Endocrine Abstracts

Background: Knowledge of glucocorticoid use during acute illness is widely known, however, knowledge of Diabetes Insipidus (DI) is suboptimal amongst healthcare professionals. In 2009, a series of medical and management failures led to the death of 22 year old from DI in a London hospital. Since then increased efforts have been made to raise awareness about the inpatient management of DI and dangers associated with delay and/or omission of desmopressin. An NHS England patient ...

The treatment of patients with carcinoid heart disease (CHD) presents substantial challenges due to the advanced multisystem nature of their disease. Intensive multidisciplinary collaboration and innovative techniques are often required in order to manage these patients. Here we describe two such cases from our institution. A 59-year old gentleman with metastatic NET and CHD was referred to our centre. Transoesophageal echocardiography demonstrated severe tricuspid regurgitati...

Introduction: Post-prandial hyerinsulinaemic hypoglycaemia (PPHH) or dumping is a recognized complication of various gastric surgeries. There are very few paediatric case reports to confirm PPHH post esophageal repair. We here report two cases who presented with dumping syndrome after a variable time period post esophageal atresia repair and response to medications.Case 1: A 6 month old female diagnosed with Wolf-Hirschhorn syndrome, born at 38+3 weeks b...

Introduction: Rare genetic causes of obesity result from disruption of the melanocortin-4 receptor (MC4R) pathway, a regulator of energy balance. Patients with obesity due to variants in multiple genes, including POMC, LEPR, SRC1, and SH2B1, have shown weight and hunger reductions after treatment with setmelanotide, an MC4R agonist. DAYBREAK is a Phase 2 trial of setmelanotide in patients with additional gene variants with suggested relevance to the...

Introduction: The MC4R pathway is the principal regulator of mammalian energy balance through its modulation of energy intake and energy expenditure. Variants in genes associated with the MC4R pathway can result in rare genetic diseases of obesity. Clinical data in patients with certain genetic defects in the MC4R pathway indicate that setmelanotide, an MC4R agonist, may effectively reduce weight and hunger in scientifically rationalized obese subpopulations in which MC4R-path...

Background: Hyponatraemia is a common electrolyte abnormality that is associated with significant morbidity and mortality in patients admitted to hospital. Fluid restriction is the recommended treatment option for syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatraemia with limited evidence for alternative treatment options. The aim of our study was to share the experience of our hospital in the successful management of SIADH where we ...

Background: Nonalcoholic fatty liver disease (NAFLD) is commonly associated with type 2 diabetes mellitus (DM) though its prevalence is not well studied. This was a prospective study of prevalence and risk factors of NAFLD in patients with type 2 diabetes. The aim of this study was to determine the frequency of NAFLD in patients with T2DM.Subjects and Methods: A total of 200 patients with T2DM fulfilling the criteria wer...

Background: Nonalcoholic fatty liver disease (NAFLD) is commonly associated with type 2 diabetes mellitus (DM) though its prevalence is not well studied. This was a prospective study of prevalence and risk factors of NAFLD in patients with type 2 diabetes. The aim of this study was to determine the frequency of NAFLD in patients with T2DM.Subjects and Methods: A total of 200 patients with T2DM fulfilling the criteria wer...

Background: Rapid implementation of tele-clinics was necessary during the COVID-19 pandemic. Patients missed routine point-of-care HbA1c testing, vital for evaluating long-term glycemic control. We evaluated the feasibility of remote HbA1c monitoring via self-collection of capillary blood samples at home, and examined clinical characteristics associated with patient engagement.Methods: Bio-Rad Haemoglobin Capillary Collection System (HCCS) was used, with...

Methods: The diagnosis of Cushing’s Syndrome (CS) was made as per the prevalent endocrine society guidelines. CS patients with serum ACTH>15 pg/ml were considered as ACTH-dependent CS. Baseline ACTH (both inferior petrosal sinuses and peripheral) values were obtained, and since 2014, stimulated ACTH values (5 and 10 minutes post one unit iv vasopressin) were obtained as standard protocol. Prolactin corrected ACTH ratios were additionally being calculated since 2016. The h...