Endocrine Abstracts

Background: Primary aldosteronism (PA) accounts for 5–10% of all patients with hypertension, and an even greater proportion of those with refractory hypertension. Accurate assessment of PA is important both for rationalisation of medical therapy and to identify those patients with unilateral disease who may benefit from surgery. Single timepoint testing may miss patients with intermittent (‘cyclical/periodic’) disease, a phenomenon seen in other endocrine hypers...

A 54-year-old man was admitted to hospital with a new diagnosis of Miliary Pulmonary Tuberculosis (TB). Early in admission he developed septic shock with multiorgan failure requiring organ support and anti-TB medications. Recovery was complicated by persistently low Glasgow coma score (GCS), noradrenaline dependency and limb threatening microvascular injury. At day-25 he was apyrexial but remained hypotensive and drowsy with no evidence of sepsis or hypoadrenalism. Over the ne...

A 69-year-old lady with a history of autoimmune diabetes mellitus and primary autoimmune hypothyroidism presented to the Specialist Diabetes Clinic with a significant inexplicable variation in her capillary blood glucose. She had been undergoing investigations with the gastroenterologists for nausea, vomiting, and weight loss. Despite extensive investigations including: oesophageal–gastro-duodenoscopy, CT–thorax, abdomen, pelvis scanning, and gastric emptying studies...

Introduction: Prader–Willi syndrome (PWS) is a genetic syndrome usually diagnosed in childhood. Its reported prevalence ranges from one in 8000 to one in 45 000 with geographical variation. Clinical manifestations include obesity, hyperphagia, short stature, incomplete sexual development, and cognitive disabilities. The majority of published data regarding PWS comes from paediatric populations.Materials and methods: This is a retrospective observati...

Introduction: SGLT2 inhibitors offer a novel approach to improve glycaemic control in patients with type 2 diabetes through inhibition of renal glucose reabsorption. Phase 3 clinical trials demonstrated consistent glucose lowering effects and weight loss. The objective of our audit was to assess the early effects of treatment with dapagliflozin 10 mg in our clinic population.Methods: We performed a retrospective audit of clinical parameters in patients (...

Cyclophosphamide is an alkylating agent used in the treatment of malignant and autoimmune diseases. Severe hyponatraemia is a serious electrolyte disorder with life threatening neurological sequelae. We report a case of recurrent severe, symptomatic hyponatraemia that developed in a 61 year old female with systemic vasculitis and Sjogrens syndrome following low-dose cyclophosphamide.Case report: A 61 year old lady, with ANA positive systemic vasculitis p...

Background: Chronic hypophosphataemia due to renal phosphorus wasting results in bone disease (rickets and osteomalacia). The principal regulators of renal phosphorous handling are parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). X-linked hypophosphatemic (XLH) rickets is the most common genetic disorder of renal phosphorus wasting; acquired disorders include tumour-induced osteomalacia (TIO). The aims of this study were: i) to assess the clinical utility of ...

Background: People who have autoimmune atrophic gastritis commonly develop type 1 gNETs, but are also at increased risk of developing gastric adenocarcinoma. Type I gNET patients usually have multiple gastric polyps and have an excellent prognosis when the polyps measure.Method: Retrospective audit of type I gNET patients managed within Liverpool ENETS Centre of Excellence 2004–2018.Results: 86 patients (median age 67 years, 5...

Background: Paediatric diabetes is predominantly an outpatient based specialty, limiting the training opportunities available to paediatric trainees. At our centre, out of hours diabetes advice calls are managed by paediatric specialty trainees working on the middle grade rota, with 24 hour support from an oncall paediatric diabetes consultant. Feedback locally from families has highlighted the quality of out of hours advice as an area of concern. We aimed to assess the knowle...

Introduction: Neonatal ambiguous genitalia can herald sensitive, time-critical, and life-threatening diagnoses and thus paediatric doctors must be competent in their management. However, ambiguous genitalia are rare, limiting clinical exposure. We assessed paediatric doctors’ knowledge of and confidence in managing this condition.Methods: A questionnaire was circulated to paediatric doctors at six paediatric teaching hospitals. It established doctor...