Endocrine Abstracts

Introduction: Achieving optimal levothyroxine replacement is more difficult in TSH deficiency compared to primary hypothyroidism because of the inability to be guided by TSH. A combination of clinical symptoms and free thyroxine levels (fT4) are typically used to monitor replacement. We reviewed adequacy of levothyroxine replacement in our patients with pituitary disease, and compared with fT4 levels in patients with primary thyroid disease.<p class="...

Introduction: Hydatid disease (Cystic echinococcosis) is a zoonotic parasitic infection with the Echinococcus granulosus tapeworm resulting in cyst(s) within viscera. The predominant site for cyst formation is the live, with primary adrenal cyst accounting for less than 0.5% of presentation. We report a case of primary adrenal hydatid disease.Case report: A 62 year old female presented to the hospital with history of rig...

Introduction: Hydatid cysts disease (HSD) is a parasitic disease caused by echinococcus granulosus. It is common in areas where the parasite is endemic; North Africa, the Middle East, Central and Far Asia, Central America and Australia. Liver (44-77%) and lungs (10-50%) are the preferred locations for HSD. Here we report a rare case of HSD affecting the adrenal gland.Case report: A 62-year-old female complained of right ...

Introduction: Melanoma is predominantly a skin malignancy, originating from melanocytes. We present a rare case of metastatic primary adrenal melanoma (PAM) mimicking adrenal cortical carcinoma (ACC).Case report: A 36-year-old male presented with right flank pain, vomiting, pyrexia & 15kg weight loss. CT revealed 6cm adrenal mass; initially treated as an abscess. Despite normal adrenal screening biochemistry & prolonged antibiotics, the mass grew...

Introduction: Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by insufficient production of cortisol and high androgens. Myelolipoma is a benign neoplasm of adrenal gland composing mature adipose tissue and scattered islands of hematopoietic elements. We report a case of rare association of giant bilateral adrenal mylelolipoma in a congenital adrenal hyperplasia patient who was non-compliant with medication.<p class="abstext"...

Introduction: Decreased bone mineral density (BMD) is a concern in Congenital adrenal hyperplasia (CAH) given life-long glucocorticoid treatment. We undertook a quality improvement project (QIP) to optimise bone health for all adult CAH patients under our care in line with Endocrine Society CAH Guidelines.Method: Retrospective case notes and electronic records’ review was undertaken to identify CAH patients in University Hospitals of Leicester (UHL)...

Background: The main dilemma in hyponatraemia management is that of fluid restriction vs fluid administration. Inappropriate fluid management may result in either cerebral oedema/death or permanent neurologic disability due to rapid sodium correction. Objective: We explore the utility of point of care ultrasound (POCUS) as an adjunct tool for assessing 3-volume groups (Hypovolaemia, Euvolaemia & Hypervolaemia) in severe hyponatraemia (Na<120 mmol...

Background: One of the main indications for parathyroidectomy surgery in primary hyperparathyroidism (PHPT) is osteoporosis. NICE guideline recommends 2-3 yearly Dual-energy X-ray absorptiometry (DEXA) assessments to evaluate bone mineral density (BMD) in asymptomatic PHPT. Objective: We undertook an audit to evaluate bone health practice in PHPT patients in line with NICE guidelines.Methodology: Retrospective case notes and electr...

Although MRI remains the investigation of choice for pituitary imaging, it does not provide information about ‘functionality’ of lesions (e.g. residual adenoma vs post-surgical scar tissue) and cannot reliably identify all microadenomas.We hypothesised that i) imaging with the PET ligand 11C-methionine, which is taken up at sites of peptide/protein synthesis, would permit more reliable identification of functioning pituitary adenoma ...

Mutations in the co-chaperone molecule AIP account for a predisposition to pituitary tumours in some families with familial isolated pituitary adenomas (FIPA). We now report on four apparently-unrelated families with the same mutation and originating from the same geographical area, suggesting a possible founder mutation.The index patient had gigantism (19 years, 208 cm) and had a female 4th cousin, once removed (13 years, 191 cm) with a large pituitary ...