Endocrine Abstracts

Cyclophosphamide is an alkylating agent used in the treatment of malignant and autoimmune diseases. Severe hyponatraemia is a serious electrolyte disorder with life threatening neurological sequelae. We report a case of recurrent severe, symptomatic hyponatraemia that developed in a 61 year old female with systemic vasculitis and Sjogrens syndrome following low-dose cyclophosphamide.Case report: A 61 year old lady, with ANA positive systemic vasculitis p...

While it is generally acknowledged that hyperthyroidism and Paget's disease are states of increased bone turnover and that treatment reduces this, whether treatment entirely corrects or reverses abnormalities has not been established. A variety of biomarkers for bone formation which include serum levels of bone alkaline phosphatase (BAP), osteocalcin (OC) and amino terminal procollagen type 1N propeptide (PINP) and resorption biomarkers which include urinary excretion of deoxy...

The importance of the differentiation between the apparent benign clinical condition of macroprolactinaemia and that of true hyperprolactinaemia, which requires therapy, is becoming widely recognised. Laboratories routinely rely on prolactin recoveries of less than 40 percent following treatment of sera with polyethylene glycol (PEG) to distinguish between the former and latter conditions. However, the 40 percent threshold employed is arbitrarily defined with little scientific...

Adrenal mineralocorticoid biochemistry differs between people of African and European ancestry. The aldosterone/renin ratio (ARR) is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.Following clinical observation of a high prevalence of abnormal ARR in patients of African origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaem...

Introduction: Fine needle aspiration cytology (FNAC) is a valuable and cost-effective pre-operative investigation for thyroid nodules. The British thyroid association (BTA) previously recommended two non-neoplastic results 3–6 months apart in aspirates to exclude neoplasia1. However, in recently updated BTA guidelines, repeat aspirates were recommended when there are clinical or ultrasound suspicions2.Aim: The aim of our study ...

Introduction: Ultrasound (US) is an extremely sensitive examination for thyroid nodules. Fine needle aspiration (FNA) cytology samples taken with ultrasound guidance, increases accuracy and reduces rates of unsatisfactory samples1. In addition, the immediate assessment of the sample for adequacy by onsite cytopathology is shown to reduce inadequacy rates by most reports2.Aim: The aim of this study was to compare the inadequacy (Thy1...

Introduction: Adrenal haemorrhage is rare. There is a broad spectrum of clinical presentation and aetiology of the condition making it challenging to diagnose. Endocrine dysfunction frequently complicates cases of adrenal haemorrhage. Failure to recognise the condition or its complications can lead to devastating consequences for the patient.Methods: All patients referred to our centre with adrenal haemorrhage between 2004 and 2014 were included in this ...

Introduction: A weekly endocrinology–radiology multidisciplinary (MDT) meeting has been recently introduced in our hospital to discuss indications and suitability of thyroid nodules for fine-needle aspiration (FNA). In a recent 5 years retrospective audit, 80% of thyroids FNAs were performed under ultrasound (US) guidance in our institution with an overall inadequacy (Thy1) rate of 11.1%.Objectives: The aim of this study was to assess whether such a...

Background: Thyroid fine-needle aspiration (FNA) is a safe, valuable and cost effective procedure and is now regarded as the investigation of choice for preoperative assessment of thyroid nodules. The reported sensitivity of thyroid FNA varies from 65 to 98% and the specificity from 73 to 98%.Aim: The aim of this study was to assess the accuracy of this procedure correlating cytology with histological outcomes, and to audit our practice against standard ...

Avascular necrosis is a rare presenting feature of endogenous hypercortisolism. The literature suggests that, if left untreated, complete collapse of the femoral head may ensue, necessitating hip replacement in up to 70% of patients. The majority of described patients with avascular necrosis due to endogenous hypercortisolaemia were treated surgically.Case report: A 36-year-old female, investigated for right leg pain, reported rapid weight gain, easy bru...