Endocrine Abstracts

Introduction: UK guidelines state that all patients undergoing adrenalectomy for phaeochromocytoma must be admitted to intensive care post-operatively due to the risk of haemodynamic instability (HDI). Intensive care beds are a scarce resource and it is important to regularly evaluate the need for admission, preventing unnecessary admission.Methods: The study population included all patients who underwent adrenalectomy for phaeochromocytoma at a UK terti...

First line screening for pheochromocytoma, as recommend by Endocrine Society guidelines, is to determine plasma free or urinary fractionated metanephrines. We routinely offer the latter. Although negative results rule out pheochromocytoma, it is not uncommon to see borderline results which require further investigation. In this situation we have historically relied on the measurement of plasma catecholamines in the clonidine suppression test (CST). Plasma metanephrines, howeve...

Severe hyponatraemia (SHN, <120 mmol/l) is reported to be associated with mortality as high as 50%; although there are several international guidelines for management of SHN, there are few data on the impact of treatment. We have longitudinally audited our treatment outcomes of SHN. We present the results of three audit periods, of six months each, from 2005, 2010 and 2015. The three periods represented; 2005, prior to hospital policy for SHN, 2010, audit of impact of poli...

A 24 year old man presented with gait instability, myalgia, and cognitive decline, after a holiday in Crete; his alcohol intake exceeded 200 units/week. He had marked facial dysmorphism, with frontal bossing, and global muscle weakness. He had hypernatraemic dehydration (plasma sodium 175 mmol/l urea 16.9 mmol/l), but denied thirst. Urine concentration was 894 mOsm/kg, excluding diabetes insipidus. CK was elevated at 15,540 U/l. CT brain shown marked hydrocephalus. Rhabdomyoly...

Background: SIADH is the most frequent underlying cause of hyponatraemia but is frequently ignored and suboptimally treated.Aim: To identify the treatment applied in clinical practice for hyponatraemia due to SIADH and to evaluate the effect of fluid deprivation.Method: A prospective, non-intervention observational study of a sequentially evaluated cohort of hyponatraemic patients during first 48 h after hospitalization from Januar...

Introduction: The natural history of adipsic diabetes insipidus (ADI) is not completely understood. Isolated case reports suggest occasional recovery of adipsia. We present the follow up of a cohort of 12 patients with ADI.Setting: National pituitary unit with interest in diabetes insipidus.Methods: ADI was identified by demonstrating absent thirst and AVP responses to hypertonic saline infusion. Results 12 patients with ADI were i...

Background: Patients taking corticosteroids for immune suppression are vulnerable to adrenal crisis during intercurrent illness or if steroids are stopped abruptly. Although patients on glucocorticoids for adrenal failure are routinely provided with sick day rules, we wished to ascertain whether patients on immunosuppressive steroids are appropriately counselled.Aim: This study sets out to compare patient awareness of steroid sick day rules in endocrine ...

Introduction: Excess mortality due to hyponatraemia is well documented but it is not clear whether the mortality associated with SIADH is different to that associated with non-SIADH hyponatraemia (NSH).Methods/design: Prospective evaluation of all patients admitted with or developing hyponatraemia in a tertiary hospital (pNa <130 mmol/l) in January 2015. Diagnosis of SIADH was based on standard clinical and biochemical criteria (pNa, spot urine sodiu...

Aim: To estimate the prevalence and clinical significance of hyponatraemia in patients with lung cancer.Methods: The data were obtained from Hospital Registry. The serum sodium (SNa) on diagnosis was used for statistical comparisons. Normonatraemia is defined as SNa 135–144 mmol/l, hyponatraemia <135 mmol/l, and hypernatraemia >145 mmol/l. The data was analysed for small cell (SCLC), non-small cell (NSCLC) and unknown group where histologica...

The pulsatile release of GnRH regulates the synthesis and secretion of pituitary FSH and LH. Two transcription factors, the cAMP response element binding protein (CREB) and inducible cAMP early repressor (ICER), have been implicated in the regulation of rat FSHβ gene expression. We hypothesized that CREB and ICER are activated by distinct signaling pathways in response to pulsatile GnRH to modulate FSHβ gene expression, which is preferentially stimulated at low (ever...