Endocrine Abstracts

Introduction: The familial risks of carcinoids are not clear. There has never been a report of gastrointestinal carcinoid coexisting with horseshoe kidney.Case presentation: We present the case of a 15 mm well differentiated metastatic small bowel NET with vascular and perineural invasion and three of four positive lymph nodes (Ki67: 1.9%, ENETS stage: pT4 pN1 pMX R1) in a 75-year-old British male with episodes of diarrhea and 24 h urinary 5HIAA: 48 (&#6...

Background: Radioiodine is a safe and effective treatment for Graves’ disease. Iatrogenic hypothyroidism is very common after treatment, but its onset is unpredictable. Even a short episode of hypothyroidism can result in significant morbidity and ideally should be avoided. In our centre a standard dose of radioiodine (400 MBq) is used, but for historical reasons two different protocols are used after radioiodine: Regimen A: regular clinical and biochemical monitoring and...

The use of 24 h urinary 5-hydroxyindolacetic acid (5-HIAA) concentrations to detect carcinoid patients is a well established procedure while random urinary 5-hydroxyindolacetic acid/creatinine ratio (5-HIAA/cr) may also offer a simpler approach in the diagnosis of carcinoid tumours. However, there is uncertainty regarding the ability of these tests to offer a prognostic indicator for patients.We retrospectively reviewed the initial paired urinary 5-HIAA/...

Although 24 h urinary 5-hydroxyindolacetic acid (5-HIAA) concentration is a well established test for the detection and monitoring of carcinoid tumours, compliance, adequacy of collection and the influence of dietary sources of serotonin are problems associated with this approach. Recently, a random urinary 5-hydroxyindolacetic acid creatinine ratio (R/5-HIAA/cr) test has become available which can be used in outpatient departments, however its correlation to 24 h 5-HIAA (24/5...

Ipilimumab and tremelimumab are monoclonal antibodies directed against the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and have been used as the immunotherapies against immune checkpoints that suppress T cell activation. These anti-CTLA4 antibody-based therapies are effective in treating various cancers including metastatic melanoma. However, a few immune-related adverse events including hypophysitis and transient thyroiditis have been reported....

Introduction: It is currently unclear how hyperthyroidism and its treatment impact on the weight trajectory of an individual. Anticipated weight gain with the treatment of hyperthyroidism is one of the main concerns of patients.Methods: We prospectively examined the BMI changes that occurred with hyperthyroidism and its therapy and sought risk factors for treatment-related weight gain. An established institutional protocol for the management of hyperthyr...

Introduction: The commonest cause of orbitopathy is Graves’ disease but the differential diagnosis includes primary and secondary neoplasia, inflammatory, vascular and infective causes. We report an exceedingly rare case of orbitopathy as the presenting feature of Acromegaly.Case report: A 43 year old lady presented with ‘periorbital puffiness’ and irritable eyes. Clinical evaluation revealed orbitopathy and magnetic resonance imaging (MRI...

Introduction: The aetiology of Graves’ orbitopathy (GO) is complex and includes genetic and environmental influences. Among potentially controllable risk factors smoking ranks highest. There is strong evidence that smoking cessation benefits patients with GO. The success of secondary prevention strategies depends largely on how the intervention is perceived by patients, especially when it involves lifestyle changes.Objectives: To determine patient p...

Context: Hyperthyroidism is a common endocrine condition that can be associated with significant morbidity. It is important to ascertain the underlying cause of hyperthyroidism as the natural history, potential complications and response to treatment can be very different.Objective: To investigate if measurement of TSH-receptor binding inhibitory immunoglobulin (TBII), a TSH-receptor antibody found in Graves disease, in the serum of newly diagnosed hyper...

A 68-year-old lady presented with a right-sided breast lump detected on routine mammography. Past medical history included type 2 diabetes, asthma, and hypothyroidism following radioactive iodine for toxic multinodular goitre. Staging CT showed 2 presumed metastases in the left lung, and one in the right lung. She was referred for biopsy and/or resection of these lesions. Histology of the left lower lobe lesion showed a typical carcinoid tumour with an adjacent neuroendocrine ...