Endocrine Abstracts

Widespread use of CT and MRI scan has led to the identification of incidental adrenal tumours. The need to determine functionality often results in a battery of investigations that are a drain to scarce resources and are frequently normal. Studies to identify tumour radiological features that suggest functionality and hence enable targeted investigations are few in the literature. To this effect we set out to analyse which features on imaging that are best predictive of functi...

A 60-year-old female was referred to the department in October 2010 after a CT thorax revealed an incidental finding of a right adrenal nodule. On questioning, the patient reported some sweats but otherwise no other symptoms of hormonal excess. Adrenal functional studies were normal and it was therefore decided that the patient should have a repeat CT scan in 6 months. Repeat CT adrenal glands in April 2011 did not show any changes to the size of the nodule but gave indetermin...

One in five people in the UK is affected by lung disease, along with millions more worldwide. Glucocorticoids represent the most utilized anti-inflammatory therapy for the treatment of pulmonary inflammation, however a subset of patients exist which do not respond to therapeutically relevant doses.The non-ciliated bronchial epithelial (Clara) cells have been identified as key mediators of the pulmonary inflammatory response. The glucocorticoid receptor (...

Aim: We performed a retrospective analysis to evaluate the surgical treatment of primary hyperparathyroidism in a tertiary referral centre.Methods: We reviewed the case notes of 80 patients who underwent parathyroid surgery (2003 to 2011). Patients were identified from the national BAETS audit.Results: Median age was 56 years (range 25–86). 72.5% of the patients were females and 30% were asymptomatic. Mean adjusted calcium con...

A 51 year old lady presented with a 3 week history of persistent headache, sweating, increase in shoe and ring size and prognathism. Imaging confirmed an 18×19 mm pituitary macroadenoma indenting the optic chiasma. Visual fields were normal.Bloods: IGF1-181 nmol/l (11.3–30.9 nmol/l), prolactin 76 mU/l (102–496 mU/l), LH 22 U/l (2–13 U/l), FSH 46.6 U/l (4–13 U/l), TSH 0.63 mU/l (0.27–4.2 mU/l), FT4- 25.9 pmol/l (12–22 pm...

Introduction: The ectopic ACTH syndrome accounts for 12% of patients with Cushing’s syndrome. Its diagnosis and treatment remains a challenge. This especially true in patients with ectopic ACTH production.Case: We report the case of a 41-year-old man who presented with progressive muscle weakness in his arms and legs. He was found to be borderline hypertensive BP 145/92, cushingoid plethoric rounded face and mild proximal muscular weakness. His init...

Background: Hyperadrogenemia is one of the most commonly encountered endocrine disorders in reproductive-aged women. By far the most common causes of androgen excess are functional which account for more than 90% of cases. Androgen and ovarian tumours producing excess androgen are however very rare and only account for about 0.2% of cases.Case history: A 62-year-old lady admitted to hospital with pneumonia was found to have an ill defined, firm, non-tend...

Extradrenal paragangliomas can occur in individuals at any age although most arise in the fourth or fifth decade. Familial paragangliomas constitute approximately 10% of cases. These are part of a rare syndrome characterized by slow-growing tumors derived from paraganglia tissue. Recent years have brought significant progress in identifying the genetic etiology of this syndrome.Thirty-eight years old female was referred to the endocrine department by ENT...

Introduction: Phaeochromocytoma is a rare neuroendocrine tumour, with serious and potentially lethal cardiovascular complications. Cerebral haemorrhage is an unusual complication of phaeochromocytoma with <40 cases reported worldwide.Case: We report the case of a 29-year-old woman who presented with sudden onset of headache and collapse. CT Brain showed right sided frontal haemorrhage, her BP > 200/100, LVH on ECG and Echocardiography suggesting ...

Seventy six year old man presented with sudden onset headache for 3 days. He was seen by the GP and treated for migraine. But no improvement in his headache and he developed drooping of left eyelid and blurring of vision. No other neurological symptom.On examination left ptosis with normal visual fields to confrontation method. Initial differential diagnosis was isolated 3rd nerve palsy probably due to posterior communicating artery aneurysm. He was on a...