Endocrine Abstracts

Aim: Review of clinical presentation of primary hyperaldosteronism (PHA) and identify unique features in our cohort.Method: Patients with PHA were identified from patients who underwent adrenal vein sampling (AVS) at our centre until October 2014.Results: 45 PHA patients (32 males, mean age of 50 years, 33 older than 45 years) were identified after confirmation with high aldosterone:renin ratio >15 and/or positive saline suppre...

Aim: To identify usefulness of adrenal vein sampling (AVS) in clinical management of primary hyperaldosteronism (PHA).Method: Biochemical and radiological review (by two independent radiologists) of 48 AVS in 45 patients with PHA who underwent CT adrenals/AVS.Results: CT adrenal findings were: 31/45 (68.9%) unilateral nodule (one had two nodules unilaterally), 5/45 (11.1%) bilateral nodules, 7/45 no nodules, 1/45 bilateral bulky ad...

Introduction: Daytime support from the diabetes-team reduces pressure on acute services however out-of-hours less support exists and diabetes related attendances to A&E are a potentially avoidable burden on resources. With the introduction of paediatric diabetes best-practice-tariff, recommendations included 24 h access to trained diabetes professionals for patients with known diabetes. In 2013 our three institutions created a consultant led out-of-hours paediatric diabete...

Background: Dopamine agonist (DA) withdrawal is common in the management of microprolactinoma. Guidelines in 19971 and 20062 suggest that DA should be withdrawn after normoprolactinaemia for 3 years.Aims: To assess DA withdrawal and adherence to guidelines.Methods: We retrospectively examined casenotes from 1997 to 2008. Patients were included with clinical and biochemical evidence of hyperprolactinaemia, and ...

Hypophysitis describes inflammatory pituitary lesions which can be classified into lymphocytic (autoimmune), granulomatous or xanthomatous. Rathke’s cleft cysts (RCC) are usually assymptomatic, benign tumours derived from remnants of Rathke’s pouch. We present a case of lymphocytic hypophysitis secondary to a ruptured RCC and the first reported case of post-surgical recurrence.A 34-year-old female presented with secondary amenorrhoea and fatigu...

Aim: Focussed parathyroidectomy is an established technique in subjects where imaging has identified a single parathyroid lesion. The aim of this study was to examine the long-term cure rate following this procedure.Method: Of 188 patients undergoing surgery for primary hyperparathyroidism between 2001 and 2006, 150 had a single parathyroid lesion on imaging using sestamibi +/− neck ultrasound. These patients were treated by focused parathyroidecto...

We investigated the relationship between gestational diabetes (GDM) and the metabolic syndrome in 368 (185 European (EUR), 103 South Asian (SA) and 80 Afro-Caribbean (AC)) women studied 20.0 (18.2-22.1) months (mean (95% CI)) following a GDM pregnancy and 482 normoglycaemic women (288 EUR, 99 SA, 95 AC) with no history of GDM. Estimates of beta-cell function (%B) and insulin sensitivity (%S) were derived using the HOMA method. Analysis was by multiple linear regression includi...

Background: Cut-offs for basal cortisol (early morning) have been determined to predict the 30-minute cortisol level post-synacthen, but not for determining when patients with suspected tertiary adrenal insufficiency (AI) are weaned off glucocorticoids.Aims: The aim of this study was to compare the predictive values of basal cortisol, basal ACTH and basal cortisol:ACTH ratio to determine appropriate thresholds to reduce ...

Background: Well-differentiated neuroendocrine tumors (WD-NET) have a relatively low tumor mutation burden and do not commonly express the programmed death ligand 1 (PD-L1), characteristics which may limit the anti-tumor activity of PD-L1 inhibitors in this disease. Response rate to single agent immune checkpoint inhibitors (ICI) for patients with G1-3 NET is <15%. The intensity of anti-tumor immune response may be enhanced by addition of liver-directed therapy (LDT), such...

Introduction: With the increased use of imaging modalities, detection of Adrenal Incidentaloma (AI) has become common.Aim: We evaluated management of patients with AI to improve service delivery.Method: Patients with AI referred to our endocrinology outpatient service (2006–2019). Data was collected from electronic case records and radiology reporting system. Demography, biochemical investigations, time interval between two sc...