Endocrine Abstracts

Case history: We present the case of a 64 year old man with an incidental finding of pituitary macroadenoma (1.1×0.8×0.5 mm). He had a past medical history of obstructive sleep apnoea, asthma, osteoarthritis, hypertension, retinal detachment and cataract.Investigations: Blood tests.Results and treatment: Pituitary function tests showed markedly elevated prolactin 4272 mIU/L (86–324), elevated free tri-iodothyronine (...

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...

Positive interference in free thyroxine (fT4) and free triiodothyronine (fT3) immunoassays is well known, however we report a rare case of negative interference in the Roche fT4 and fT3 immunoassays in a 3-year-old girl with undetectable fT4 and fT3. She presented with increasing tiredness, abdominal pain, pain in her lower limbs and constipation. Examination was unremarkable. Thyroid func...

Background: Thyroid cancer is the most frequent endocrine malignancy, with >7000 cases diagnosed in central Europe every year. Recently, ALK/EML4 translocations have been reported in single cases in anaplastic thyroid cancer (ATC). Little is known about the frequency of ALK alterations in poorly differentiated thyroid cancer (PTC). Our aim was to investigate the frequency of ALK alterations in patients with advanced thyroid carcinomas.Material and me...

Introduction: Bedside blood ketone measurement has often been used in the management of diabetic ketoacidosis. However there is no available data on its reliability in the evaluation of hypoglycaemia in children. We aimed to assess the reliability of bedside ketones (beta-hydroxybutyrate (BHB)) in the evaluation of hypoglycaemia in children.Methods: We collected data on 20 children who had paired measurement of bedside and lab BHB at the end of a control...

Background/aims: The short synacthen test (SST) is a dynamic function test used to assess the hypothalamic pituitary adrenal axis. Interpretation requires consideration of sample timing and cortisol method. Currently the 30 minutes post-synacthen cortisol (CORT30) at NHS Greater Glasgow and Clyde (NHS GGC) is >450 nmol/l measured on the Abbott Architect. A large reference range study published a cut-off of >430 nmol/l for this method. This audit aims to document clinic...

Asfotase alfa (AA, STRENSIQ, Alexion Pharmaceuticals, Inc.) is the first FDA-Approved treatment for patients with hypophosphatasia, the result of a mutation in the tissue-nonspecific alkaline phosphatase (ALPL) gene. Because it contains the ALP active site, AA is able to catalyse the substrate as the antibody-conjugated ALP would within an assay. Therefore, AA present in a patient’s sample may generate a false positive or a false negative result. We investigated ...

Background: The short Synacthen test (SST) is frequently used to diagnose adrenal insufficiency; however the role of baseline cortisol. With the recent European shortage of synacthen, there was a pressing need to identify the best possible way to use the resource and rationalize the test. Our aim is to identify whether baseline cortisol can be safely used to rule out adrenal insufficiency in clinical practice.Methods: All SSTs performed at the OPD, Royal...

Diabetes is endemic in society. Beyond lifestyle modification (often short lived) and metformin, which while effective has gastrointestinal side effects, other available pharmacological options are challenging to implement across populations of newly diagnosed patients. The recent position statement by ADA/EASD calls for patient-centred individualised therapies to suit patients’ need. Glucose-lowering nutritional supplements may be an effective and safe option for newly d...

Introduction: The length of patient survival after cancer treatment is increasing and, in some cases, does not differ from the average life span in healthy individuals. The aim of the study is to evaluate thyroid function after oncologic treatment in children.Description of Methods: A group of 158 patients aged 16–25 who underwent oncologic treatment in childhood and the control group – 66 children and young adults were examined. The prospectiv...