Endocrine Abstracts

Introduction: Anterior pituitary cells are characterised by functional lineages based on the expression pattern of transcription factors. Functional differentiation in the form of pituitary adenomas co-secreting ACTH and growth hormone is very rare. We report a case of multiple cell line pituitary adenoma resulting in acromegaly and ACTH dependent Cushing’s.Case: A 52-year-old woman of Ghanian origin (BMI of 57.5 kg/m2) presented with pro...

Background: Hormone therapy is an important part of transition for many gender nonconforming people and implant treatment is an alternative route of oestrogen administration. We assessed the efficacy of oestrogen implant in transwomen for hormone replacement therapy.Methods: 83 transgender women had 100 mg estradiol implant inserted subcutaneously in the anterior abdominal wall. All subjects graded their energy, drive and libido from a scale of 0 to 10 p...

Introduction: Free thyroxine (FT4) assays are available on different commercial platforms where manufacturers provide different reference ranges. The lower limit of normal varies considerably between 8 and 13.9 pmol/l depending on the FT4 assay being used. There is concern about the validity of these reference ranges in paediatric populations, especially for the Roche FT4 assay; here there is a tendency for FT4 results to be below age-related lower limits of 13.9 or 13.6 pmol/...

A 50-year-old female with complex chronic hypoxic congenital heart disease was incidentally identified with a 2 cm extra-vesicular nodule of the bladder during a surveillance ultrasound scan. Suspicious of a bladder carcinoma she uneventfully underwent open partial cystectomy. Histology confirmed a bladder paraganglioma with local lymph node invasion. Post-operative biochemical work-up disclosed raised plasma metanephrine”s: normetadrenaline 7073 pmol/l (120-1180 pmol/l),...

There is limited data on primary hyperparathyroidism in Nepal. We did a retrospective study, where we analyzed data of sixteen patients who presented in our endocrine clinic from January 2016 to December 2022. Among them 10 patients (62.5%) were female and 6 (37.5%) were male. The mean age of the patients was 53.88 +/- 17.72 years ranging from 24 to 82 years. The mean BMI of the patients was 28.38 +/- 5.22 kg/m2. The most common presenting features were bone and joi...

Nepal has limited data on acromegaly patients. We did a retrospective study of acromegaly patients who were diagnosed in our center or were referred to our center. We included 10 patients of acromegaly who presented in our center from January 2018 to December 2022. Four (40%) were males and six (60%) were females. Their mean age was 38.70 +/- 6.51 years, ranging from 31 to 50 years. The mean BMI was 26.13+/-1.77 kg/m2. The most common presenting symptom was joint pa...

Introduction: Checkpoint inhibitor (CPI) related endocrine toxicities are increasingly commonly with the use of these new cancer agents. With one of the largest cancer departments in UK, we studied the clinical management and outcome of patients who developed different endocrine toxicities over the last five years, with the use of CTLA-4, PD-1 and PDL-1 agents.Methods: All patients treated with CPI between 1 Jan 2014 to 31 Jan 2019 were included for the ...

Introduction: Immunotherapy has become standard treatment for an increasingly wide range of cancers. Checkpoint inhibitors (ICT; CTLA4, PD1 & PD-L-1) can cause endocrine toxicity, principally affecting the pituitary and thyroid glands. We have studied the clinical management and outcome of patients with endocrine adverse effects over 5 years at our cancer centre.Methods: All patients treated with ICT agents between 1 Jan 2014 to 31 Jan 2019 were incl...

Introduction: Immune checkpoint therapies are novel cancer agents, which have been associated with the development of endocrine toxicities. ESMO and SfE endorsed management guidelines have been helpful for the early recognition of these toxicities, but in clinical practice, having early access to specialist endocrine advice improves the decision making and effective use of these agents when toxicities occur. In response to need we developed an easily accessible interdisciplina...

Introduction: TSHOMAs are rare pituitary tumors with prevalence of 1–2 cases per million. We present a case of of TSHoma where the course was complicated by the coexistence of autoimmune hypothyroidism.Case: 41 year old male presented with fatigue, lethargy and palpitations. On screening was found to have raised t3 – 216.30 ng/dl (N-70-204 ng/dl), t4 – 12.10 μg/dl(N-4.2-11.6 μg/dl) and TSH – 27.55 uIU/ml (0.2–5.7 uIU/ml...