Searchable abstracts of presentations at key conferences in endocrinology

ea0007p212 | Steroids | BES2004

Role of PPAR-gamma receptor agonist therapy in two patients with newly diagnosed pituitary-dependent Cushing's syndrome

Hull S , Sheridan B , Atkinson A

Existing treatments for pituitary-dependent Cushing's Syndrome include pituitary or adrenal surgery, pituitary irradiation and medical therapy. Pituitary microsurgery is the usual therapy of first choice but is not always successful in achieving early apparent remission and is associated with significant late relapses. An effective drug therapy for humans would be a major advance as there is significant morbidity and mortality in Cushing's Syndrome. Recent elegant in vitro and...

ea0007p231 | Thyroid | BES2004

Pretibial myxoedema as the first manifestation of Graves disease

Watt A , Vaidya B , Macleod K

Pretibial myxoedema (thyroid-associated dermopathy), an extrathyroidal manifestation of Graves disease, is a localized thickening of the skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Almost invariably, pretibial myxoedema occurs in the presence of ophthalmopathy.We report the case of a 57-year-old man of North African origin, who presented with pretibial myxoedema as the first manifestation of Graves disease. He was admitted w...

ea0007p257 | Clinical case reports | BES2004

Transformation of a micro-prolactinoma to a macro-prolactinoma during pregnancy without symptoms or signs of pituitary enlargement: two case reports

Dixon A , Rangan S , Singh B

Transformation of a micro-prolactinoma to a macro-prolactinoma during pregnancy is rare. During treatment of micro-prolactinoma it is conventional to stop dopamine agonist treatment prior to or at conception and only re-image the pituitary if the patient presents with symptoms or signs of pituitary enlargement. We present two cases of micro-prolactinoma transforming to macro-prolactinoma during pregnancy. Neither case presented with symptoms or signs of pituitary enlargement. ...

ea0007p291 | Clinical case reports | BES2004

A case of adrenal failure secondary to metastasis from a breast angiosarcoma

Shalet S , Khan A , Issa B

A 76yr old lady presented to A&E with 'collapse and fall', 2 days following self-discharge for the same complaint. She had a medical history of type 2 diabetes on Gliclazide 80 mg o.d. and osteoarthritis of the spine.She was noted to be tanned with pigmented palmar creases and had marked postural hypotension. Biochemistry showed serum sodium 124 millimols per litre, potassium 4.6 millimols per litre and cortisol 43 nanmols per litre. A short synacthe...

ea0007p300 | Clinical case reports | BES2004

Severe reactive hypoglycaemia alleviated by acorbose administration

Thomas C , Ward A , Leatherdale B

Reactive hypoglycaemia is usually mild, often presents with non-specific symptoms and may be difficult to distinguish from neuropsychiatric illnessThe diagnosis should be considered when these symptoms are related to eating. We present a severe case of idiopathic hypoglycaemia which responded dramatically to the alpha-glucosidase inhibitor acarbose.A 25 year old woman presented with a nine year history of intermittent thirst, feeling hot, distal paraesth...

ea0007p309 | Clinical practice | BES2004

Mutation testing in multiple endocrine neoplasia (MEN1): an audit

Vaidya B , Hattersley A , Ellard S

Background: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder characterised by various combinations of tumours of the parathyroid, enteropancreatic and anterior pituitary glands. With the identification of the MEN1 gene, the genetic diagnosis of this condition is now possible. In this study, we have examined whether different clinical presentations of MEN1 are more likely to yield positive mutation result.Methods: We analysed t...

ea0005p56 | Clinical Case Reports | BES2003

An occult cause of hirsutism

O'Mullane N , Watson A , Bannerjee B

A 64 year-old woman was referred because of male pattern baldness and hirsutism. There were no virilizing or Cushingoid features and no abnormalities on gynaecological assessment.Investigations: Testosterone 7.4 nmol/L [0-2.4], FSH 81.0 iu/L, LH 38.3 iu/L, 17 Alpha hydroxyprogesterone 11.0 nmol/L [0-10], Free androgen index 21.1 [0-7.5], DHEA sulphate 1.9 micromol/L [2.2-10.0], urine free cortisol less than 150 nmol/24 hrs. Chest x-ray normal, abdominal and pelvic ultrasou...

ea0003p38 | Clinical Case Reports | BES2002

Sustained improvement in vision in a recurrent growth hormone secreting macroadenoma during treatment with octreotide in the absence of marked tumour shrinkage. A reason for cautious optimism ?

Harding J , Sheridan B , Atkinson A

A 45-year-old lady presented with a 12-month history of blurred vision. Visual assessment revealed a bitemporal hemianopia and CT scan demonstrated a large pituitary tumour with lateral and suprasellar extension. A GTT showed her growth hormone was raised basally at 7.5 milliunits per litre and incompletely suppressed to 5.7 milliunits per litre confirming acromegaly. Transsphenoidal hypophysectomy was performed. Histology confirmed a somatoptroph adenoma. Post operatively she...

ea0003p39 | Clinical Case Reports | BES2002

Hyperprolactinaemia in a patient taking the herbal remedy Agnus Castus

Harding J , Sheridan B , Atkinson A

A 34-year-old woman, presented to her General Practitioner with hot flushes. Investigations showed her to have a normal LH, FSH, free T4 and TSH. Her prolactin was elevated at 1110 milliunits per litre (NR <350 ). She had a normal menarche age 14 and had regular 28 day menstrual cycles. Before the onset of the hot flushes she had started to take agnus castus, a herbal remedy said to help symptoms of premenstrual tension.Whilst she continued to take ...

ea0056p208 | Calcium &amp; Vitamin D metabolism | ECE2018

A Curious phenomenon of Post radioiodine therapy induced hypocalcemia in Graves’ disease: Case series

Panchangam Ramakanth Bhargav , Ramesh B , Rajesh B , Vimaladevi N , Rajkiran Reddy B , Venkateshwara Reddy M , Vignesh D , Chakrapani B

Introduction: GravesÂ’ disease (GD) is often treated with radioiodine therapy for cure. While, post external irradiation and post-radioiodine therapy (RAI) induced hyperparathyroidism after many years of latency is a well known phenomenon, there are only anectodal reports of post-radioiodine hypocalcemia. The factors contributing to this are poorly understood. In this context, we evaluated our own series to look deeper in to this issue.Material and m...