Endocrine Abstracts

Introduction: The first-line imaging modalities to locate adenomas preoperatively in primary hyperparathyroidism (PHPT) are ultrasonography (US) and subtraction scintigraphy (SuSc). When these contradict each other or are inconclusive an [11C]-methionine PET/CT (MET-PET/CT) or a 4-dimensional computed tomography (4D-CT) can be performed.Objectives: The aim of this retrospective study was to evaluate the value of MET-PET/CT in the preoperative localizatio...

Background: The brain’s thermoregulatory center is stimulated by activation of neurokinin 3 receptor (NK3R) and inhibited by estrogen. In menopause, declining estrogen disturbs this balance, producing vasomotor symptoms (VMS). This study assessed response to the NK3R antagonist fezolinetant in women with menopausal VMS.Methods: This phase 2b, double-blind trial (NCT03192176) randomized menopausal women (age >40−65 y) with moderate/severe V...

Idiopathic Isolated ATCH deficiency (IIAD) is a rare cause of secondary adrenal insufficiency characterised by ACTH deficiency with otherwise intact pituitary function. Our objective was to describe the presentation, the autoimmune associations and diagnostic findings observed in IIAD. We present a case series of 19 cases of idiopathic Isolated ACTH deficiency which were identified from the National Pituitary Register in Ireland. A chart and biochemical review was performed to...

Aims: To assess the incidence of Ipilimumab associated hypophysitis and its common presentations.Methods: All patients who developed Ipilimumab induced hypophysitis following treatment for Malignant melanoma at a large tertiary care centre in West Midlands, United Kingdom from 2012 to 2014 were included in the study. Patients with known pituitary disease prior to treatment and/or received other systemic immunotherapy following Ipilimumab treatment were e...

Introduction: Carcinoid crisis, as an entity is poorly defined, but can be seen in patients with small bowel NET tumours after open bowel surgery or tumour unrelated procedures as cardiovascular instability (CI). Recent evidence suggests that cardiovascular instability (CI) during NET surgery is more common than previously considered.Aims and methods: We audited the incidence of CI during procedures and determined the relationship to perioperative octreo...

Introduction: There remains controversy about which patients benefit from removal of their primary small bowel tumour and whether this should be performed in a specialist tertiary referral hospital as an elective procedure. Part of the decision making and consenting process in patients with metastases will be a shared decision about surgery with the patient in light of symptoms, morbidity from surgery and survival. The aim of this study was to elucidate important institution s...

Nocturnal salivary cortisol (NSC), urinary free cortisol (UFC) and overnight dexamethasone suppression testing (ODS) are recommended screening tests for Cushing’s syndrome (CS). Individual centers differ in their screening approach; UFC being the test of choice in Northern Ireland with ODS in patients with adrenal incidentalomas. NSC, which measures free cortisol, is not routinely used. The aims of this study were to 1. Evaluate the utility of NSC in the diagnosis of CS; ...

Introduction: Unilateral adrenalectomy is an effective treatment for aldosterone producing adenoma. However, after adrenalectomy, suppression of the contralateral zona glomerolura (ZG) function can lead to transient hypotension & hyperkalaemia. We present a protracted case of post-operative adrenalectomy related hypoaldosteronism.Case: A 54-year-old hypertensive male with confirmed primary hyperaldoseronism (PRA<0.1 nm/h, aldosterone 1050 pmol/l;...

First line screening for pheochromocytoma, as recommend by Endocrine Society guidelines, is to determine plasma free or urinary fractionated metanephrines. We routinely offer the latter. Although negative results rule out pheochromocytoma, it is not uncommon to see borderline results which require further investigation. In this situation we have historically relied on the measurement of plasma catecholamines in the clonidine suppression test (CST). Plasma metanephrines, howeve...

An adrenal incidentaloma is defined as an adrenal mass >1 cm diameter, discovered serendipitously on radiological imaging done for another reason. They are important because a percentage will turn out to be malignant or secrete excess hormones. The aim of the current study was to ascertain if these lesions were being investigated and followed appropriately compared to American Association of Clinical Endocrinologists guidelines. All imaging reports for the calendar year 20...