Endocrine Abstracts

Section 1: Case history: A 23-year-old female presented to the Emergency Department with a 3-month history of intermittent chest pain and palpitations. She was found to be hypokalaemic and hypocalcaemic. On direct-questioning she reported 3 weeks of perioral paraesthesia and muscle spasms. She had an unrestricted diet and no other personal or family history of note. She was normotensive with a sinus tachycardia and normal QT-interval, Chvostek’s negative, with no features...

Case presentation: A 66 year old male presented to the clinical physiology department for a routine ECHO. He was found to be hemodynamically unstable with fast Atrial fibrillation and was referred to ED for immediate management. He was subsequently admitted in CCU under Cardiology. He presented with a 3 month history of shortness of breath, palpitations, persistent tremors, unintentional weight loss and generalised fatigue. No previous thyroid problems. He had a longstanding h...

Background: CALM-NET (EudraCT 2013-002194-22; NCT02075606), a prospective, exploratory study, evaluated enumeration of pre-treatment circulating tumour cells as a predictor of symptomatic response to lanreotide autogel (LAN) in patients with functional midgut neuroendocrine tumours (NETs). Here, we describe the effect of LAN on biomarkers.Methods: Patients, ≥18 years, with functional, well- or moderately-differentiated midgut NETs were treated with...

Introduction: Insulinoma a neuroendocrine tumour is diagnosed by inappropriately raised Insulin concentrations during a spontaneous or induced episode of hypoglycaemia. A provocative 72-h supervised fast is done to evaluate suspected inappropriate insulin secretion. Our aim is to see if it is feasible for a shorter duration of fast is enough to confirm Insulinoma.Method and results: In our Trust we analysed retrospectively in the last 10 years, ...

We present the case of a 64 year old woman who presented with one month history of tiredness and 8 kg weight loss. Severe hypokalemia (2.2 mmol/l) was identified by the GP. Clinically she appeared mildly Cushingoid. Biochemical investigations showed a random cortisol significantly elevated at 2170 nmol/l, 24-hour urinary cortisol was 15 700 nmol/l(0−135). ACTH level was elevated at 7400 ng/l(0−40). The low dose dexamethasone suppression test demonstrated failure to...

Introduction: Non-Hodgkin lymphoma (NHL) involving the hypothalamus and pituitary gland is rare. Central nervous system involvement by NHL may be either as a primary tumour or from systemic lymphoma. We report an interesting case of aggressive central nervous system (CNS) lymphoma presenting as pituitary macroadenoma.Case report: A 67-year-old Caucasian woman presented with sudden onset of left eye ptosis and diplopia. Examination showed left third nerve...

Case history: A 72 year old male was diagnosed with primary lung adenocarcinoma grade T4N2M1b with adrenal and brain metastasis 1 year previously. On diagnosis his tumour was strongly positive for PDL-1 expression. This patient was started on dexamethasone 8 mg once a day that was weaned down to 4mg twice daily and then slowly weaned off steroids whilst receiving whole brain radiation. He was started on pembrolizumab therapy and had received ten cycles of treatment when he beg...

Background: Approximately 20% of NET patients develop CS, characterised by diarrhoea and flushing. However, CS is not the only cause of diarrhoea among NET patients. Non-CS causes should be considered to allow for appropriate management. We investigated the reported occurrence of diarrhoea from various non-CS causes in patients with gastroenteropancreatic NETs (GEP-NETs), to explore the need for differential diagnosis (DDx) of NET diarrhoea.Methods: MEDL...

Monitoring patients with NETs reveals a significant prevalence of gastrointestinal symptoms, often unrelated directly to the tumour1. Exocrine pancreatic insufficiency exemplifies a common treatable cause of gastrointestinal symptoms in NET patients undergoing therapy with somatostatin analogues. There is a paucity of data regarding this important issue which affects quality of life in NETs. We explored the value of faecal elastase (FE) as a marker of exocrine pancr...

Introduction: Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder; its evaluation includes biochemical investigations and imaging studies prior to surgical intervention. Imaging is advised as an aide to surgery and not for diagnostic purposes. Coexistence of PHPT and vitamin D deficiency is common; however, the exact nature of the relationship (causal vs secondary) is not clear.Subject and methods: We conducted a retrospective ...