Endocrine Abstracts

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is tightly associated with insulin resistance and type 2 diabetes (T2DM), both risk factors for disease progression, liver failure and cardiovascular complications. A multidisciplinary approach involving hepatologists and diabetologists working alongside allied health professionals is thus advocated for the management of NAFLD. Interv...

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Current treatments, including surgery, medical therapy, radiotherapy, and radionuclide therapy for neuroendocrine tumours of the pancreas (PNETs) and bronchus (BNETs) are often unsatisfactory, leading to a 5-year survival of <50% and 5%, respectively. PNETs and BNETs frequently have mutations in chromatin-remodelling genes and the protein encoded by the multiple endocrine neoplasia type 1 (MEN1) gene, menin. Menin binds the...

Introduction: Histology is a poor predictor of the malignant potential of phaeochromocytomas and paragangliomas (PPGL) and only the presence of distant metastasis confirms malignancy. This study reviews patterns of recurrence, treatment and mortality in patients with malignant PPGL presenting to our department at UCLH over 30 years.Materials and Methods: In our series of 128 patients with PPGL, 26 (20%) with maligna...

Background: Cross-sectional imaging (e.g. CT/MRI) can not always reliably identify the site of ACTH secretion in Cushing’s disease (CD) or the ectopic ACTH syndrome (EAS). We report our experience of localising the source of ACTH-dependent Cushing’s syndrome, using functional imaging with 11C-methionine positron emission tomography (Met-PET).Methods: Forty consecutive patients with: (i) de novo ...

Introduction: Obstructive sleep apnoea (OSA) is reported to have effects on a number of hormone systems including glycaemic control, catecholamines, and the HPA axis. In this study we aimed to determine the impact of OSA on IGF-I levels.Patients & Methods: This is a prospective cohort study performed at Leeds Teaching Hospitals. Patients were recruited from the Sleep Apnoea Clinic between November 2014 and May 2...

Background: BIPSS is considered the gold-standard procedure for differentiating autonomous pituitary [Cushing’s Disease (CD)] and ectopic ACTH syndrome (EAS) sources of ACTH hypersecretion. A basal (i.e. unstimulated) pituitary:peripheral ACTH ratio >2, and/or a CRH stimulated pituitary:peripheral ACTH ratio >3, have been proposed as indicative of CD, with a range of sensitivities and specificities cited in the literature. Ad...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Background: The British Thyroid Association’s thyroid cancer guidelines (2014) advocate the U1-5 nodule grading system as a primary diagnostic and classification tool.Aims: We assessed whether practice reflected guidelines, and examined patient outcomes.Methods: Patients with a thyroid ultrasound, undertaken by radiographers or general radiologists, in January-June 2015 were identified. Investigation and outcomes...

Context: Primary aldosteronism (PA) accounts for 5–10% of all hypertension and 20–25% of refractory cases. Diagnosis is important as PA is associated with increased morbidity and mortality compared with ‘essential’ hypertension, and up to 50% of patients may benefit from unilateral adrenalectomy. Screening requires measurement of plasma renin activity (PRA) or concentration (PRC), and plasma aldosterone concentration (PAC), to yield an aldosterone:renin rat...