Endocrine Abstracts

Background: Immune checkpoint inhibitors are now commonly used in melanoma, renal cell carcinoma and non-small cell lung cancers. Patients on immune check point inhibitors experience at least one type of immune related adverse event(irAEs) which can occur even after discontinuation of therapy. Endocrine toxicities are commonly reported irAE′s and tend to be irreversible. The most frequently recognized endocrine complications include thyroid dysfunction (30%) hypophysitis...

A 50 year-old lady was referred to the endocrine service for evaluation of significantly elevated 3-methoxytyramine (3-MT) levels. Past medical history included well controlled HIV and hypertension controlled by a single agent only (amlodipine). On one occasion, she was noted to have an elevated systolic blood pressure of 189 mmHg in clinic and therefore 24 h urinary metanephrines were requested. She did not have any other symptoms to suggest excess catecholamines. Systems rev...

Introduction: Traditionally the long synacthen test (LST) is used in some centres to assess hypothalamic/ pituitary and adrenal (HPA) axis. Evidence that it offers advantage over short synacthen test (SST) is lacking. Whilst changing our local protocol we evaluated 27 patients who had both tests in our trust. We compared the impact of the results in clinical decision making.Results: Mean age was 53 years. The indications for th...

Objective: Hyperprolactinaemia is one of the most common disorders of the hypothalamic-pituitary axis. Endocrine Society guidelines state that a single prolactin measurement in a blood sample obtained at any time of day is adequate to confirm hyperprolactinaemia. However, prolactin levels can be confounded by physiological stimuli, e.g sleep, stress or exercise. Our objective was to assess the clinical significance of prolactin level obta...

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

A 22-year-old female first presented in 2008 with a six-month history of galactorrhoea and irregular menses. She had hyperprolactinaemia (2401 mIU/L), a negative macroprolactin screen and her pituitary MRI scan demonstrated a 4 mm microadenoma. Her cannulated prolactin levels were >1500 mIU/L. TFTs, IGF-1, cortisol and remaining pituitary profile were within normal range.Cabergoline was commenced and gradually i...

: We report a case of a 56-year-old gentleman who presented to the endocrine clinic with erectile dysfunction. He had elevated SHBG levels, MCV, gamma GT, ferritin, iron and markedly elevated testosterone and transferrin saturation (GGT 167 IU/l, ferritin 1128 ug/l, testosterone 62.5 nmol/l). He had a marginally low platelet count (123X109/l). He denied ever taking testosterone supplements. His calculated free testosterone was normal. His full blood count was otherwise unremar...

Introduction: Traditionally the long synacthen test (LST) is used in some centres to assess hypothalamic/ pituitary and adrenal (HPA) axis. Evidence that it offers advantage over short synacthen test (SST) is lacking. Whilst changing our local protocol we evaluated 27 patients who had both tests in our trust. We compared the impact of the results in clinical decision making.Results: Mean age was 53 years. The indications for th...

Objective: Hyperprolactinaemia is one of the most common disorders of the hypothalamic-pituitary axis. Endocrine Society guidelines state that a single prolactin measurement in a blood sample obtained at any time of day is adequate to confirm hyperprolactinaemia. However, prolactin levels can be confounded by physiological stimuli, e.g sleep, stress or exercise. Our objective was to assess the clinical significance of prolactin level obta...