Endocrine Abstracts

We report a case of two incidental lesions, a benign adrenal schwannoma and cerebral meningioma. There are no cases in the literature to link de-novo adrenal schwannoma and meningioma in patients. This case highlights the importance of multidisciplinary working to ensure expedited management in such cases.A 76 year old gentleman presented to ED with a seizure and a community-acquired pneumonia. Past medical history included atr...

We present a case of a middle-aged lady with clinical features suspicious of Addisons, however an initial false negative short synacthen test (SST), resulted in delay of diagnosis.Case: A 62-year-old lady presented to ED with a month history of generalised malaise, weakness, dizziness and vomiting. She had a background of type2 diabetes mellitus, previous left parathyroidectomy for primary hyperparathyroidism and B-thalassaemia trait. Admission bloods in...

This study assesses adherence to the NICE guidance of GLP-1 agonist and DPP-IV inhibitor prescribing from 2021-2022, during the COVID-19 pandemic, in primary care. We took a group of 86 patients with type 2 diabetes mellitus (T2DM) and monitored HbA1c, BMI, frequency of diabetic reviews, medication changes and symptoms throughout the pandemic. Evaluation of adherence to the NICE guidance during COVID-19 and the effects on these patients was made. The intervention was an MDT me...

Background: Neuroendocrine tumours (NET) are rare cancers arising from cells of the neuroendocrine system and frequently present with advanced disease. They are characterised by the presence of somatostatin receptors (SSTR) on the tumour surface. The presence of SSTR are associated with the inhibition of NET proliferation and have formed the basis of peptide receptor radionuclide therapy (PRRT), such as Lutathera. PRRT relies on SSTR tumour expression and patients without this...

History: A 54 years old gentleman was admitted to the hospital after being found unconscious at home by his wife with a tongue bite and urinary incontinence. He had perineal approach biopsy 2 days ago for prostate cancer. Since biopsy, he had poor urine output with clots and dribbling. He also gave 2 days history of constipation. Wife was a doctor and mentioned that she palpated a distended bladder the night before. On examination, he was haemodynamically stable although he di...

Case history: A 59-year-old lady with a background of type 2 diabetes, hypercholesterolemia and hypertension presented with a 3-week history of progressively worsening central abdominal pain and vomiting. Her drug history included bezafibrate and atorvastatin on which she was unable to meet her cholesterol and lipid targets and hence were stopped two weeks prior to her admission. The plan had been to start once fortnightly Alirocumab, a PCSK9 inhibitor; which had been delayed ...

Introduction: Thyroid Storm is a life-threatening but rare (incidence 0.2 per 100 000) disease state which presents as an extreme form of thyrotoxicosis. A hyper-metabolic state resulting from excessive thyroid hormone release which can be precipitated by both thyroidal and non-thyroidal illness.Case: In this case we discuss a 72 year old female with previously treated Graves disease who presented in thyroid storm one week after annual flu vaccination. O...

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We present a case of a 53 year-old lady with HIV, who was referred to the endocrine service with a random cortisol of <20 nmol/l. She complained of fatigue, appetite loss and 13 kg weight loss. She had a history of brain histoplasmosis, which had been successfully treated >5 years previously. At that time she required a short course of steroid therapy acutely. Short synachthen test revealed inadequate response (cortisol at 0 min: 378 nmol/l, 30 min: 481 nmol/l, 60 min:...

25% of Cushing’s syndrome cases are caused by cortisol producing tumours of the adrenal glands. Adrenalectomy is standard treatment followed by glucocorticoid replacement therapy until the hypothalamic-pituitary-adrenal axis recovers. We present a challenging case of adrenal insufficiency after unilateral adrenalectomy for Cushing’s syndrome. A 38 year-old woman was referred with hyperlipidaemia and uncontrolled hypertension diagnosed 4 years previously. Examination ...