The 16th Hammersmith Multidisciplinary Endocrine Symposium took place as planned on 3rd December 2021. Over 150 delegates from throughout the UK attended in person or online. An update on various aspects of adrenal disease was presented from the Imperial adrenal multidisciplinary team members: Dr Wernig presented the Hammersmith involvement in the international randomised trial of subclinical Cushing’s Syndrome, Prof Tan demystified syndromic phaeochromocytomasa and Dr Ali Alsafi explained what to look for in adrenal imaging. Comprehensive lectures on Neuroendocrine tumours were presented by Prof Martyn Caplin and Mikael Sodegren. The decision making algorithm in Graves’ disease was discussed by Dr Mark Vanderpump and the evolving field of the use of biomarkers in thyroid cancer diagnosis and targeted treatment was explained by Miss Aimee DiMarco. Dr Neill Duncan gave an outstanding talk on secondary hyperparathyroidism from renal disease.
One of the highlights of the meeting was the lecture on classic, normocormonal and normocalcaemic primary hyperparathyroidism (NCPHPT) by Dr Jeremy Cox. Dr Cox’s comprehensive explanation of the natural history of primary hyperparathyroidism and his complex case studies highlighted an unrivalled experience in the understanding in particular of NCPTPT. He explained the diagnostic challenges that occur in more subtle presentations of PHPT, the value of surgery when the diagnosis is robust and the diagnostic pitfalls that can lead to unnecessary surgery. The methods available to exclude secondary causes of the raised PTH was clearly presented and the published experience with the calcium load test discussed. Attendees took away the message that PHPT patients benefit from surgery but a careful endocrinological work up is essential especially in NCPHPT patients. The importance of an experienced parathyroid surgeon was discussed given that unlocalised disease is associated with often subtle findings.
Our department’s experience with unlocalised disease – including NCPHPT is due for publication in the Journal of Clinical Endocrinology & Metabolism in2022