Endocrine Abstracts

The first case is a 19-year-old male who presented to his GP with lumbar pain, scrotal bruising, and weight loss. Abdominal CT showed a left 6.4 cm x 12 cm suprarenal mass; the right adrenal gland was atrophic. Plasma metanephrines and MIBG were normal. Urinary steroid profile (USP) showed raised 11-deoxycortisol, consistent with adrenocortical carcinoma (ACC). He underwent a left nephrectomy and adrenalectomy. Histology confirmed ACC. The lesion was encapsulated with negative...

A 47-year-old female presented to the Emergency department following an episode of loss of consciousness at home that her daughter had identified as due to hypoglycaemia (using her husband’s capillary blood glucose meter 1.1mmol/l) and treated. She reported several episodes of fainting, sweating and generalised weakness over 6 months which improved after eating snacks. There was no previous history of diabetes; she had been diagnosed with Graves’ disease 6 months pre...

Introduction: 99m/Tc-MIBI parathyroid scintigraphy (MIBI) is the most common test used for pre-operative localization of parathyroid adenoma in primary hyperparathyroidism. We evaluated the influence of serum calcium and parathyroid hormone (PTH) levels on sensitivity of MIBI imaging in successful parathyroid localisation in patients identified as having primary hyperparathyroidism.Methods and material: Retrospective review of 403 patients who had MIBI s...

Case history: 22 year old female presented with left sided hemiparesis following a generalised seizure; the blood glucose was 1.2 mmol/l. Corrective treatment restored cerebral function. In the preceding 6 months, she had symptoms of drowsiness on waking which corrected with sugary drinks and described tiredness with lethargy. There had been no reported change in appetite or bowel habits however, there had been a degree of weight loss during this period. During hospital admiss...

A 19 year old Bangladeshi male attended ED with a fractured finger. He was noted to have a severely delayed bone age of 13.5 years, and no facial hair. He had moved to the UK aged 11 and could recall little information regarding his childhood or his parents. He had no significant medical co-morbidities, and in particular no history of mumps, measles or testicular injury. He reported being the shortest in his class, and being unable to keep up with his classmates in physical ac...

Dehydroepiandrosterone (DHEA) has been a subject of controversy for more than a decade being called ‘a miracle hormone’, the ‘elixir of life’ and ‘an anti-aging supplement’. However, recent literature has proven mild to moderate benefit in selected group of patients. Data is mostly limited to primary adrenal failure patients with adequate glucocorticoid and mineralocorticoid replacement and in hypopituitarism from variable aetiology associated wit...

Background: Pancreatic neuroendocrine tumours (pNETs) are commonly reported in patients with MEN1. The estimated incidence is reported as 40–80% of adults with MEN1 and pNETs are frequently multifocal. Guidelines recommend that CT, MRI and endoscopic ultrasound (EUS) can be used for detection and surveillance of pNETs in MEN1. MRI has been the most commonly used modality, but EUS may be more sensitive in detecting pNETs.Objective: To compare the sen...

Background: There is no consensus on the optimal timing of surgery for primary hyperparathyroidism (PHPT) in MEN1. Experienced centres recommend subtotal or total parathyroid surgery with three and a half gland surgery along with thymic removal as a favoured procedure; but long-term outcomes have rarely been reported.Objective: To investigate the indications and outcomes for surgery in patients with PHPT in MEN1Methods: Review of c...

Germline mutations account for hereditary phaeochromocytoma (PCC) and paraganglioma (PGL) syndromes. SDHB immunostaining can be used to functionally characterise SDH status on PCC and PGL tumours. Genetic testing of multiple candidate genes is increasingly performed in patients presenting with PCC/PGL tumours. We investigated the effectiveness of SDHB immunostaining as an initial screening tool in identifying SDH mutations.This was a retrospecti...

Performing water deprivation test (WDT) and prolonged water deprivation test (PWDT) is some of the roles undertaken by endocrine nurse in specialist endocrine units. These tests need to be done in a safe and control environment.Objectives: To provide safe information to patients to avoid fluids overload when they arrive for the tests. Can the specialist endocrine nurse make clinical decision to terminate the test base on clinical evidence and at what poi...