Endocrine Abstracts

Introduction: Sodium Glucose Co-transporter 2 inhibitors (SGLT2i) are a novel class of glucose-lowering therapies that have demonstrated prognostic benefit in the management diabetes, heart failure and renal impairment. National Institute for Health and Clinical Excellence (NICE) guidance recommends offering SGLT2i, in addition to metformin, first-line in individuals with type 2 diabetes (T2D) and chronic heart failure/ established atherosclerotic cardiovascular disease. Howev...

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

68 years old male was admitted with cough and fever during the second UK covid surge. Recent new diagnosis of hypertension and diabetes with worsening psychotic symptoms on background of schizophrenia. Noted previous hypernatremia, hypocalcemia, hypomagnesemia along with marked refractory hypokalemia and metabolic alkalosis. Cushing’s syndrome phenotype was not noted. Failed to suppress cortisol during an overnight dexamethasone suppression test with plasma cortisol remai...

Background: Hyperprolactinaemia is a common presentation in endocrine clinics. Current guidelines on BMJ best practice recommend evaluation with MRI only if levels are >2000 mU/l or absence of an identifiable secondary cause.Aim: To identify if pituitary pathology would go undetected if pituitary imaging is not performed and determine a suitable threshold for performing pituitary imaging in the diagnosis of prolactinoma.Methods: A ...

Spindle cell oncocytoma (SCO) is a rare nonfunctioning neoplasm of the anterior pituitary gland .This tumour is often misdiagnosed as pituitary adenoma or pituitcytoma due to it’s location and symptoms. Such tumours are highly vascular radiologically and histologically. We report a 54 year old gentleman who was found to have pituitary adenoma on CT head performed after a fall. Subsequent Pituitary MRI showed 25×18 mm pituitary macroadenoma with optic chiasm compressi...

Introduction: Endocrine disrupting chemicals (EDC) are exogenous substances altering function(s) of the endocrine system. EDCs have been implicated in the decline in male reproductive health. We aimed to systematically review the pathophysiological effects of EDCs on male reproductive health.Methods: Searches of EMBASE, MEDLINE and PubMed were conducted using the following terms: ‘endocrine disrupt*’ OR ‘endocrine disruptors’ OR &#145...

21 year old man presented to the emergency department with hypotensive shock. He had been seeing the GP with complains of poor appetite, intermittent vomiting, increased thirst and postural dizziness for the last 6 months. Previous medical history included tonsillitis, gastritis and learning difficulties. The working differential was severe gastroenteritis with hypovolemic shock, and so he was given immediate fluid resuscitation. He remained hypotensive, and so was given empir...

Introduction: Morbid obesity has serious associated co morbidities and is an independent risk factor for ischaemic heart disease. Obesity together with low functional status and exercise tolerance makes pre-operative cardiac assessment difficult and patients with few cardiac risk factors are often referred for cardiac assessment. This can not only be burdensome to services and prolongs waiting times for surgery but can also cause patient anxiety and poor compliance.<p clas...

Case history: We describe a rare case of a 59-year-old woman, whose hypercortisolism was unmasked following transphenoidal surgery for Acromegaly. She presented to the Endocrine Clinic in 2006 with acromegalic features and MRI revealing a pituitary macroadenoma 20×18×18 mm. Repeat dynamic evaluation showed inadequate GH suppression (initially normal), raising the possibility of early rumbling Acromegaly. 0900 h serum cortisol was 287 nmol/l. She was started on Caberg...

Objective: Hyponatraemia is the most common electrolyte disturbance encountered in patients – yet its management remains challenging and variable. We audit the management of hyponatraemia in a busy district general hospital, focusing on length of stay (LOS), readmissions and mortality.Methodology: A retrospective analysis was carried out of 30 consecutive inpatients alerted by the hospital biochemistry department with a sodium concentration of &#880...