Endocrine Abstracts

Introduction: Antiphospholipid syndrome (APS) is the association of anti-cardiolipin antibodies and venous & arterial thrombosis. APS accounts for <0.5% of cases of hypoadrenalism. We present a series of 5 such cases occurring at our institution plus a further patient identified with unilateral adrenal haemorrhage. Case 1 presented with nausea, vomiting and weight loss. Lupus anticoagulant positive. Commenced aspirin 300 mg. 6-weeks later represented with dehydration, ...

Background: Testosterone replacement therapy has been shown to produce a wide range of benefits for men with hypogonadism with studies showing improvement in libido, bone density, muscle mass, body composition, mood, cognition, and erythopoiesis. The risks associated with testosterone replacement therapy are less well characterised and there is a lack of larger randomised trials. One recognised risk is polycythaemia. The aim of this study is to assess the frequency of polycyth...

Background: Primary hyperparathyroidism (PHPT) and familial hypercalcaemic hypocalciuria (FHH) can both present with hypercalcaemia, but their management and prognosis are quite distinct. The 24 h urine calcium: creatinine clearance ratio (CCCR) is used to distinguish FHH from PHPT, where patients with FHH have a CCCR of <0.01. This study compares the use of a spot urine sample to measure CCCR with the gold-standard 24-h urine CCCR.Objective: To eval...

Context: Prolactinomas are the most common functioning pituitary adenomas & it is recognised that gender has an influence on presentation and management of this condition.Objective: To examine the effects of gender on presentation and response to treatment in a large cohort of adults with confirmed prolactinoma (MRI performed and macroprolactin excluded).Design & patients: This retrospective cohort study design used an elec...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

SDH mutations that contribute 15%–20% of PCC/PGL syndromes predispose to the development of tumours that originate from Adrenal, Parasympathetic and extra-adrenal sympathetic-associated chromaffin tissues. We conducted a retrospective analysis to identify the prevalence of PCC/PGL and elevated biomarkers during initial screening in patients newly identified as carrying a pathogenic SDH mutation.Method: Data collection from our random cohort of patie...

Introduction: 99m/Tc-MIBI parathyroid scintigraphy (MIBI) is the most common test used for pre-operative localization of parathyroid adenoma in primary hyperparathyroidism. We evaluated the influence of serum calcium and parathyroid hormone (PTH) levels on sensitivity of MIBI imaging in successful parathyroid localisation in patients identified as having primary hyperparathyroidism.Methods and material: Retrospective review of 403 patients who had MIBI s...

Case history: 22 year old female presented with left sided hemiparesis following a generalised seizure; the blood glucose was 1.2 mmol/l. Corrective treatment restored cerebral function. In the preceding 6 months, she had symptoms of drowsiness on waking which corrected with sugary drinks and described tiredness with lethargy. There had been no reported change in appetite or bowel habits however, there had been a degree of weight loss during this period. During hospital admiss...

Background: Pancreatic neuroendocrine tumours (pNETs) are commonly reported in patients with MEN1. The estimated incidence is reported as 40–80% of adults with MEN1 and pNETs are frequently multifocal. Guidelines recommend that CT, MRI and endoscopic ultrasound (EUS) can be used for detection and surveillance of pNETs in MEN1. MRI has been the most commonly used modality, but EUS may be more sensitive in detecting pNETs.Objective: To compare the sen...

Background: There is no consensus on the optimal timing of surgery for primary hyperparathyroidism (PHPT) in MEN1. Experienced centres recommend subtotal or total parathyroid surgery with three and a half gland surgery along with thymic removal as a favoured procedure; but long-term outcomes have rarely been reported.Objective: To investigate the indications and outcomes for surgery in patients with PHPT in MEN1Methods: Review of c...