Endocrine Abstracts

Case history: A 74-year-old gentleman with primary aldosteronism (PA) was referred for the ‘MATCH’ study – a prospective comparison of 11C-metomidate PET CT with adrenal vein sampling. He took no exogenous steroids.Investigations: Na 147 mmol/l, K 3.7 mmol/l, aldosterone 496 pmol/l, renin activity <0.17 nmol/l per h, random cortisol 247 nmol/l and concomitant ACTH 9.3 ng/l. Two overnight dexamethasone suppression tests recorded values ...

Background: Growth monitoring identifies treatable conditions in apparently healthy children and prevents inappropriate referrals. Systematic growth monitoring is not currently a UK priority and growth disorders are frequently diagnosed late.Objectives: Develop and test the accuracy of a smartphone app which enables families to measure a child’s height at home as a cost-effective alternative to primary care growth monitoring.M...

During pregnancy progressive maternal insulin resistance occurs which is normal, ‘sparing’ glucose that can be transported across the placenta to be used by the fetus. In gestational diabetes mellitus (GDM) maternal glucose dysregulation is exacerbated, characterised by hyperglycaemia and associated with long-term adverse outcomes in mother and child, such as increased risk of diabetes and/or cardiovascular disease in later-life. Continuous glucose monitoring (CGM) i...

Objective: We reported 3 patients with primary aldosteronism who presented at times of high plasma LH, and had somatic CTNNB1 mutations causing ˜100-fold elevation of LHCGR in their APAs (Teo et al. NEJM 2015). Subsequently we identified 4 further patients, but the association with pregnancy was not found by others. Whole exome sequencing (WES) of an APA diagnosed at onset of puberty suggests an explanation.Method: WES of tumour and blood w...

Primary aldosteronism (PA) is the cause of 5–10% of hypertension, surgically curable in patients with unilateral aldosterone-producing adenomas (APAs). However <1% of patients are currently diagnosed and cured. Newer and simpler modalities of diagnosis and treatment are required. The aim of FABULAS (a feasibility study of endoscopic ultrasound-guided ablation as a non-surgical, adrenal sparing treatment for aldosterone-producing adenomas) is to determine in 30 patient...

Burosumab, monoclonal antibody targeting fibroblast growth factor 23, is now available for clinical use in children with X-linked hypophosphatemia (XLH). We explored the effects of this treatment in a clinical setting, considering biochemistry, growth, deformity, functionality, quality of life, pain and fatigue.Methods: Clinical, biochemical, radiological and questionnaire data were reviewed at 6 and 12 months(m) for 8 children with XLH starting burosuma...

Background: Primary aldosteronism (PA) is responsible for 5-10% of all cases of HTN. The current gold standard test for determining the side of aldosterone hypersecretion is adrenal vein sampling (AVS). 11C-Metomidate PET/CT (METO-PET) has recently emerged as a potential non-invasive alternative to AVS. As 11C-Metomidate is concentrated within ‘hyperfunctioning’ nodules, METO-PET potentially not only identifies the side, but the exact site of al...

Background: Primary aldosteronism (PA) is now recognised to account for 5–10% of all cases of hypertension (and 20–25% of refractory hypertension). For patients with a demonstrable unilateral cause, adrenalectomy offers the potential for cure of PA, although resolution of hypertension occurs in only ~50% of patients. We have examined histological appearances and radiological features in patients with APAs undergoing adrenalectomy in an attempt to further our understa...

Although adrenal vein sampling (AVS) remains the gold-standard for distinguishing unilateral and bilateral disease in primary hyperaldosteronism (PHA), it is technically demanding and not always feasible. Metomidate (MTO), a potent inhibitor of CYP11B1 and CYP11B2, can be C11H3-labelled as a PET tracer (11C-MTO), and we have previously shown it to be an alternative to AVS for localising unilateral aldosterone-producing adenomas (APAs) (Burton <...

Interferon alpha (IFNα) and Ribavirin combination therapy effectively eradicates Hepatitis C Virus (HCV) in up to 80% of patients. Transient thyroid dysfunction (TD) (>80% hypothyroidism) usually due to a destructive thyroiditis has been recognised to occur in up to 25% of patients treated in Italy, Japan and Australia. However, data are lacking in a UK cohort and no standardised protocol for testing of thyroid function testing exists. The aim of this study was to det...