Endocrine Abstracts

Background: Spinal Epidural Lipomatosis (SEL) is an excessive fat deposition in the spinal canal which can lead to compression of nervous structures. SEL is a rare but recognised side effect of exogenous steroid excess. There are only six previously reported cases of SEL associated with endogenous steroid excess in the available literature. We present a case of SEL, caused by Cushing’s disease, that presented in the immediate post-operative period.C...

Objective: To examine the monitoring, management and outcomes of adrenal tumours in pregnancy.Design: A national, prospective observational, cohort study over 4 years using the UK Obstetric Surveillance System (UKOSS).Setting: Consultant led obstetric units.Patients: Women with hormone-secreting adrenal tumours (pheochromocytoma, primary aldosteronism or Cushing’s syndrome) diagnosed before or during pre...

Background/objectives: While patients are commonly referred to endocrinology with a low FT4 and normal TSH, there is no consistency in the management of these patients. The aim of this audit was to assess management of these patients including investigation, diagnosis and pharmacological intervention and compare to the current Association for Clinical Biochemistry guidelines.Methods: This was a retrospective audit studying 41 endocrine outpatients at Uni...

Introduction: Adrenal insufficiency (primary/secondary) is a rare and potentially life-threatening condition which can be easily overlooked. Patient awareness and management of problems is critical and central to effective treatment. The NICE Clinical Knowledge Summaries for patients identifies and recommends critical areas that require attention in adrenal insufficiency. In particular, patients should:i) Realize the need for lifelong glucocorticoid repl...

Background: Metastatic insulinomas are very rare (fewer than 1:100000) and therefore may pose a therapeutic challenge as there are no case controlled studies comparing the efficacy of various therapeutic approaches avialable. The Ki 67 index from the histology of the primary tumour is an established prognostic marker for metastatic disease with tumours showing low Ki 67(<3%) being defined as low risk of early recurrence.Case Presentation: A 60 year o...

5α-Reductase 1 (5aR1) catalyses A-ring reduction of glucocorticoids and androgens, predominantly in liver and modulates steroid hormone action. We previously demonstrated transgenic disruption of 5aR1 predisposes mice to developing fatty liver. Here we tested whether 5aR1 disruption increases susceptibility to the development of liver injury, using the carbon tetrachloride induced liver fibrosis model.Male 5aR1−/− (KO) mice and wild-type...

Iodine deficiency may lead to reduced thyroid hormone production and ultimately hypothyroidism. The UK has previously been considered to be iodine sufficient, however recent evidence suggests the UK may be iodine deficient. Iodine status can be assessed in several ways, including measurement of urinary iodine excretion, for which inductively coupled plasma-mass spectrometry (ICP-MS) is considered the gold standard method.An ICP-MS method for determinatio...

Background: Phaeochromocytomas (PHAEOs) and paragangliomas (PGLs) are rare catecholamine producing tumours which are potentially lethal if left untreated and may be associated with a wide variety of complications. Optimum management demands multidisciplinary input from endocrinologists, biochemists, geneticists and endocrine surgeons.Objective: A retrospective audit into the management of PHAEOs/PGLs at our institution against the 2005 recommendations ma...

Background: The screening investigation of choice for phaeochromocytomas (PHAEO) and paragangliomas (PGL) in the UK is usually a 24 h urine collection for fractionated metadrenalines +/− free catecholamines. These assays have high diagnostic sensitivity (approaching 98%) but lower specificity.Aim: To review causes of false positive (FP) catecholamine and metabolite results in our centre over a 12-year period.Methods: Data wer...

Introduction: Neuroendocrine tumors of GI tract are a heterogeneous group of rare neoplasms that secrete peptides and amines. These tumors are highly vascular and their vascularity reflects increased tumour related angiogenesis. Adenosine, a major regulator of angiogenesis, is released by enhanced degradation of ATP, during cellular stress, damage and hypoxia.Material and methods: The expression of adenosine receptors (AR) was investigated in two human n...