Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2016

Brighton, UK
07 Nov 2016 - 09 Nov 2016

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07 Nov 2016 to 09 Nov 2016 Brighton, UK Further information

ea0044p233 | Thyroid | SFEBES2016

The use of the radiologically determined U grading for Thyroid Nodules prior to Fine Needle Aspiration is a reliable and highly Predictive way to determine Abnormal Cytology

Ahmad Ehtasham , Plictha Aleksandra , Joseph Stonny

Controversy exists as to the best way to determine which thyroid nodules we should have fine needle aspiration (FNA). The lack of consensus in the British and American Thyroid Association guidelines has not helped to clarify this. The use of ultrasound scan (USS) determined U grading versus a composite of nodule size and pre-determined number of suspicious features continues to be debated. We therefore set out to compare the accuracy of U grading with other identified USS feat...

ea0044p234 | Thyroid | SFEBES2016

Serum thyroid function, mortality and disability in a cohort of 85 year olds

Razvi Salman , Yadegarfar Mohammad , Martin-Ruiz Carmen , Kingston Andrew , Collerton Joanna , Visser Theo , Kirkwood Tom , Jagger Carol , Pearce Simon

Perturbations in thyroid function are common in older individuals but their significance in the very old is not fully understood. We examined thyroid hormone status (serum TSH, FT4, FT3, rT3) at baseline in a cohort of 643 85-year-olds and followed their mortality and disability outcomes for 9 years. All cause mortality, cardiovascular mortality and disability according to categorical thyroid disease status and baseline thyroid hormone paramete...

ea0044p235 | Thyroid | SFEBES2016

Hypothyroidism induces hyperplasia of unilocular adipocytes in perirenal adipose tissue of the ovine fetus

Harris Shelley E , De Blasio Miles J , Wooding FB Peter , Blache Dominique , Meredith David , Fowden Abigail L , Forhead Alison J

Thyroid hormones are important regulators of fetal growth, although their mechanism of action remains unclear. In the sheep fetus, thyroid hormone deficiency increases plasma insulin and leptin concentrations. This study investigated the effects of hypothyroidism on perirenal adipose tissue (PAT) development and adipose insulin signalling pathways in fetal sheep.All procedures were performed under the UK Animals (Scientific Procedures) Act 1986. In 10 tw...

ea0044p236 | Thyroid | SFEBES2016

Increasing awareness of Graves’ orbitopathy with “Early Warning” cards – a TEAMeD multicentre quality improvement project

Mitchell Anna L , Zammitt Nicola , Ajjan Ramzi , Vaidya Bijay , Hickey Janis , Perros Petros , Dayan Colin

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...

ea0044p237 | Thyroid | SFEBES2016

Management and investigations of woman with hypothyroidism before and during pregnancy in a joint Medical/Obstetric clinic a DGH

Balafshan Tala , Chattington Paula , Llewellyn Oliver

Maternal thyroid hormones play a critical role in foetal brain development in the first 12 weeks of gestation. Children born to hypothyroid mothers, especially those undertreated, are more likely to suffer lower IQ. Based on BES guidance 2007 and NICE 2011 at confirmation of pregnancy a woman with hypothyroidism should immediately increase the dose of levothyroxine by 25–50 mcg with aim TSH of less than 2.5 mu/l as soon as possible with monitoring of TFT every 4 weeks.</p...

ea0044p238 | Thyroid | SFEBES2016

Five year follow-up of patients who received radio-iodine therapy at district general hospital

Abusahmin Hussam

Background: Radioiodine is used as a method of treating hyperthyroidism secondary to Grave’s disease and toxic goitres. Radioiodine therapy most often results in patients becoming hypothyroid, however a small percentage of patients (around 10–20%) require repeated doses to treat persistent hyperthyroidism.Aim: The aim of this audit was to determine the outcome of patients who received radioiodine for hyperthyroidism over 5 years period.<p c...

ea0044p239 | Thyroid | SFEBES2016

Optimising the medical treatment of Graves’ Disease through developing a novel carbimazole dosing-algorithm

Brewster Rosalind , Abbara Ali , Clarke Sophie , Comninos Alexander , Peters Deborah , Sam Amir , Meeran Karim , Dhillo Waljit

Introduction: Graves’ disease is the commonest cause of hyperthyroidism accounting for 80% of all cases. The first line treatment for Graves’ disease in the UK is medical therapy, most frequently using a ‘dose-titration’ regimen. Currently, there is a lack of guidance to aid clinicians in carrying out optimal dose-titration of carbimazole, resulting in a risk of under- or over-treatment. Thus, we aimed to develop a carbimazole dosing-algorithm for the medic...

ea0044p240 | Thyroid | SFEBES2016

Epidemiology, management and outcomes of Graves’ disease in a U.K. Population – a Retrospective Cohort Study

Hussain Yusuf , Hookham Jessica , Allahabadia Amit , Balasubramanian Sapabathy

Background: Graves’ disease is the commonest cause of hyperthyroidism. Although first line and definitive treatment options are clearly defined, management practices and the natural history in terms of outcomes of treatment in a large consecutive cohort of Graves’ disease has not been well characterised.Aims: To describe incidence, presentation, diagnosis, management strategies and medium term outcomes following anti-thyroid drug treatment, rad...

ea0044p241 | Thyroid | SFEBES2016

Contrasting phenotypes in Resistance to Thyroid Hormone α correlate with divergent properties of thyroid hormone receptor α1 mutant proteins

Moran Carla , Agostini Maura , McGowan Anne , Schoenmakers Erik , Fairall Louise , Lyons Greta , Rajanayagam Odelia , Watson Laura , Offish Amaka , Barton John , Price Susan , Schwabe John , Chatterjee Krishna

Resistance to Thyroid Hormone alpha (RTHα) is characterised by tissue-selective hypothyroidism with near-normal thyroid function tests, and is due to thyroid receptor α gene mutations. We sought to correlate the clinical characteristics and response to thyroxine treatment of two RTHα patients with the properties of their defective TRα proteins.Clinical, biochemical and physiological parameters were assessed in each patient at baseline...

ea0044p242 | Thyroid | SFEBES2016

Occupational disability and access to psychological tools in thyroid eye disease

Kim Jennifer , Cook Anne , Higham Claire

Purpose: To evaluate the impact of thyroid eye disease (TED) on occupational disability and access to psychological input. Previous European studies have demonstrated a negative effect of TED on occupation but there are no similar UK studies.Methods: 102 outpatients under the age of 75 were identified for participation from a joint thyroid eye clinic at a tertiary centre. 42 completed a standardised fixed-choice questionnaire about occupational disabilit...

ea0044p243 | Thyroid | SFEBES2016

Evaluation of clinical diagnosis of Graves’ or Non-Graves’ Hyperthyroidism Compared to Gold-Standard TRAb Test

Bell Lauren , Syed Akheel

Background: TSH receptor antibody (TRAb) measurement, with a sensitivity of >97% and specificity of 100%, is considered the gold standard investigation for diagnosing Graves’ disease (GD).Aim: To evaluate clinical diagnosis of GD or non- GD hyperthyroidism at a University Teaching Hospital compared to TRAb result.Methods: Electronic records of patients who had a TRAb measurement between December 2009 and October 2015 were ...

ea0044p244 | Thyroid | SFEBES2016

TIGIT gene variants and thyroid disease susceptibility in dogs and humans

Bhatnagar Ishita , Massey Jonathan , Kennedy Lorna , Ollier William , Cordell Heather , Pearce Simon , Mitchell Anna

Background: The autoimmune thyroid diseases, primary autoimmune hypothyroidism (AH) and Graves’ hyperthyroidism (GD), represent the most prevalent endocrine disorders. Although clinically distinct, they share several genetic susceptibility loci, many of which remain unidentified.TIGIT (T cell immunoreceptor with immunoglobulin and ITIM domains), expressed on the surface of T-cells, interacts with CD-155 on dendritic cells to form an alternative cost...

ea0044p245 | Thyroid | SFEBES2016

Thyroid autoimmunity as a biomarker of breast cancer outcome: large-scale study using data from the Taxotere as Adjuvant Chemotherapy Trial (TACT: CRUK01/001)

Muller Ilaria , Kilburn Lucy , Taylor Peter , Barrett-Lee Peter , Bliss Judith , Paul Ellis , Marian Ludgate , Dayan Colin

Background: An association between breast cancer (BC) and thyroid autoimmunity has been frequently observed, and several small-scale studies correlated the presence of autoantibodies to thyroid peroxidase (TPOAb) with an improved BC outcome. We aimed to clarify in a large cohort of patients whether circulating TPOAb are prognostic for BC recurrence.Materials and methods: Available plasma samples for patients with node-positive or high-risk node-negative ...

ea0044p246 | Thyroid | SFEBES2016

High tumoral expression of PBF and PTTG modulates the DNA damage response and is associated with poor survival in thyroid cancer

Read Martin , Fong Jim , Imruetaicharoenchoke Waraporn , Nieto Hannah , Modasia Bhavika , Fletcher Alice , Thompson Rebecca , Sharma Neil , Bacon Andrea , Watkinson John , Boelaert Kristien , Turnell Andrew , Smith Vicki , McCabe Christopher

Despite extensive genomic profiling a better understanding of the contributory factors that promote aggressive thyroid cancer is urgently needed. The proto-oncogenes PBF and PTTG have been implicated in thyroid cancer but there is a lack of information regarding their co-expression and specific roles in tumour progression. Separate studies have previously indicated that PBF and PTTG may disrupt pathways associated with the tumour suppressor p53 that are central to DNA-damage r...

ea0044p247 | Thyroid | SFEBES2016

Aiming for a serum TSH in the higher reference range in older levothyroxine treated hypothyroid individuals – a randomized controlled proof of concept trial (SORTED 1)

Razvi Salman

Context: Serum TSH reference range increases with age but target TSH is similar in younger and older hypothyroid patients on treatment. It is unknown if quality of life (QoL), hypothyroid symptoms and cardiovascular (CV) risk factors change in older patients in whom a higher serum TSH is aimed for.Objective: To assess if a higher target serum TSH of 4.01–8.0 mU/l is feasible in and acceptable to older treated hypothyroid patients.<p class="abste...

ea0044p248 | Thyroid | SFEBES2016

One third of thyroid radionuclide uptake scans is deferentially interpreted leading to potentially differential treatment for patients with thyrotoxicosis

Aziz Aftab , Avades Tamar , Poyner Richard , Vaidya Bijay , Patel Kashyap

Background: Accurate diagnosis of an underlying cause of thyrotoxicosis is critical for targeted therapy. Thyroid radionuclide uptake scan is a useful second line investigation in patients who lack TSH receptor antibody. The uptake scan patterns identify patients who can be preferentially treated with anti-thyroid drugs (diffuse pattern - Graves’ disease) or radio-iodine treatment (patchy uptake - multinodular or localised uptake – toxic adenoma) or simple monitoring...

ea0044p249 | Thyroid | SFEBES2016

ESR2 mutations in RET mutation-negative familial medullary thyroid carcinoma

Afghan Wazir K. , Iacovazzo Donato , Alevizaki Maria , Foulkes William , Lugli Francesca , Druce Maralyn , Dutta Pinaki , Dang Mary N. , Gabrovska Plamena , Morrison Patrick J. , Owens Martina , Ellard Sian , Sampson Julian , De Marinis Laura , Korbonits Marta

Introduction: Approximately 25% of medullary thyroid cancer (MTC) cases arise in a familial setting, either as MEN2 or fMTC. While most of these are caused by mutations in the RET gene, a few families have unidentified mutations. Recently, a frameshift mutation in the ESR2 gene (coding oestrogen receptor beta) was found in a family with RET-negative fMTC associated with C-cell hyperplasia. In vitro, transfection of mutant ESR2 led t...

ea0044p250 | Thyroid | SFEBES2016

Auditing outcomes post radioiodine therapy in patients with hyperthyroidism

Vimal Venugopal , Carone Vito , Macriyiannis Thrasos , Levy Miles

Objectives: To evaluate outcomes post radioiodine (I-131) therapy for hyperthyroidism at a tertiary hospital in a two-year period.Method: The local database (Leicester Clinical Workstation) was used to identify patients with hyperthyroidism who had received radioiodine therapy (RAI) between January 1st 2010 and December 31st 2011 and their records were retrospectively analysed.Results: 84 patients were identif...

ea0044p251 | Thyroid | SFEBES2016

Distribution of free T4 levels in patients with low-risk thyroid cancer on thyroid hormone replacement and pituitary diseases: comparison with the normal population

Seejore Khyatisha , Kyriakakis Nikolaos , Gerrard Georgina , Gill Vanessa , Murray Robert D

Background: Diagnosing secondary hypothyroidism can be challenging, particularly for patients with low-normal free T4 (fT4). Thyroid hormone replacement (THR) in these cases is guided by the normal population fT4 range. The aim of this study was to compare thyroid function tests in thyroid cancer patients on THR and patients with pituitary diseases with or without central hypothyroidism.Methods: We retrospectively collect...

ea0044p252 | Thyroid | SFEBES2016

Weight-related concerns in endocrine outpatients and its relationship to thyroid function

Kyriacou Angelos , Kyriacou Alexis , Economides Nicholas

Introduction: Weight concerns are common in endocrine outpatients. Weight indices seem to have a complex interaction with thyroid function. The two have not been studied in eastern Mediterranean populations.Methods: Prospective collection of baseline data on weight, BMI and thyroid function on consecutive patients presenting to an endocrinology outpatients. The setting included a medical centre in Limassol, Cyprus. Exclusion criteria were as follows: age...

ea0044p253 | Thyroid | SFEBES2016

Prognostic factors of unsuccessful medical treatment of hyperthyroidism; longitudinal analysis of outcomes in the cohort of 538 patients

Torlinska Barbara , Johnson Oliver , Boelaert Kristien

A prolonged course of antithyroid drugs (ATD) is commonly used as first line treatment in patients with hyperthyroidism, although long term cure rates are poor – 40–50%. We performed a longitudinal analysis of outcomes in patients treated with a complete course of ATD and identified factors predicting remission.583 consecutive patients with newly diagnosed hyperthyroidism presenting between 2005 and 2014 and treated with ATD for a minimum of 6 ...

ea0044p254 | Thyroid | SFEBES2016

An Audit on Fixed dose (555 MBq) Radioactive-iodine for Hyperthyroidism at a University Hospital

Vijay Arun Muthukaruppan Alagar , Cooper Julie , Varadhan Lakshminarayanan , Nayak Ananth U

Background/Aim: Radioactive-iodine (RAI) therapy aims to cure hyperthyroidism, with some International authorities recommending a sufficient RAI dose to render patients hypothyroid. An audit on low dose RAI (<400 MBq) at our University Hospital in 2014 suggested above national average rates of Thyrotoxicosis relapse (24%) and lower rates of hypothyroidism (41%) 6-months post RAI. From 2015, a fixed dose (555 MBq) RAI was utilised and we present the audit outcomes using thi...

ea0044p255 | Thyroid | SFEBES2016

Comparison of post-operative histology versus pre-operative cytology in thyroidectomy patients who had two pre-operative fine needle aspirates (FNA)

Gill Gurmit , Kalidindi Sushuma , Wilson Paul , Kalyansundaram Karthik , Varughese George , Varadhan Lakshminarayanan

Aim: Patients with thyroid nodules, usually undergo FNA, prior to considering surgery however the results may not be conclusive. Our aim is to compare the cytology results in patients who have had two FNA’s with post-operative histology.Methods: All patients who have had thyroidectomy and two pre-operative FNA’s over 7 years were identified. Post-operative histology and FNA cytology was collected from pathology records. Standard ‘Thy’...

ea0044p256 | Thyroid | SFEBES2016

How effective are thyroid ultrasound and cytology compared to histology in identifying thyroid malignancy in thyroidectomy patients?

Kalidindi Sushuma , Gill Gurmit , Varughese George , Varadan Lakshminarayanan

Aim: Investigation of thyroid nodules usually involves an ultrasound and fine needle aspiration (FNA); however it could still be challenging to devise a management plan based on these. The aim of our study was to compare the reliability of two thyroid FNA’s and ultrasound in comparison to post-operative histology in managing thyroid nodules.Methods: The data on patients who had underwent thyroidectomy and had at least two FNAs and Ultrasound pre-ope...

ea0044p257 | Thyroid | SFEBES2016

Vitamin D supplementation in Graves’ disease and risk of relapse

Ashraff Suhel , Addison Caroline , Tsatlidis Vasilieos , Razvi Salman

Background: Graves’ disease (GD) is an auto-immune condition where the thyroid gland produces excess hormones due to stimulation of the TSH receptor. Treatments for GD have largely remained unchanged for over 60 years. The commonest treatment strategy is to use anti-thyroid drugs (ATD) which has limited efficacy and may have serious side-effects. Newer therapies are required that will supplement existing therapies and impact on the underlying immune mechanisms of GD. Vita...

ea0044p258 | Thyroid | SFEBES2016

The fluctuating clinical and biochemical thyroid status of patients with oscillating TSH receptor antibody predominance

Wordsworth Georgina , Anguelova Lia , Robinson Tony

TSH receptor antibodies (TRAb) are autoantibodies directed against the TSH receptor, predominantly located on the thyroid epithelial cell surface. Two types of TSH receptor antibody have been found to exist in patients with autoimmune thyroid disease: thyroid stimulating antibodies (TSAb) and TSH-stimulation blocking antibodies (TSBAb). It has generally been felt that patients with positive TSAbs develop Graves’ hyperthyroidism and those with TSBAb antibodies develop hypo...