Endocrine Abstracts

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Background: Acromegaly is a rare condition characterised primarily by tumourous production of excess Growth Hormone (GH) from a pituitary adenoma. The Octreotide Challenge Test (OCT) has been used in the RVI to predict short term efficacy of long-acting Somatostatin Analogue (SSA) therapy.Aims: We retrospectively reviewed the OCT results of all patients with acromegaly treated at RVI from 2005 to 2021 to evaluate its clinical utility.<p class="abstex...

Background: The recent Get It Right First Time (GIRT) report suggests short stay pathways should be aimed for in pituitary surgery in England, with 1–2 days being realistic. We prospectively audited the length of stay (LOS) for patients undergoing transsphenoidal surgery (TSS) for sellar and suprasellar lesions at the Royal Victoria infirmary hospital (RVI) over a 2-year period, from October 2019.Methods: Data was prospectively collected for each pa...

Background: Acromegaly is a rare condition characterised primarily by tumourous production of excess Growth Hormone (GH) from a pituitary adenoma. Clinical management aims at normalising serum IGF1 levels within sex and age-adjusted reference parameters. Treatment options include pituitary surgery, medical therapy with somatostatin analogue (SSA), cabergoline, pegvisomant or radiotherapy. A combination of treatment modalities is common for the majority of patients.<p class...

Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessment. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid excess: ACTH-inde...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

Introduction: Adrenal tumors are commonly discovered incidentally on cross-sectional abdominal imaging. The Incidence of adrenal tumors increased 10-fold in the past 2 decades, with most diagnosed in older adults. In any patient with a newly discovered adrenal mass, determining whether it is functioning adenoma or non-functioning and identifying whether it is ACTH dependent or not is crucial to avoid missing the real underlying pathology.Clinical case: A...

Introduction: Hypercalcaemia diagnosed in hospital setting is most commonly PTH-independent and malignancy related, whilst hypercalcaemia discovered in community setting is commonly secondary to Primary Hyperparathyroidism (PHPT). Other rare causes include granulomatous diseases such as sarcoidosis and familial hypocalciuric hypercalcaemia (FHH).Case Summary: A 73-year-old male with a background of hypertension and chronic kidney disease stage 3 was foun...

Case history: We describe a case of 35 year old female who presented with abdominal pain, nausea and lower backache. She was initially treated with Trimethoprim for a urinary tract infection. 5 days later, she re-attended hospital with feeling more unwell, ongoing lower abdominal pain and vomiting. On examination, she was haemodynamically stable. She had suprapubic tenderness on abdominal palpation, and the rest of her systemic examination was normal.Inv...

Background and aims: Electrolyte imbalance is common among hospital inpatients, reflecting severity of underlying illness, but also independently contributing to excess morbidity and mortality. However, studies have largely been retrospective, with incomplete data capture. We prospectively evaluated the prevalence of major Na and Ca disorders among inpatients at the Newcastle-upon-Tyne Hospitals.Method: With approval of the Information Guardian, we used ...