Endocrine Abstracts

Background: Grade 3 pancreatic neuroendocrine tumor (G3-PanNET) and neuroendocrine carcinoma (PanNEC) are both defined by Ki67>20% and/or mitoses >20 per 2mm2. PanNET and PanNEC are thought to be molecularly distinct entities and progression from PanNET to PanNEC is considered rare. MEN1, ATRX, DAXX, and TSC1/2 mutations are common in PanNET, while TP53, RB1, KRAS, and SMAD4 mutations are typical of PanNEC. Immunostains for ATRX/DAXX/p53/Rb aid in the classification of...

Background: Pancreatic neuroendocrine tumors (panNETs) are heterogeneous, with grade (G) defined by Ki67 proliferation index (<3% G1, 3-20% G2, and >20% G3) or mitotic rate. Previous studies suggest that baseline Ki67 index may be confounded by biopsy site (primary or metastasis), biopsy technique and primary tumor size. Ki67 differences leading to grade discordance in PanNETs at baseline is relatively understudied. Our study aims to evaluate grade discordance in synch...

Introduction: Duchenne muscular dystrophy (DMD) is associated with progressive decline in muscle function and loss of ambulation in the teenage years. Objective assessments of upper limb performance are required but functional assessments and magnetic resonance imaging (MRI) are time consuming and costly. ACTIVE-seated (Ability Captured Through Interactive Video Evaluation) is a fun, inexpensive, movement tracking video game that can measure Functional Reaching Volume (FRV). <...

Primary hyperparathyroidism causing symptomatic hypercalcaemia is often encountered in clinical practice. However, hyperparathyroid crisis is a rare and potentially fatal presentation of primary hyperparathyroidism characterised by profoundly symptomatic hypercalcaemia, altered mental status, and cardiac and renal dysfunction. Recognising the need for rapidly controlling hypercalcaemia with aggressive medical therapy and definitive management with early parathyroidectomy are n...

Background: The incidence of germline pathogenic/likely pathogenic variants (P/LPV) is relatively well described in low grade well differentiated neuroendocrine tumors (NETs). However, germline findings in G3 NENs including grade 3 NETs (G3NET) and poorly differentiated neuroendocrine carcinoma (NEC) is gravely understudied, and guidance related to germline testing in G3NEN is lacking.Methods: An IRB approved, single institution, retrospective chart revi...

Background: Germline pathogenic or likely pathogenic (P/LP) variants occur in approximately 10% of NEN patients with recent data suggesting a higher frequency in pancreatic NENs or paraganglioma/pheochromocytoma (PPGL). However, identification of VUS can complicate interpretation of germline results, particularly when diverse populations are under study and the optimal gene panel size for testing remains unclear.Methods: A single-center retrospective cha...

Introduction: Hyperosmolar hyperglycaemic state (HHS) is an acute complication of diabetes which requires prompt recognition to prevent morbidity and death. Owing to its low prevalence, clinicians report a lack of confidence in management, which may result in delayed diagnosis and worsened outcomes. The limited literature on HHS management means most guidelines are based solely on expert opinion, resulting in significant discrepancies between care in centres.<p class="abst...

Background: Joint British Diabetes Societies (JBDS) have developed guidelines for the treatment and management of diabetic ketoacidosis (DKA) in adults in the United Kingdom (UK). Multiple single center audits are known to assess compliance to guidelines. However, unified data on DKA management across multiple centers is unknown.Aims: To study the precipitating factors and assess for differences in DKA management across UK hospitals.<p class="abstext...

Background: The appropriate and timely management of diabetes-related ketoacidosis (DKA) has important implications for patient outcomes. Despite the availability of national management guidelines to promote standardised care, we do not know if there are differences in DKA outcomes and complications between hospitals.Aim: To assess for differences in DKA outcomes and treatment complications between hospitals.Methods: This retrospec...

Non-functioning pituitary macroadenomas (NFPAs) are commonly associated with headaches, visual deficits and hypopituitarism. Urgent transsphenoidal surgery (TSS) should be considered for all patients presenting with visual compromise. We evaluated outcomes in 65 patients with NFPAs undergoing TSS in our unit. Patients who had undergone previous pituitary surgery or prior radiotherapy were excluded from this evaluation, as were those with classical pituitary apoplexy and predom...