Endocrine Abstracts

Advances in the treatment of acromegaly mean biochemical 'cure ' should be possible in the vast majority of patients. The challenge of the future will be designing treatment algorithms to optimise outcomes for individual patients, to ensure not only life expectancy but also QOL is normalised. QOL data is lacking in acromegaly, as is a disease-specific tool for measuring QOL. ACROQOL is a disease-specific QOL questionnaire compromising 22 questions (scored 1-5, high score good)...

Case history: A 42-year old female was urgently referred to the endocrinology clinic. Symptomatology included worsening lethargy, polydipsia, poor appetite, postural dizziness and hypogalactia. Relevant background included the delivery of a healthy baby at term four weeks prior (Emergency caesarean section, 1000 ml blood loss documented). She had undergone an MRI at 39 weeks gestation following a 10-day history of persistent headaches with associated photophobia and dizziness ...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Background: Hyponatraemia (most commonly secondary to SIADH) is very common in cancer patients; it is associated with delays to oncology treatment and mortality.Aim: To evaluate the number of patients with hyponatraemia at a tertiary referral cancer centre and assess adherence to national recommendations for investigations and treatment.Methods: All biochemistry results (in-patient and outpatient) analys...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Background: Hyponatraemia (most commonly secondary to SIADH) is very common in cancer patients; it is associated with delays to oncology treatment and mortality.Aim: To evaluate the number of patients with hyponatraemia at a tertiary referral cancer centre and assess adherence to national recommendations for investigations and treatment.Methods: All biochemistry results (in-patient and outpatient) analys...

Case history: A 53-year-old male with melanoma who had a previous surgical excision of his skin lesion in December 2018 was being treated with adjuvant pembrolizumab. In June 2019 his treatment changed to combination immune checkpoint inhibitor therapy (ICPi) with ipilimumab and nivolumab due to radiological recurrence.Investigations: There were no pre-ICPi endocrine investigations available. In July 2019, thyroid function tests (TFTs) showed thyroid-sti...

Case History: A 53 year old woman presented with a 12-month history of progressive hirsutism and deepening of her voice. Her symptoms coincided with the onset of the menopause. On clinical examination she had evidence of virilisation with muscle hypertrophy.Investigations: Biochemical tests revealed a serum testosterone (serT) of 30 nmol/l, a DHEA-Sulphate of 1.5 umol/l (1.0–12.0), an androstenedione of 3.2 nmol/l (0.0–6.0), a post-overnight de...

Introduction: Late-night salivary cortisol assessment is an important element when investigating suspected Cushing’s syndrome (CS). The goal of medical therapy is achieving a mean (of 5 samples during a single day) serum cortisol (serumF) of 150–300 nmol/l (Cushing Day Curve [CDC]). Metyrapone is an 11β-hydroxylase inhibitor elevating levels of 11-deoxycortisol causing conventional immunoassay (IA) to overestimate SerumF; a problem obviated by LC–MS/MS. We ...

Introduction: Hypoparathyroidism is most commonly observed following neck surgery and is characterized biochemically by deficient parathyroid hormone (PTH) and hypocalcaemia alongside hyperphosphataemia and reduced 1,25-dihydroxyvitamin D. Standard treatment with oral calcium and vitamin D aims to maintain serum calcium within the low-normal range whilst avoiding hypercalciuria due to over replacement. However, concerns remain over the presence of hypercalciuria and the associ...