Endocrine Abstracts

Introduction: Following the recent publication of The Endocrine Society Clinical Practice guideline for Congenital Adrenal Hyperplasia (CAH), we performed an evaluation of the service provided for adults with CAH to assess how well we are meeting the guideline standard and to make recommendations for service improvement.Methods: We performed an audit of adults with CAH under the care of the University Hospitals of Leicester. We undertook a cross-sectiona...

The main-stay management of Beta thalassaemia major is blood transfusion but this carries a risk of endocrinopathy from hemosiderosis in endocrine organs. Iron chelation therapy aims to mitigate this risk. Access to this therapy isn’t available in some healthcare systems. Known Syrian refugee diagnosed with Beta thalassaemia major in infancy referred via the refugee medical services for thalassaemia management. There was previous history of intermittent transfusion suppor...

Background: Pituitary adenomas commonly present with palsies involving the cranial nerves in the cavernous sinus. It is unusual, however, for other cranial nerve palsies to co-present and to have biochemical results that do not fit with the clinical picture.Case: A 47 year old man was admitted with 3 days of headache, vomiting, right sided facial paraesthesia and facial droop. He had no symptoms suggestive of endocrine disturbance. Neurological examinati...

Introduction: An insulinoma is a rare neuro-endocrine tumour originating in the pancreatic beta-cells with unregulated secretion of insulin resulting in profound hypoglycaemia.Methods: A search of electronic hospital records identified all patients with a primary diagnosis of insulinoma. Clinic and discharge letters, radiology investigations, laboratory investigations and case notes were reviewed to highlight the presentation, investigations and laborato...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: There are patients who remain symptomatic with hypothyroidism despite apparent adequate replacement on levothyroxine (LT4) therapy. We present an observation where monozygotic twins responded only to combination therapy with liothyroinine (LT3), and were found to have a genetic variation which may have clinical significance in thyroid metabolism.Case report: A 47-year-old female with polyglandular auto-immune syndrome (APS1) presented with ...

Background: World Gastroenterology Organisation (WGO) quotes gallstones prevalence of 9-21%, incidence of 0.63/100 persons/year in Europe; 10-15% of UK population have gallstones (1). Acromegaly patients’ prevalence is 8.3% and 35% developing incidental gallstones during somatostatin analogue (SSA) treatment (2).Objective: To evaluate the prevalence of gallstones in SSA treated Acromegaly patients in University Hospitals of Leicester (UHL).<p cl...

Introduction: There is a clinical need to develop better biomarkers for the monitoring of patients with neuroendocrine tumours (NETs), including for patients with multiple endocrine neoplasia (MEN). Chromogranins are widely used, as are individual hormones for specific syndromes. Neurone specific enolase (NSE), however, is measured less commonly and its utility is debatable.Aims: To assess the value of measuring NSE in the clinical management of patients...

Thyroid cancer is the most common endocrine malignancy accounting for 1% of new cancer cases each year. Even after treatment, one in five patients develop recurrence eventually. Therefore, close follow up is crucial after treatment. Current tumour biomarkers are not perfect, and there is a need for a more sensitive and specific way of detecting early recurrence. Liquid biopsies have emerged as a novel marker in tumour surveillance and monitoring response to treatment. In parti...

Introduction: Meningiomas are the most common brain tumours and they express progesterone receptors. Cyproterone acetate (CPA) is a synthetic progestogen approved for use as an anti-androgen in Polycystic Ovarian Syndrome (PCOS). We report a case of meningioma probably resulting from long-term CPA treatment and a review of our PCOS cohort for further cases.Case report: A 47-year-old lady with PCOS was treated with CPA 100 mg once daily for hirsutism and ...