Endocrine Abstracts

The insulin stress test (IST) continues to be considered a potent test for assessing ACTH and GH reserve. The test has been shown to be safe when performed in an experienced unit. Many endocrine nurse specialists independently perform IST's using appropriate protocols. We audited all consecutive IST's performed by an individual endocrine specialist nurse in our unit. IST was not performed if patients had a history of seizure, ischaemic heart disease or were > 60 yrs. All pa...

A 70 yr old man presented with an episode of syncope and complaints of leg weakness. He was hypogonadal with coarse facial features and a marked proximal myopathy. Hypopituitarism was confirmed biochemically: serum FT4 7.7 pmol/l (9.7-25.7), TSH 1.65 mIU/l (0.05-5.00), FSH 1.8 IU/l (1.6-18.0), LH 1.0 IU/l (2.0-18.0), testosterone 1.13 nmol/l (5.70-28.8) and 9am cortisol 122 nmol/l. Treatment with hydrocortisone and thyroxine was commenced. Further investigation revealed elevat...

We presenting a case of 26 old lady who is known to have Denys-Drash syndrome, epilepsy and bronchial asthma who presented with history of recent significant weight gain, extensive abdominal bruising and significant muscle weakness which she described literally as not able to use her upper limbs to move to help shuffle her bottom in the floor, a manoeuvre that she was able to do before. Patient is on Carbamazepine, sodium valporate, levetiracetam , salbutamol and Pulmicort inh...

Objective: Diabetic mastopathy (DMP) is an uncommon fibrous disease of the breast, most commonly found in premenopausal women with type 1 diabetes exposed to long-standing insulin therapy. Often mimicking breast cancer clinically and on imaging, this condition poses a diagnostic challenge requiring pathological confirmation.Case presentation: A 68-year-old woman with type 1 DM and a family history of breast cancer in paternal aunt had an abnormal screeni...

Introduction: Diabetes teams need to keep electronic data records for supporting participation in the National Paediatric Diabetes Audit (NPDA), and other governance activities. NPDA benchmarks diabetes services against each other, and services are keen to make sure their data is accurate so that it gives a good reflection of their service. Twinkle is a specialised database that is widely used for this purpose.Twinkle allows units to produce specific rep...

Case History: A 69-year-old woman with bipolar schizoaffective disorder of 11 year’s duration and recent diagnosis of atrial fibrilation was admitted with acute onset of delirium, lethargy, shakiness and confusion. On admission, the patient was restless and non-compliant. Her skin was warm and sweaty, clinically dehydrated. Her heart rate ranging between 75 and 100 /min. The rhythm was irregular, consistent with atrial fibrillation on ECG and was afebrile. She was oriented to ...

Background: Up to 60% of patients with neuroendocrine tumours (NETs) are malnourished. This negatively impacts survival, length of hospital stay, risk of complications, treatment response, fatigue and quality of life. Malnutrition is typically defined by body mass index (BMI) or weight loss, which provides no information on body composition. Research in other cancers has shown sarcopenia is more significant than BMI. Information is lacking on the influence of ...

Introduction: Neuroendocrine tumours of the gastrointestinal tract often cause carcinoid syndrome and in advance cases carcinoid heart disease. These tumours secrete serotonin, which can bind to heart valves and cause fibrosis and eventually valve incompetence. Most cases involve the tricuspid valve +/− pulmonary valve. Medical management comprises diuretics for fluid overload and somatostatin analogues to reduce circulating serotonin. Definitive treatment is heart-valve...

Background: In mammalian cells, poly(ADP-ribose) polymerase-1 (PARP1) is among the earliest proteins to reach the site of DNA damage and play key roles in different cellular responses ranging from DNA repair to cell death. PARP-inhibitors are recommended in mono or combination therapy for a subset of breast and ovarian cancers with BRCAness type of DNA repair deficiency. In addition, current clinical trials are examining whether PARP-inhibitors can potentiate the efficacy of c...

Functioning adrenal masses are often a diagnostic challenge and can present with unusual symptoms. We describe a case of a 37-year-old male with a background of ulcerative colitis, who presented with gynecomastia in the breast clinic. His serumbiochemistry showed persistently elevated Oestradiol and prolactin, with low testosterone and FSH. On physical examination, he had marked breast tenderness, bilateral gynecomastia and no signs of steroid excess. He reported a decline in ...