Endocrine Abstracts

It is now well established that unilateral autonomous aldosterone secreting tumour (AST) in contrast to bilateral adrenal hyperplasia (BAH) - are corrected by surgery. The optimal method of pre-operatively defining a unilateral autonomous AST still remains controversial. There is agreement that adrenal scanning techniques are often unreliable or misleading. The aim of the current study was to analyse if a random aldosterone:renin (AR) ratio (after stopping anti-hypertensive me...

Anti-thyroperoxidase autoantibodies (TPOAb) are one of the major secondary autoantibodies associated with AITD. Many endocrine hospital referrals are received for patients with elevated TPOAb levels without other disordered thyroid function tests.This study aimed to investigate the use of TPOAb testing in hospital practice, to determine whether the presence or absence of TPOAb indicates the existence of thyroid disease and the effect of the TPOAb result ...

A 65 year old lady presented to her GP in 1997 with an extensive rash. She was referred to a dermatologist but the rash which failed to settle with topical treatments. A plasma glucagon level was elevated at 275 pmol/l (NR 0-50). CTscan revealed a mass in the pancreatic tail and hepatic metastases consistent with malignant glucagonoma. She was commenced on octreotide and the rash resolved. She underwent a distal pancreatectomy, partial left hepatic lobectomy and intraoperative...

ObjectiveTo assess the results of bilateral adrenalectomy and further assess the relevance of Nelson's syndrome as a complication of bilateral adrenalectomy.Patients33 patients treated by bilateral adrenalectomy at the Hammersmith Hospital were identified (earliest operation performed in 1958). Although all bilateral adrenalectomies in recent years were included, it was not possible to confirm that all bilate...

We report the case of a 57-year-old woman who presented with headache of sudden onset and with blurring of vision in the right eye. This had been preceded by a week's history of fever, rigors and coryzal symptoms which had been treated as malaria and had subsequently settled. Examination demonstrated proptosis and complete ophthalmoplegia of the right eye with 6/60 acuity. Baseline investigations included normal urea and electrolytes, clotting screen and full blood count, with...

Background: Arginine Vasopressin Deficiency [AVP-D] can occur as consequence of any abnormality or injury at one or more of the sites involved in the Antidiuretic hormone [ADH] secretion. AVP-D is one of the presenting features of suprasellar lesions with panhypopituitrism. The natural course of the disease differs based on the underlying aetiology. It is likely to be transient post-operatively. Idiopathic DI is usually permanent however DI can be reversible w...

Although NICE guidelines recommend that radioiodine is the first-line treatment for Graves disease, carbimazole is often used initially to get control of the hyperthyroidism. This patient was exquisitely sensitive to carbimazole initially, and despite initial recurrence, he cannot be treated with radioiodine as he now has intermittent hypothyroidism.Case: A 42-year-old male was diagnosed with Grave’s disease and initially treated fo...

Background: Short Synacthen Tests (SSTs) are integral to the diagnosis of Adrenal Insufficiency (AI). A 30-minute stimulated cortisol value is assessed against local assay dependent thresholds to ascertain or exclude the diagnosis. A diagnosis of AI is a life changing event requiring the initiation of life long glucocorticoid replacement therapy for survival. Glucocorticoid replacement is associated with long term morbidity and mortality, including an increased risk of diabete...

Background: Management of adrenal insufficiency (AI) with glucocorticoid replacement is associated with increased mortality and morbidity. There is growing evidence that this is because of excess, non-physiological steroid exposure. Low dose prednisolone (2-4 mg) is a once-daily alternative to standard hydrocortisone regimens that more closely mimics the circadian rhythm and may translate to better outcomes. There is however a paucity of studies comparing the two treatments.</...

Introduction: Iatrogenic Cushing’s syndrome (ICS) can be caused by virtually all forms of steroid treatment with or without suppression of hypothalamic–pituitary–adrenal (HPA) axis. Here we report betamethasone nasal drops used as treatment post septorhinoplasty as a cause of iatrogenic Cushing’s syndrome.Case: A 36 years old female with background history of depression presented to endocrinology clinic for evaluation of progressive w...