Endocrine Abstracts

On behalf of the Combined immunosuppression & radiotherapy in thyroid eye disease (CIRTED) InvestigatorsBackground: Thyroid eye disease is an inflammatory orbital condition which causes visual dysfunction and psychological morbidity. Current evidence is conflicting on the benefit of radiotherapy and antiproliferative immunosuppression in addition to systemic corticosteroid treatment. In particular, little is known about clinical outcomes mor...

Introduction: There has been a substantial increase in our knowledge of the genetic architecture of thyroid function, with numerous variants associated with TSH and/or FT4 levels. However, our knowledge of the genetic variants associated with thyroid disease is more limited.Methods: Data was obtained from the Neale laboratory† which provided a case-control study to identify single nucleotide polymorphisms associated with a diagnosis of hypothyroidi...

Context: Thyroid eye disease is disabling and disfiguring and has a substantial negative impact on quality of life. Medical therapies to reduce inflammation are widely used, but there is limited data from clinical trials beyond 6 months of follow-up. Methods: 3 year follow-up of a subset of the CIRTED trial (n = 68) which randomized patients to receive high-dose oral steroid with azathioprine/placebo and radiotherapy/sham radiotherapy. We compar...

Introduction: Thyroid quality indicators were removed from the Quality Outcome Framework (QOF) targets in 2014, resulting in discontinuation of statutory system alerts to remind GPs to check annual thyroid function in patients with primary hypothyroidism treated with levothyroxine.Aim: To investigate the impact of the discontinuation and reinstitution of the QOF thyroid e-alerts on the management of hypothyroidism in primary care.<p cla...

Introduction: Thyroid quality indicators were removed from the Quality Outcome Framework (QOF) targets in 2014, resulting in discontinuation of statutory system alerts to remind GPs to check annual thyroid function in patients with primary hypothyroidism treated with levothyroxine.Aim: To investigate the impact of the discontinuation and reinstitution of the QOF thyroid e-alerts on the management of hypothyroidism in primary care.<p cla...

Objective: Thyroid hormones are essential for maintaining metabolic balance and particularly influence lipid synthesis and degradation. Metabolomics and in-depth lipid profiling may enable us to assess for differential effects of thyroid hormones and provide insight into tissue thyroid status, that cannot be captured by levels of serum free thyroid hormones alone.Methods: 4,347 children from the Avon Longitudinal Study of Parents and Children who had thy...

Introduction: Around 15% of people diagnosed with primary hypothyroidism remain significantly symptomatic despite TSH normalisation with levothyroxine (LT4). The Thr92Ala substitution (rs225014) in a key deiodinase that activates T4 to T3, DIO2 may influence tissue levels of T3 but previous studies have been inconsistent regarding symptoms on LT4 and the presence of this polymorphism.Methods: We assessed HADS anxiety and depression scores in the HUNT2 st...

Introduction: Thyroid hormone replacement is frequently suboptimal but interventions that are proven to optimise therapy are lacking. In 2017, we developed in EMIS an electronic Protocol for Monitoring Patients on Thyroxine in General Practice (‘e-Prompt GP’), to offer automated alerts to prompt GP's to test and address out of range thyroid function tests in patients with hypothyroidism.Aim: To investigate the long-term impact of an electronic ...

Background: Clinically significant Graves’ orbitopathy (GO) develops in 20% of those with Graves’ Disease (GD). Up to 90% of cases present at the same time as, or after, hyperthyroidism develops. Most cases of GD in the UK are managed in endocrinology clinics. Despite this, patients report significant delays before a correct diagnosis of GO is made. We argued that measures to increase awareness of the early signs of GO in those with GD and establishing a fast-track r...

Introduction: Following the introduction of the Quality Outcome Framework (QOF), 98–100% patients with hypothyroidism received annual TSH checks during the period 2009–2014. However, there was no evidence this resulted in improved care. We have developed an electronic protocol in EMIS web to both emulate the former QOF thyroid e-alerts in prompting GP’s to check annual thyroid function in patients with treated primary hypothyroidism, and also to alert if TSH is ...