Searchable abstracts of presentations at key conferences in endocrinology

ea0003p25 | Clinical Case Reports | BES2002

Congenital adrenal hyperplasia: A tale of two enzymes

Chaudhri O , Goodlad C , Hameed A , Barakat M , Meeran K

A 24-year old male who, was normal at birth, became listless and volume depleted at 3 weeks of age. Investigations yielded an Addisonian picture (serum Na+ 115 mmol/l; K+ 8.2 mmol/l; urea 15.8 mmol/l). Serum 17-hydroxyprogesterone (17-OHP) levels were measured and found to be high (2,564 nmol/l). Urinary 17-oxosteroids and 17-OHP were also elevated. The neonate was thought to have 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH) and therapy with fludrocortisone an...

ea0003p26 | Clinical Case Reports | BES2002

A new management for congenital adrenal hyperplasia?

Goodlad C , Chaudhri O , Barakat M , Meeran K

A thirty year old woman with complete 21-hydroxylase deficiency presented with a five centimetre adrenal mass necessitating operative removal to exclude malignant change. Her medical management had always been unsatisfactory, and she had been tried on both hydrocortisone and dexamethasone. When taking 1 milligram dexamethasone daily she had partially suppressed androgen levels, (evidenced by a fall in 17-hydroxy-progesterone levels to 29 nmol/l), at the expense of marked Cushi...

ea0003p303 | Thyroid | BES2002

The use of lithium as an adjunct to radioiodine therapy for thyrotoxicosis

Murphy E , Bassett J , Frank J , Meeran K

Following the establishment of a telephone clinic follow-up for patients receiving radioiodine for recurrent thyrotoxicosis, we wished to further improve our results in achieving hypo(eu)thyroidism while minimising the risk of transient hyperthyroidism and thyroid storm post-therapy. Although not widely used, lithium has been shown to increase the effectiveness of radioiodine therapy, leading to prompter control of hyperthyroidism. Since August 2001, patients undergoing radioi...

ea0002p65 | Neuroendocrinology | SFE2001

ANNEXIN 1 EXPRESSION IN PERIPHERAL BLOOD LEUKOCYTES (PBLs) FROM PATIENTS WITH ENDOCRINE DISEASES CORRELATES WITH THE SERUM CORTISOL

Mulla A , LeRoux C , Meeran K , Buckingham J , Solito E

Annexin 1 (ANXA1), a Ca2+ and phospholipid binding protein, is an important mediator of glucocorticoid (GC) action in the host defence and neuroendocrine systems (1). It is not however known whether the dysregulation of the inflammatory response sometimes observed in patients with disturbances in GC secretion is associated with alterations in PBL ANXA1 expression/activity. To address this question we have (a) examined ANXA1 expression (flow cytometry and western blot analysis)...

ea0044p212 | Reproduction | SFEBES2016

Gonadotrophin secretion is a useful adjunct in the diagnosis of patients with hyperprolactinaemia

Clarke S , Abbara A , Nesbitt A , Ali S , Comninos AN , Hatfield E , Martin NM , Sam A , Meeran K , Dhillo W

Background: Hyperprolactinaemia accounts for 1 in 7 patients presenting with amenorrhoea. Recent data suggests that prolactin acts at the hypothalamus to reduce GnRH-pulsatility. Conditions in which GnRH-pulsatility is reduced, such as hypothalamic amenorrhoea, favour FSH over LH secretion from the pituitary gland. We examined gonadotrophin secretion in hyperprolactinaemic patients as a surrogate marker of GnRH-pulsatility.Methods: A retrospective analys...

ea0029p872 | Endocrine tumours and neoplasia | ICEECE2012

Lutetium-177 DOTATATE for paraganglioma refractory to conventional chemotherapy: a single case report

Wernig F. , Soneji N. , Klinaki I. , Todd J. , Al-Nahas A. , Meeran K.

A 31-year-old man presented with a two month history of sweating, right-sided abdominal pain and supraclavicular swelling. CT scanning showed widespread lymphadenopathy with multiple retroperitoneal lymph nodes. Biopsy of a left supraclavicular node resulted in a diagnosis of metastatic paraganglioma. Raised urinary catecholamine as well as urinary metanephrine levels further confirmed the diagnosis.A normocytic anaemia requiring repeated blood transfusi...

ea0019p101 | Clinical practice/governance and case reports | SFEBES2009

Severe obstructive sleep apnoea causing a pseudo-Cushing's state

Bravis V , Todd J , Dhillo W , Martin NM , Tan T , Meeran K

A 59-year-old lady presented with significant weight gain, and a history of hypertension for investigation of possible CushingÂ’s syndrome. Her BMI was 29, with mainly central obesity. Initial tests revealed elevated untimed cortisol on two separate occasions, at 905 nmol/l and 893 respectively with detectable midnight cortisol, at 548 and 481. Of 24-hour urinary free cortisol (UFC) was also elevated on two separate occasions, at 931 nmol/24 h and 827 respectively. ACTH wa...

ea0019p271 | Pituitary | SFEBES2009

The challenges in managing prolactinomas in patients with psychiatric illness treated with antipsychotic medication

Mehta SR , McGowan BMC , Ghaffar A , Shaikh H , Martin NM , Hatfield ECI , Meeran K

Antipsychotic induced hyperprolactinaemia, mediated by blockade of dopamine D2 receptors, is much more common than prolactinoma in patients receiving antipsychotic medication. We present two cases of the latter.Case 1: A 47-year-old gentleman with depression treated with amitriptyline, fluoxetine and risperidone presented with headaches and a left sided visual field defect. Pituitary MRI showed a 2 cm macroadenoma abutting the optic chiasm. Prolactin was...

ea0019p272 | Pituitary | SFEBES2009

A single early morning serum cortisol in the early post operative period following transphenoidal surgery for pituitary tumours accurately predicts hypothalamo–pituitary–adrenal function

Jayasena CN , Gadhvi KA , Gohel B , Martin NM , Mendoza N , Meeran K , Dhillo WS

Background: Secondary adrenal insufficiency is a common complication of transsphenoidal hypophysectomy (TSS) for pituitary adenoma. It is therefore imperative to rapidly and accurately identify patients requiring glucocorticoid replacement, thus minimising risks of adrenal insufficiency or unnecessary glucocorticoid exposure. The gold-standard test of HPA axis reserve, the insulin tolerance test (ITT), cannot be performed safely until after post-operative recovery. Nine am cor...

ea0012p83 | Pituitary | SFE2006

Pituitary macroadenomas: are combination antiplatelet and anticoagulant therapy contraindicated?

Tan TM-M , Caputo C , Mehta A , Hatfield E , Martin N , Meeran K

We describe a case of pituitary apoplexy in a patient with a known non- functioning macroadenoma. A 57 year old female was incidentally found to have a 20 x 16 mm solid and cystic pituitary mass abutting the optic chiasm on MRI scanning. She had gonadotrophin deficiency on endocrine testing and normal visual fields. Although repeat perimetry 12 months later revealed a mild superior bi-temporal hemianopia, the patient elected not to have surgery.Several m...