Endocrine Abstracts

Case: A 50-years-old gentleman underwent cardiac surgery which was complicated by postoperative arrythmias and ischemic stroke. He was found to have raised calcium of 2.9 (2.2–2.6 mmol/l) subsequent to which PTH was tested and found to be raised at 34.2 (1.6–6.9 pmol/l) which increased to 41.2 pmol/l in few days. He was referred for work up and management of primary hyperparathyroidism. An USS of the neck showed 1.5 cm nodule posterior to left thyroid lobe and Sestim...

Background: Cushing’s syndrome is defined as a hormonal disorder resulting from elevated serum cortisol leading to specific physical and biochemical abnormalities that might be detrimental to life itself. Majority is caused by steroid intake while endogenous sources although representing only a minority of patients often lead to delay in diagnosis. Ectopic ACTH syndrome considered a rare entity are usually found as small cell lung cancer and carcinoid tumors. Rare types o...

Background and significance: Endogenous Cushing’s syndrome is a rare disease entity approximately 13 cases per million population. In Asia, and specifically in the Philippines incidence is unknown. As well, it’s clinical presentation among Filipinos is not well described. The local epidemiology of obesity, diabetes and hypertension are different from other countries. These conditions are the usual initial differential diagnosis for Cushing’s syndrome. This repor...

The pathogenesis of gonadotrophin secreting pituitary tumours (gonadotrophinomas) remains poorly understood. BMP2, known to be important in the control of cell proliferation and differentiation, is essential for commitment of undifferentiated pituitary cells to the gonadotroph cell lineage. Attenuation of its expression is critical in allowing terminal differentiation. BMPs are associated with up-regulated expression of Id (Inhibitors of differentiation) proteins with predicte...

A previously fit 39 year old joiner presented in November 2003 with a 6 month history of intermittent right-sided abdominal pain. There was no associated nausea or vomiting. An abdominal ultrasound requested by his general practitioner revealed a single gallbladder calculus and a 10 cm right-sided cystic mass with some echogenic areas, probably of hepatic or adrenal origin. He was normotensive and clinical examination was normal. CT scan of the abdomen confirmed a 9 cm mass ar...

Introduction: Genetic testing for Familial Endocrine Syndromes has an important role in diagnosis, timing/extent of surgery, and follow-up. Our survey explored experiences and attitudes towards genetic testing in the UK and Abroad.Methods: Attendees of 2022 Conferences of ESES, BSPED, SfE, BAETS and AsianAES were asked to participate in an online survey (31 questions on demographics; genetic testing availability and expe...

Primary hyperparathyroidism (PHP) is the most common aetiology for hypercalcaemia. Its prevalence in pregnancy is reported to be between 0.15% and 1.4%[i][ii]. It presents a threat to the health of both mother (hyperemesis, nephrolithiasis) and foetus (foetal death, congenital malformations, neonatal severe hypocalcaemia induced tetany)[iii][iv]. However, there is a lack of clear guidance on management of primary hyperparathyroidism in pregnancy. We describe the ...

A 72-year-old male patient presented to the ER because of general weakness, myalgia, frequent paroxysms of atrial fibrillation, shortness of breath, and hoarseness. The symptoms persisted for two months, gradually worsening and causing him to lose weight. At some point, he noticed redness of the sclera and soreness of the eyeballs. Paroxysms of rapid atrial fibrillation have been known for more than 15 years, so he had amiodarone in therapy. His initial laboratory findings sho...

Introduction: Current clinical practice guidelines recognise that a calculated free testosterone (T) level is the single most-useful, clinically sensitive marker of androgen excess in women, but there is no clear guidance as to the best way to measure free T. Several equations have been proposed to calculate clinically useful estimates of free T including the free androgen index (FAI) and calculated free T (cFT). The FAI is not used in men but it is...

Variability in treatment response with respect to GLP1 agents is well-accepted but incompletely understood. In a specialist GLP-1 clinic at UHCW, we describe a case of improved therapeutic response following change in injection site. Currently, advice is injection in the abdomen or thigh.A 61 year old man was commenced on Liraglutide 1.2 mg subcutaneous OD injection, in 2013. Previously managed with glimepiride 4 mg and ...