cases | SFEEU2018

Hyperprolactinaemia resistant to dopamine agonist due to an ectopic source of prolactin arising from a Uterine Tumour Resembling Ovarian Sex Cord Tumours (UTROCST)

Bakhit Mohamed , Arshad Sobia , Bidmead John , Haq Masud , Lewis Dylan , Diaz-Cano Salvador , Aylwin Simon J. B.

Introduction: Moderate hyperprolactinaemia occurring in a patient with a normal pituitary MRI, assuming macroprolactin and stress are excluded, is generally considered to be due to a lesion below the level of detection of the MRI scanner. Most patients with mild-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We describe a patient who had prolactin elevation typical of a prolactin-secreting macroadenoma, but with a normal MRI, and in whom the...

ea0049ep985 | Pituitary - Clinical | ECE2017

Venous glucose levels, peak GH and peak cortisol during Insulin Tolerance Test using 0.15 UNITS/Kg and 0.1 UNITS/Kg body weight

Yeoh Phillip , Grossman Ashley , Chew Shern L , Bouloux Pierre , Khoo Bernad , Carroll Paul , Aylwin Simon , Baldweg Stephanie

Insulin Tolerance Test (ITT) is a procedure commonly done by Endocrine Specialist Nurse in endocrine department. We look at over 120 ITT results done in 2 endocrine centres using Insulin Actrapid 0.15 UNITS/kg and 0.10 UNITS/kg dose plotting the glucose levels at 30, 45 and 60 min. We also look at peak GH and peak cortisol on each of these groups.Aims: We wanted to know how many percentage of patients achieving hypoglycaemia below 0.5 mmol/l, 0.5–1....

ea0044p8 | Adrenal and Steroids | SFEBES2016

Full characterisation of adrenal steroidogenesis by liquid-chromatography–mass spectrometry (LC–MS/MS) in metyrapone and/or ketoconazole-treated pituitary/adrenal Cushing’s

Taylor David R , Leong Christine H M , Bhatt Aagna E , Ghataore Lea , Aylwin Simon , Whitelaw Ben , Vincent Royce P

Introduction: Pituitary and adrenal Cushing’s may be managed by pharmacological-inhibition of adrenal steroidogenesis, using metyrapone and/or ketoconazole. Assessment of biochemical control is challenging owing to cross-reactivity in immunoassays (e.g. cortisol and 11-deoxycortisol) leading to over/under-treatment. Off-target effects can also result, e.g. hyperandrogenism/mineralocorticoid hypertension (increased 11-deoxycorticosterone/DOC). LC-MS/MS analysis is free fro...

ea0038p315 | Pituitary | SFEBES2015

Expression of MGMT in a large series of pituitary adenomas: lactotroph and corticotroph adenomas are more likely to be MGMT-negative than somatotroph and gonadotroph adenomas

Dixon Danielle A , Xekouki Paraskevi , Salaris Paola , Mustafa Omar , Prague Julia , Abbas Nadeem , Whitelaw Benjamin , Bodi Istvan , Aylwin Simon J B

Background: Lack of expression of MGMT (O-6-methylguanine-DNA methyltransferase) is associated with a better tumour response to temozolomide. There are no systematic studies of MGMT expression in pituitary tumour series.Aim: We introduced MGMT immunohistochemistry for all pituitary adenoma specimens in 2011. In this study we investigated the immunohistochemical expression of MGMT in a large series of pituitary adenomas, in order to determine (1) the over...