Searchable abstracts of presentations at key conferences in endocrinology

ea0021p120 | Clinical practice/governance and case reports | SFEBES2009

The role of adrenal vein sampling (AVS) in the diagnosis and management of primary hyperaldosteronism: an audit of 10 years experience at a tertiary referral centre

Hopkins Tom , Salem Victoria , El-Gayar Heba , Tan Tricia , Palazzo Fausto , Meeran Kareem

Hyperaldosteronism is a significant cause of secondary hypertension, but there are often delays in obtaining the diagnosis. The recent BES publication of Guidelines for the investigation and management of this condition represent a move to standardise the work-up of these patients.We present an audit of cases, dating back to 2000, with confirmed biochemical hyperaldosteronism (on the basis of plasma aldosterone/renin activity ratio or lack of aldosterone...

ea0021p219 | Endocrine tumours and neoplasia | SFEBES2009

MEN2B patients with a RET A883F mutation have less aggressive MTC than those with the common RET M918T mutation

Worth Gabriella , Palazzo Fausto , Tolley Neil , Robinson Stephen , Cox Jeremy , Williams Graham , Bassett Duncan

MEN2B is the most aggressive form of MEN2. Consequently, the new American Thyroid Association guidelines recommend prophylactic thyroidectomy early in the first year of life. Ninety-seven percentage of MEN2B cases result from a germline methionine to threonine mutation at codon 918 (M918T) of the RET proto-oncogene. In addition, an exceedingly rare alanine to phenylalanine mutation at codon 883 (A883F) has been reported in 4 unrelated adults. In each case metastatic MTC and th...

ea0018oc2 | (1) | MES2008

Adrenocortical carcinoma presenting as Cushing's syndrome: 2 case reports

Ghaffar Adeel , Morganstein Daniel , Kirkby-Bott James , Todd Jeannie , Palazzo Fausto

A 69-year-old lady presented with pancreatitis, which was managed conservatively and resolved. However, imaging identified a 4 cm left adrenal lesion. She had no features of Cushing’s syndrome, and was normotensive, but serum potassium was low. Renin:aldosterone ratio was normal. She failed a low dose dexamethasone suppression test (LDDST). She underwent laparoscopic adrenalectomy. Histology showed an adrenocortical carcinoma extending into the adjacent adipose tissue. Si...

ea0018p16 | (1) | MES2008

Primary hyperparathyroidism and pregnancy

Kirkby-Bott James , Williamson Catherine , Palazzo Fausto , Banerjee Anita , Meeran Karim , Tan Tricia

Primary hyperparathyroidism (HPT) in pregnancy is an uncommon phenomenon, mostly occurring in the 2nd or 3rd trimester. HPT in pregnancy may cause complications affecting both the mother (renal stones, pancreatitis) and fetus (neonatal tetany, seizures, intra-uterine growth retardation and preterm labour). We report two recent cases that highlight the potential risks.Results: The patients, 37 and 35 years old at presentation respectively, both presented ...

ea0018p26 | (1) | MES2008

Manubrial split provides adequate exposure for mediastinal exploration for parathyroid adenoma

Lake Edward , Kirkby-Bott James , Imtiaz Fawzia , Jackson James , Palazzo Fausto

Introduction: The traditional approach to mediastinal ectopic parathyroid adenomas has been through a median sternotomy. With improved localization techniques it has become possible to use less invasive approaches to access the mediastinum. We present our recent experience of three cases of mediastinal parathyroid adenomas successfully treated using a manubriotomy approach which provides good access to the superior and anterior mediastinum.Method: All pa...

ea0073aep42 | Adrenal and Cardiovascular Endocrinology | ECE2021

A case of adrenal tuberculosis mimicking non-functioning adrenal incidentaloma

Hirani Dhruti , Ladha Tasneem , Khan Shaila , Hilal Zaib , Palazzo Fausto , Vakilgilani Tannaz

A 77 year old gentleman was referred to the endocrinology team following the incidental finding of an adrenal nodule on computer tomography (CT) colonography. Following this, dedicated CT of the adrenal showed a 4cm nodule with an attenuation of 30 Hounsfield Units. Biochemical investigation found no evidence of adrenal insufficiency or functional hormone production. Subsequent imaging by magnetic resonance imaging (MRI) and further CT showed stable appearances in size of the ...

ea0073aep662 | Thyroid | ECE2021

An audit of thyroidectomy in Graves’ Disease, in a large UK tertiary centre

Jones Larissa , Khan Shaila , Tolley Neil , Palazzo Fausto , Cox Jeremy , Agha-Jaffar Rochan , Robinson Stephen

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...

ea0094op4.1 | Thyroid | SFEBES2023

Management of thyroid nodules in patient with phosphatase and tensin homolog gene (PTEN) mutation

Yang Wei , Palazzo Fausto , Tolley Neil , Dimarco Aimee , Brady Angela , Tan Tricia

Introduction: Phosphatase and tensin homolog gene (PTEN) gene encodes a lipid phosphatase that plays a central role in cell-cycle processes. PTEN hamartoma tumour syndrome (PHTS), caused by the mutation of the PTEN gene, is a diverse multi-system disorder. PHTS is characterised by the hamartomatous growths, increased risk of breast, thyroid, and renal cancers. In terms of thyroid presentation of PHTS, there is up to 75% risk of multinodular goitre and the life...

ea0099p414 | Adrenal and Cardiovascular Endocrinology | ECE2024

Aldosterone:metanephrine ratio better predicts laterality in patients with primary aldosteronism and mild autonomous cortisol co-secretion than aldosterone:cortisol ratio

Htut Zin , Sharma Aditi , Foran Daniel , Palazzo Fausto , Dimarco Aimee , Meeran Karim , Alsafi Ali , Wernig Florian

Introduction: Adrenal Venous Sampling (AVS) is considered the gold standard to identify surgically treatable primary aldosteronism (PA) subtypes. Current guidelines suggest using plasma cortisol concentrations to confirm successful adrenal vein (AV) cannulation and lateralisation, but cortisol co-secretion by adrenal adenomas can lead to diagnostic misinterpretation. Plasma metanephrines (MN) have a half-life of 3 to 6 min and are not affected by cortisol co-secretion, and the...

ea00100p15 | Poster Presentations | SFEEU2024

Finding the culprit – a case of multifactorial hypercalcaemia

Calvo Latorre Julia , Sheikh Anum , Agarwal Pallavi , Kostoula Melina , Palazzo Fausto , E Ostberg Julia

Case history: We present the case of a 59-year-old gentleman admitted to our hospital in February 2023 with severe hypercalcaemia. He had a background of mild intermittent hypercalcaemia since 2018 (highest 2.73 mmol/l), chronic kidney disease, hypertension, and a recently climbing prostate-specific antigen that had warranted a 2-week-wait Urology referral. On admission, his only symptom was constipation, without weight loss or constitutional symptoms. His parathyroid hormone ...