Endocrine Abstracts

A 53 year old gentleman from Ghana was referred to our clinic for further management of his Conn’s syndrome. This had been diagnosed at another hospital 3 years previously when he presented with hypertension and hypokalaemia on the back of 14 years of poorly controlled hypertension. Serum aldosterone was raised at 3178 pmol/l and serum renin mass was 3.9 mU/l. MRI revealed a 5 mm nodule in the medial limb of the right adrenal gland. He was initially commenced on medical t...

Obesity in pregnancy is associated with an increased risk of complications for mother and child. Epigenetic modifications have been proposed as an important underlying mechanism. As the placenta plays a key role in fetal nutrition and metabolism we hypothesized there would be placental DNA methylation differences between lean and obese placenta. DNA methylation array (Human Methylation 450K) was performed on placentas from n=31 obese (BMI&...

Obesity in pregnancy is associated with an increased risk of complications for mother and child. Epigenetic modifications have been proposed as an important underlying mechanism. As the placenta plays a key role in fetal nutrition and metabolism we hypothesized there would be placental DNA methylation differences between lean and obese placenta. DNA methylation array (Human Methylation 450K) was performed on placentas from n=31 obese (BMI&...

Background: Adrenal insufficiency (AI) poses a significant health burden on patients, their families, and the healthcare system. Cost of illness for this patient population is four times higher than the general population. Hospital admissions due to adrenal crisis (AC) form a considerable proportion of this cost. Almost 1 in 200 patients die from AC. One in 12 patients with AI are hospitalised at least once a year following an acute AC episode if not treated promptly with pare...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...

A 65 year-old male was evaluated at another hospital for frequent episodes of fainting preceded by sweating, palpitations fatigue and hunger over several years. There was no personal or family history of diabetes mellitus. Hypoglycaemia was confirmed on a supervised fast and, guided by some equivocal uptake on a dotatate scan, he underwent a distal pancreatectomy, but the symptoms persisted. He was referred to our centre. He reported relentless weight gain and a need to eat po...

Background: Aldosterone producing cell clusters (APCCs) are microscopic pockets of cells in the adrenal zona glomerulosa (ZG), which stain densely for aldosterone synthase (CYP11B2). They exist in 30% of normal adrenal glands and have similar somatic genetic mutations as some aldosterone producing adenomas (APA), especially of CACNA1D. Some APCCs are precursors to APAs. Adrenalectomy for primary aldosteronism (PA) cures hypertension in < 50% of patients, maybe bec...

The amount of radioactivity given to patients undergoing ablation for remnant tissue in thyroid cancer at our centre has been greatly reduced to 1100 MBq I-131 in recent years, prompting a review of practice. An extensive risk assessment, focusing particularly on radiation exposure to the public during the patient’s commute home was conducted and found patients could now be discharged safely on the day of treatment. Owing to these findings and audit showing 86% of patient...

A 54-year-old female presented to her GP with a 9-year history of poorly controlled hypertension (requiring five drugs) and type 2 diabetes mellitus, associated with central weight gain, low mood and poor wound healing. On examination she had clinical evidence of glucocorticoid excess. Cushing’s syndrome was confirmed on low dose dexamethasone suppression testing (2+0 cortisol 857 nmol/l, 2+48 cortisol 346 nmol/l). Cushing’s day curve demonstrated loss of circadian r...

Phaeochromocytomas are life-threatening catecholamine-producing tumours of the adrenal medulla. Our understanding of their pathogenesis is incomplete, with limited ability to predict malignant potential and disappointing treatment results in disseminated disease. Phaeochromocytomas occur in the inherited cancer syndrome von Hippel-Lindau (VHL). One function of VHL protein is in the formation and maintenance of primary cilia. These are microtubule-based organelles that protrude...