Endocrine Abstracts

Case: This 23-year-old lady initially presented in 2013 with headaches, galactorrhoea and secondary amenorrhoea. Visual fields were normal to confrontation. Prolactin levels were elevated at 3028miu/l. MRI pituitary revealed a 14x13x15mm adenoma pushing the pituitary stalk posteriorly, and compressing the left side of the optic chiasm.Initial Management: Cabergoline was commenced (250mg twice weekly), with good clinical ...

Background: Cranial diabetes insipidus (DI) is characterised by the inability to produce ADH (antidiuretic hormone) also known as AVP (arginine vasopressin) resulting in uncontrolled diuresis. Desmopressin is a synthetic form of AVP used to treat this. Treatment errors can lead to dehydration and hypernatremia which can be life-threatening. In view of recent literature suggesting current concerns with Desmopressin administration worldwide, Diabetes Insipidus i...

A 4.9-year-old girl presented with symptoms suggestive of early puberty and rapid growth. Her medical history revealed that she had been a tall child since infancy. Family history was notable for Lynch syndrome in her father and paternal grandmother. Upon examination, the patient was pre-pubertal but had a height of 124 cm (SDS 3.5) and a height velocity of 15 cm/year. Further investigations revealed elevated levels of IGF-1, IGFBP3, and failed GH suppression on an OGTT, indic...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: There are patients who remain symptomatic with hypothyroidism despite apparent adequate replacement on levothyroxine (LT4) therapy. We present an observation where monozygotic twins responded only to combination therapy with liothyroinine (LT3), and were found to have a genetic variation which may have clinical significance in thyroid metabolism.Case report: A 47-year-old female with polyglandular auto-immune syndrome (APS1) presented with ...

Background: World Gastroenterology Organisation (WGO) quotes gallstones prevalence of 9-21%, incidence of 0.63/100 persons/year in Europe; 10-15% of UK population have gallstones (1). Acromegaly patients’ prevalence is 8.3% and 35% developing incidental gallstones during somatostatin analogue (SSA) treatment (2).Objective: To evaluate the prevalence of gallstones in SSA treated Acromegaly patients in University Hospitals of Leicester (UHL).<p cl...

Introduction: There is a clinical need to develop better biomarkers for the monitoring of patients with neuroendocrine tumours (NETs), including for patients with multiple endocrine neoplasia (MEN). Chromogranins are widely used, as are individual hormones for specific syndromes. Neurone specific enolase (NSE), however, is measured less commonly and its utility is debatable.Aims: To assess the value of measuring NSE in the clinical management of patients...

Introduction: There is a clinical need to develop novel and better biomarkers to monitor patients with neuroendocrine neoplasms (NENs). Our aim was to identify and track plasma circulating cell free tumour derived DNA (ctDNA) in a cohort of patients using a personalised, patient specific approach.Materials and methods: 35 serial plasma samples were collected from 9 patients with metastatic NENs (6 small intestinal and 1 each of lung, ovarian, and pelvic;...

Case presentations: Case 1: The index case is a 10 year old girl who presented episodic symptoms of feeling unwell, unexplained headache, seizure, vomiting and dehydration over a period of 8 months. She was subsequently found to have systemic hypertension which led to further investigations revealing raised plasma noradrenaline of 32 and 103.7 (NR 0–5 nmol/). US abdomen suggested bilateral pheochromocytoma but an MIBG showed unilateral left sided increased uptake. She und...

Thyroid cancer is the most common endocrine malignancy accounting for 1% of new cancer cases each year. Even after treatment, one in five patients develop recurrence eventually. Therefore, close follow up is crucial after treatment. Current tumour biomarkers are not perfect, and there is a need for a more sensitive and specific way of detecting early recurrence. Liquid biopsies have emerged as a novel marker in tumour surveillance and monitoring response to treatment. In parti...