Endocrine Abstracts

Introduction: Diabetes has been associated with poorer outcomes with COVID-19 infection, but precise predictors of mortality in patients with diabetes remain unclear. We assessed predictors of adverse outcomes in patients hospitalised with COVID-19 in Imperial College Healthcare NHS Trust (ICHNT) hospitals during the first and second waves of COVID-19 to determine if outcomes for patients with diabetes have evolved with new variants and treatments.Method...

Von Hippel-Lindau (VHL) disease is an inherited tumour syndrome, caused by a mutation in the VHL tumour suppressor gene encoding the VHL protein. Patients are prone to cysts and neuroendocrine tumours in the pancreas and other benign and malignant neoplasms. Pancreatic cysts occur in approximately 70% of VHL patients. We describe two cases of VHL disease with extensive multi-cystic changes affecting the whole pancreas, both patients had deletions of exon 2–3 of the VHL ge...

Background: An increasingly recognized complication of Roux-en-Y Gastric Bypass (RYGB) surgery is the development of postprandial hypoglycaemia (PPH). However, there remains no agreed standard on how to diagnose this condition. Commonly used tests include a prolonged oral glucose tolerance test (POGTT) and mixed meal tolerance test (MMTT). Little is known regarding how these tests compare in the post-bariatric population.Methods: Ten patients who had con...

Context: Hydrocortisone day curves (HCDC) are used to monitor hydrocortisone replacement by obtaining serum samples to measure cortisol levels throughout the day. Salivary measurement of free cortisol offers a non-invasive alternative to serum measurements.Objective: To validate salivary cortisol measurement as an alternative method to assess the adequacy of hydrocortisone replacement in patients with hypoadrenalism.Setting, patien...

We present the case of a 33-year-old woman diagnosed with congenital adrenal hyperplasia (CAH) due to classical 21-hydroxylase deficiency following a salt-losing crisis as a newborn. She had previously been controlled on dexamethasone 0.25 mg bd and fludrocortisone 100 mcg od, as evidenced by high-normal 17-hydroxyprogesterone (17-OHP) and low-normal testosterone levels (8.5 and 0.4 nmol/l respectively).However, she had experienced significant symptoms o...

This gentleman was diagnosed with hyperparathyroidism at the age of 34 and was found to have multiple manifestations of MEN1.Hyperparathyroidism: He was diagnosed with hyperparathyroidism and underwent a parathyroidectomy with removal of 2 glands. Four years later calcium levels were raised once again and two further hyperplastic glands were removed, with cure of his hypercalcaemia.Gastrinoma and other pancreatic islet cell tumours...

Background: It is apparent that COVID-19 may cause persistent symptoms beyond 12 weeks (‘long COVID’). However its underlying pathophysiology is unclear. Several symptoms of long COVID draw similarities to that of endocrine diagnoses. We recently observed that adrenal and thyroid function were normal in survivors of COVID-19 at follow-up. Here we assess additional endocrine axes that could plausibly have a role in long COVID to determine their relationship to ongoing...

Introduction/Aims: Currently, the most successful long term treatment for obesity is bariatric surgery, however the underlying mechanisms are not fully understood. Changes in gastrointestinal and central neuroendocrine signalling have been postulated as mediators of psychological and eating behaviour changes following bariatric surgery. We aimed to investigate changes in eating behaviour and psychological factors pre- and 1 month post-very low calorie diet (VLCD) and 3-month p...

Background: Bariatric surgery has been proven to produce substantial weight loss and amelioration of metabolic syndrome-associated co-morbidities. However, at five-year follow-up, only 20–40% of patients maintain diabetes remission and 40% of patients return to their baseline weight. The limiting factor in treating refractory diabetes following obesity surgery is the lack of knowledge about its aetiology.Aims: Evaluate the eating pattern and clinica...

Introduction: An excessively long blind-end of the alimentary limb following RYGB, known as a ‘candy cane’ (CC), may cause symptoms such as pain, gastrointestinal symptoms and weight regain. Very few studies have examined the efficacy of surgical resection of the CC. We aimed to assess symptom resolution following CC surgery.Methods: Single centre observational study of 28 CC revisions from 2010 to 2017 (mean age 45±8, female preponderance...