Endocrine Abstracts

Phaeochromocytomas (PCC) and paragangliomas (PGL) are rare tumours derived from the sympathetic or parasympathetic paraganglia. They characteristically secrete catecholamines (noradrenaline/adrenaline/dopamine), which are metabolised to the metanephrines (normetadrenaline/metadrenaline/3-MT respectively). These tumour markers can be detected in acidified 24-h urine collections as first-line investigative tests. Plasma 3-MT has been characterised as a biomarker of metastatic PG...

Pituitary apoplexy caused by pure infarction is rare. Here we present three cases of pituitary macroadenoma infarction following hypotension.1. An 84 year old gentleman had a 2 × 2 cm pituitary macroadenoma causing chiasmal compression and a bitemporal hemianopia. He had panhypopituitarism and was on prednisolone, thyroxine and testosterone replacement. Before surgical intervention of the macroadenoma, he fell and broke his humerus, which requi...

Cabergoline has long been used to treat prolactinomas for symptomatic, radiological and biochemical resolution of pituitary tumours. As clinicians we are well-versed at screening for physical side effects, but are we holistic enough? We present two cases illustrating the damaging social consequences of cabergoline treatment for prolactinomas.Case 1A 49-year-old married father of two presented with a seizure in April 2018. MRI showe...

A 38-year-old man presented on the acute medical take with a week’s history of sore throat, dysphagia, neck swelling, and fever. One month prior he had suffered a respiratory tract infection, which resolved without antibiotics. He had no notable past medical and family history. He was a non-smoker and drank 15 units of alcohol per week. On examination he looked well, was afebrile, sweaty and flushed; chest was clear, heart sounds were normal, regular pulse (110 bpm) and B...

Background: Vitamin D deficiency is a common feature of primary hyperparathyroidism (PHP). However, replacement of vitamin D is not routinely performed in clinical practice, due to concerns about its safety. Furthermore, it is not clear whether vitamin D deficiency worsens the biochemical derangements observed in patients with PHP.Aim: To determine the relationship between 25(OH) vitamin D status and biochemical markers in patients with PHP.<p class=...

A 65-year-old lady presented to the emergency department with breathlessness due to an exacerbation of chronic airways disease. Her past medical history included laryngeal carcinoma treated with total-laryngectomy, thyroidectomy and adjuvant radiotherapy in 2003. She remained on stable post-operative replacement doses of 125mcg of levothyroxine and 1mcg 1-Alfacalcidol/1g Sandocal TDS for hypoparathyroidism for several years. Three days prior to her admission, strontium ranelat...

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 transfusions was believed to be...

Lithium increases retention of Iodine-131 in the thyroid gland and inhibits thyroid hormone release following radioactive iodine (RAI) administration. However, outcomes of studies of the effects of lithium on the efficacy of RAI are conflicting. The aim of this study was to assess whether adjuvant lithium increases the efficacy of RAI treatment in hyperthyroidism. A retrospective cohort study was performed of 204 hyperthyroid patients (163 Graves’ disease, 26 toxic multin...

A 31-year gentleman presented with a four day history of anxiety and confusion. Over several months, he had noticed red eyes and a ‘stomach-ache’. A collateral history revealed a previous episode of confusion and concern about excessive alcohol intake. He denied any current medication. On examination, he had bilateral conjunctivitis. Investigations demonstrated severe hypercalcaemia of 3.54 mmol/l (NR 2.15–2.6 mmol/l). He was treated with intravenous fluids and ...

Background: Patients with acromegaly require lifetime monitoring due to the excess mortality and morbidity associated with untreated disease, and the propensity for disease relapse following treatment. There is controversy whether GH or insulin-like growth factor 1 (IGF1), better predicts the onset of cardiovascular complications such as cardiomyopathy and ischaemic heart disease (IHD) in acromegalic patients.Aim: To examine associations of overall GH an...