Endocrine Abstracts

Introduction: Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with important long term health consequences such as higher chance of developing Type 2 diabetes, reduced overall wellbeing with poor quality of life. Such a common condition is mainly treated and investigated in the primary care setting.We therefore set out to see if the randomized controlled trials (RCT) represent the most common setting of care.<p class="abstex...

Background: Adrenal incidentalomas are classified as adrenal lesions picked up on imaging performed due to reasons other than to look at the adrenals. With cross sectional imaging becoming more frequent, the frequency of adrenal lesions being detected and referred to endocrine services is increasing and dedicated adrenal incidentaloma clinics are being set up to screen these patients for potential pathology.Case: We present a 63 year old lady who underwe...

Background: Knowledge of Cranial Diabetes Insipidus (CDI) is poor amongst healthcare professionals. Intra-nasal Desmopressin sprays are often mistaken for pulmonary inhalers, and Diabetes Insipidus mistaken for Diabetes Mellitus, leading to incorrect management and harm. Correct Desmopressin administration and fluid management is paramount in inpatients, especially in reduced conscious states.Aim: To explore Clinicians’ concerns regarding safety iss...

Case: A 32 year old with known classical 21 hydroxylase deficiency was planning her first pregnancy. She had a history of clitoral reduction and vaginal reconstructive surgery as a baby. Pre-conception control on prednisone and fludrocortisone was good: 17(OH) progesterone 8.3 nmol/l, androstenedione 9.8 nmol/l (0.7–10.8), testosterone 3.0 nmol/l (0.2–3). EUA showed a small vaginal opening and she was given vaginal dilators. She conceived successfully and was counsel...

A forty-three year old woman (SR) presented to her GP in 2004 with persistent back pain. Following MRI, an incidental right adrenal mass was discovered. Laparoscopic adrenalectomy was performed in the private sector and histology was consistent with a phaeochromocytoma. No further biochemical investigations were performed at that stage. Six years later, her fourteen year old daughter presented with a solitary neck lump. Fine needle aspiration was inconclusive and subsequent le...

A 67-year-old lady with no significant past medical history presented with a left-sided neck swelling. An FNA under ultrasound scan guidance revealed malignant cells of indeterminate origin. Left neck exploration revealed an enlarged left lobe of thyroid and a retrosternal mass extending into the aortic arch. A left thyroid lobectomy and removal of retrosternal mass was performed and the histology showed a thyroid colloid goitre and low grade paraganglioma respectively. She wa...

We audited the management of adrenal incidentaloma (AI) in our hospital.29 patients (12 male) were referred with AI, mean age 68y (48–87 years). Mode of detection: 7 ultrasound (2 no mass on subsequent CT/MRI), 20 CT, 1 MRI and 1 lumbar XR. Site of tumour: 18 right, 7 left, 1 bilateral, 1 N/A. Size: <4 cm in 17, 4–6 cm in 4, >6 cm in 2, “large” in 1, not stated in 4. History: 8 had clinical features of possible hormone excess....

Introduction: Levothyroxine is the first choice treatment for patients with hypothyroidism However, some people would continue to have symptoms of thyroid disease despite biochemical control on levothyroxine. Others might be intolerant to levothyroxine.Aim: The aim of this audit is to evaluate UHL endocrinology practice against local and national guidelines with regards to prescribing and monitoring of liothyronine treatment in 2019.<p class="abstext...

Introduction: The hypercortisolaemic state of Cushing’s syndrome can lead to ophthalmic complications. We present two case reports of rare association of central serous retinopathy (CSR) and Cushing’s syndrome.Case 1: A 46-year-old man presented with gradual deteriorating vision. He was diagnosed with CSR and was referred to the Endocrine department for screening for Cushing’s given suspicious clinical features. Past history included hyper...

Introduction: Adrenocortical carcinoma (ACC) is rare, with an incidence of 0.5-2 cases per million. Although generally aggressive, prognosis is highly variable and difficult to predict. Unlike other malignancies, there are no biomarkers routinely available for use in patients with ACC to help guide management. Circulating cell free tumour derived DNA (ctDNA), the proportion of circulating cell free DNA (cfDNA) originating from tumour cells, is a liquid biopsy that is quickly g...