Endocrine Abstracts

A 74-year-old diabetic lady presented to emergency-department following a collapse due to hypoglycaemia (blood glucose 1.7 mmol/l) and responded dramatically to intravenous–glucose. She had recurrent hypoglycaemic episodes in the last-fortnight, despite discontinuation of her oral hypoglycaemics and no other obvious precipitating factors/toxins like alcohol. She was on prednisolone, 10 mg along with azathioprine, 150 mg, atenolol, 25 mg, and candesartan, 8 mg. She has rhe...

Introduction: Significant hyponatraemia (serum sodium <128 mmol/l) is a potentially modifiable cause of prolonged hospital length of stay (LOS). By correcting euvolaemic hyponatraemia more rapidly than imposed fluid restriction, vasopressin receptor-2 antagonists may be useful adjuncts to existing treatments.Aim: To explore the potential clinical utility of vasopressin antagonists by describing the frequency and nature of hyponatraemia typically enco...

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...

A 27 years old girl presented with weight gain, hirsutism, fatigue, bruising and striae. On examination she was Cushingoid. On initial assessment, 3 out of 4 24 h urinary free cortisol collections were elevated. 0800 h serum cortisol was 280 nmol/l after 1mg dexamethasone given at 2300 h. After formal 48 h low and high dose dexamethasone suppression tests cortisols were 164 and 34 nmol/l respectively. Basal 0800 h ACTH was 33 ng/l. Given the clinical features and the discrepan...

Introduction: Hypo-&hyperkalaemia are common laboratory abnormalities, complicating up to 10% of all hospital admissions and contributing to mortality. Ideally, patients with mild deviations can be treated as outpatients, and only those patients with objectively severe or life-threatening levels are hospitalized. Once admitted, there are few data as to whether the degree of electrolyte disturbance consumes greater resource(s). We analysed the admission and discharge data, ...

Introduction: Hyponatraemia is a common biochemical abnormality, complicating up to 15% of all hospital admissions and associated with increased mortality. Hypernatraemia, occuring less frequently, is strongly associated with mortality and is almost always due to a free water deficit. There is limited data about hospital healthcare burden of these two relatively common electrolyte imbalances. We analysed the length of stay, for acute admissions, with reference to the admission...

Background: The highest rates of childhood obesity are among children from lower socioeconomic groups. Tier 3 weight management services for children currently rely on an MDT approach that is focused on the management of complications associated with excessive weight, but the resources are generally limited. Evidence suggests that the input in the community is key to empower children, young people, and their families to make healthy lifestyle changes, although the availability...

Introduction: Standard endoscopic resection of rectal neuroendocrine tumours (NETs) is often associated with histological incomplete excision due to the submucosal position of the tumour within the bowel. This can lead to multiple attempts to achieve a complete excision or uncertainty leading to ongoing endoscopic surveillance. Endoscopic full thickness resection may allow early definitive management. We report a simple definitive technique for the full thickness excision of r...

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...

It is recommended that all patients with PA who are suitable for surgery should undergo adrenal CT and AVS unless there is a large unilateral adenoma with a completely normal contralateral gland. We reviewed 100 patients diagnosed with PA. AVS was performed in 93. Different lateralisation criteria for AVS were assessed using ROC curve analysis to determine the optimal one for identifying an adenoma. We reviewed the outcomes of adrenalectomy evaluating which pre-operative chara...