Endocrine Abstracts

Background: The accuracy of thyroglobulin (Tg) as a tumour marker following lobectomy for differentiated thyroid cancer (DTC) remains controversial. A Tg (<10 µg/l) looked promising in identifying those without clinically apparent recurrence after median 51 months of follow-up. Longer term follow up allows assessment of the diagnostic utility of thyroglobulin in predicting relapse.Methods: Ninety-nine patients who underwent lobectomy for DTC wer...

Introduction: There is great variation in management of perioperative cortisol management in patient’s undergoing pituitary surgery across UK Hospitals. We evaluated safety and effectiveness of standards followed in ARI. The aim of audit was to confirm safety, improve knowledge and change practice for better patient care if needed based on information gained from the available data.Description of methods/design: We evaluated 30 patients who have und...

Introduction: Low dose radioiodine (LDRAI) has been used to treat benign thyroid disease for over 70 years (1). However, controversies remain about the optimal dosage to administer. The Royal College of Physicians guidelines recommend a dosage of 400–600 MBq for uncomplicated Graves’ disease (2); the dose administered varies between centres.Methods: Outcome data at Edinburgh Royal Infirmary were collected retrospectively for patients who receiv...

Background: While few hypothyroid patients require more than the expected weight related dose of levothyroxine, the underlying causes of larger-than-expected dosing requirements have not been studied in a single cohort. Our aim was to determine and quantify the multiple factors contributing to high dose levothyroxine requirements in a cohort of patients with hypothyroidism.Methods: The Grampian Automated Follow-Up Register (GAFUR) monitors around 17 500 ...

Introduction: In our institution the post high-dose RAI whole body scan (WBS) report includes a measurement of quantitative percentage uptake of the dose of RAI administered although this may not be standard practice elsewhere. We aimed to ascertain whether this was associated with the extent of unresected thyroid tissue or residual thyroid cancer following total thyroidectomy and neck dissection represented by the post-surgery TSH-stimulated thyroglobulin concentrations. Meth...

Case report: A 33-year-old pregnant Nigerian woman presented at 37 wks gestation with a 2-week history of frequent headaches and visual disturbance. She had persistent galactorrhoea following previous pregnancy in 1998, which settled after a short course of bromocriptine. On examination, she had classical bitemporal hemianopia. Her prolactin was raised at 19,220 mU/L (higher than expected in a normal pregnancy), random cortisol 553 nmol/L and thyroid function tests satisfactor...

The widespread use of cross-sectional imaging has led to increased detection of adrenal masses in 2% of general population and over 7% of those above age 70. Although majority are benign, it is important to exclude hormonally active or malignant lesions. Mild autonomous cortisol secretion (MACS) is the most common and found in 30-50% of patients with adrenal mass. We reviewed our adrenal incidentaloma database for patients who attended the nurse-led pathway for biochemistry in...

Using nurse led clinics (including telephone and virtual reviews) in NHS Grampian to improve patient satisfaction following a diagnosis of hyperthyroidism.Aims: To reduce waiting times for patients with hyperthyroidism, nurse led clinics were introduced. Telephone and virtual follow up reviews are offered after commencement of thyroid treatment (e.g. anti-thyroid medication or radioactive iodine (RAI)). Nurse-led thyroid clinics aim to i...

Background /Methods: Adrenal incidentalomas pose a significant burden to endocrinology services in assessing the clinical significance of these lesions. Following vetting of the incidentaloma referrals, the patients at our centre are initially seen in a nurse-led clinic for biochemical investigations and to ensure completion of radiology assessment using a structured proforma. This step facilitates efficient patient flow and quicker decision making. The clinical outcomes of th...

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...