Searchable abstracts of presentations at key conferences in endocrinology

ea0050p291 | Neuroendocrinology and Pituitary | SFEBES2017

Predictors of post-operative hypopituitarism following transsphenoidal surgery

Mulay Akhilesh , Moneim Joe , Keenan Heather , Flynn Rachel , Walsh Sean , Misquita Lauren , Koulouri Olympia , Powlson Andrew S , Gurnell Mark

Background & Aims: The aims of transsphenoidal surgery (restoration/preservation of vision and amelioration of hormonal excess) are balanced against the risk of inducing new post-operative pituitary deficits. This study aims to assess the rate of new anterior hormonal deficits following transsphenoidal pituitary adenoma surgery in our centre and to assess whether the visibility of normal pituitary gland on pre-operative imaging predic...

ea0069p4 | Poster Presentations | SFENCC2020

Applying a novel molecular imaging technique in a case of pseudo-phaeochromocytoma

Sheikh Anum , Senanayake Russell , Bisambar Chad , Bashari Waiel , Shaw Ashley , Cheow Heok , Challis Ben , Gurnell Mark , Casey Ruth

Case history: A 41 year old female was admitted following development of severe hypertension (226/146 mmHg), complicated by heart failure and acute kidney injury. She otherwise had no relevant past medical history. On clinical examination she was obese (BMI 51.94 kg/m2). As part of her cardiac investigations, she underwent a cardiac magnetic resonance imaging (MRI) which detected a 3 cm right sided adrenal nodule. An adrenal biochemical screen identified an elevated...

ea0065p341 | Nursing practice | SFEBES2019

One-week biochemical investigations in Cushing’s disease – from the endocrine specialist nurse perspective

Serban Laura , Palma August , Hu Lihua , Hale Julia , Tapa Denise , Pitfield Deborah , Senanayake Russell , Bashari Waiel A , Gurnell Mark

Background: Cushing’s disease is the most common cause of endogenous Cushing’s syndrome in adults, affecting females>males (ratio 3:1). In suspected cases, careful clinical assessment is required to ascertain a pre-test probability. This is followed by robust biochemical testing, which guides further management.One-week test protocol: Congruent biochemical tests are conducted over a one-week period in an outpatient setting. Patients attend on d...

ea0048cp4 | Poster Presentations | SFEEU2017

A novel approach to the investigation of an atypical adrenal lesion: 11C-metomidate PET-CT combined with 18F-FDG PET-CT in a rare case of adrenal Hodgkin’s lymphoma

Powlson Andrew S , Koulouri Olympia , Cheow Heok K , Shaw Ashley , Jamieson Neville V , Follows George , Gurnell Mark

Case history: A 66-year-old man presented with a 1 month history of a productive cough, in the context of a 20 pack-year smoking history. CT chest revealed minor bronchiectasis and an incidental 3 cm right adrenal lesion. He was referred to the endocrine clinic for further evaluation. On questioning, he reported no symptoms suggestive of adrenal hormone hypersecretion and, aside from a short history (<1 month) of sweating episodes at night, he described no other constituti...

ea0044cc9 | Featured Clinical Cases | SFEBES2016

Successful treatment of primary aldosteronism with partial adrenalectomy, facilitated by the use of 11C-Metomidate PET/CT

Bashari Waiel , Powlson Andrew , Koulouri Olympia , Quill Denis , Brown Morris , Cheow Heok , Dennedy Michael Conall , Gurnell Mark

Background: Primary aldosteronism (PA) is responsible for 5-10% of all cases of HTN. The current gold standard test for determining the side of aldosterone hypersecretion is adrenal vein sampling (AVS). 11C-Metomidate PET/CT (METO-PET) has recently emerged as a potential non-invasive alternative to AVS. As 11C-Metomidate is concentrated within ‘hyperfunctioning’ nodules, METO-PET potentially not only identifies the side, but the exact site of al...

ea0059oc4.6 | Clinical highlights | SFEBES2018

11C-Methionine PET/MRI is superior to MRI for localisation of functioning prolactinomas and may facilitate targeted intervention

Bashari Waiel , Powlson Andrew , Senanayake Russell , Sekaran Arvindh , Serban Laura , Koulouri Olympia , Gillet Daniel , Cheow Heok , Mendichovszky Iosif , Gurnell Mark

Background: Prolactinomas are the commonest hormone-secreting pituitary adenomas. First-line treatment is dopamine agonist (DA) therapy. However, side-effects are increasingly recognised, leading to an increasing consideration of transsphenoidal surgery (TSS) and/or radiotherapy. Co-registration of 11C-methionine Positron Emission Tomography (Met-PET) imaging with Spoiled Gradient Recalled Acquisition MRI (SPGR MRI), referred to in combination as Met-PET/MRI, can aid accurate ...

ea0059cc8 | Featured Clinical Cases | SFEBES2018

Clinical and biochemical acromegaly associated with pituitary FSHomas

Huang Doran Isabel , Koulouri Olympia , Oddy Sue , Halsall David , O'Donovan Dominic , Roncaroli Federico , Mannion Richard , Allinson Kieran , Gurnell Mark

Acromegaly is a clinical manifestation of excessive peripheral growth hormone (GH) action. Most cases result from pituitary somatotroph adenomas displaying varying degrees of GH immunoreactivity. Occasionally, GH is cosecreted with a second hormone from adenomas containing mixed cell populations (e.g. somatolactotroph tumours). Coexistence of multiple discrete adenomas, identical or distinct in hormone secretion, is infrequent. In very rare cases, acromegaly results from neuro...

ea0038p212 | Obesity, diabetes, metabolism and cardiovascular | SFEBES2015

Distinguishing different subtypes of aldosterone-producing adenoma by histological, immunohistochemical and radiological features; a basis for individualised treatment strategies in primary aldosteronism?

Powlson Andrew S , Teo Ada , Haris Lalarukh , Maniero Carmela , Marker Alison , Azizan Elena , Gurnell Mark , Brown Morris J

Background: Primary aldosteronism (PA) is now recognised to account for 5–10% of all cases of hypertension (and 20–25% of refractory hypertension). For patients with a demonstrable unilateral cause, adrenalectomy offers the potential for cure of PA, although resolution of hypertension occurs in only ~50% of patients. We have examined histological appearances and radiological features in patients with APAs undergoing adrenalectomy in an attempt to further our understa...

ea0037gp.20.09 | Pituitary – Hypopituitarism | ECE2015

Thyrotropinoma: diagnosis and management of a rare but increasingly recognised pituitary tumour – novel insights from a large prospective UK study

Koulouri Olympia , Moran Carla , Powlson Andrew , Antoun Nagui , Donnelly Neil , Mannion Richard , Pickrd John , Halsall David , Chatterjee Krish , Gurnell Mark

Background: Thyrotropinomas (TSHomas) are traditionally considered a rare, albeit important cause of thyrotoxicosis. Although early case series reported a predominance of invasive macroadenomas, emerging evidence suggests microadenomas are being increasingly diagnosed, and the clinical/biochemical phenotype appears to be more variable than previously suspected. We therefore performed detailed phenotyping of patients referred to our centre with a diagnosis of TSHoma over a 4-ye...

ea0037gp.21.02 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Bilateral inferior petrosal sinus sampling reliably differentiates pituitary from ectopic Cushing's, but frequently fails to predict pituitary tumour location, especially when lateralizing to the right

Koulouri Olympia , Nigam Nishita , Powlson Andrew , Donnelly Neil , Mannion Richard , Pickard John , Koo Brendan , Halsall David , Gurnell Mark

Background: BIPSS remains the gold standard for differentiating pituitary and ectopic sources in ACTH-dependent Cushing’s syndrome. A pituitary:peripheral ACTH ratio >2 in the basal state, and/or >3 following CRH stimulation, is considered indicative of pituitary Cushing’s, with a range of sensitivities and specificities cited in the literature. In addition, in Cushing’s disease a peak interpetrosal gradient of >1.4 has been reported to predict the s...