Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

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The Society for Endocrinology BES will take place 19-21 Nov 2018 in Glasgow. Come and exchange knowledge, share experiences and strengthen collaborations across our global community of endocrinologists.

ea0059p200 | Thyroid | SFEBES2018

Controlled Antenatal Thyroid Screening (CATS) II: long-term cardiometabolic effects of treating maternal sub-optimal thyroid function

Muller Ilaria , Daniel Rhian , Hales Charlotte , Scholz Anna , Yin Xiaochen , Candler Toby , Pettit Rebecca , Evans William , Taylor Peter , Shillabeer Dionne , Draman Mohd , Dayan Colin , Tang Carolyn , Okosieme Onyebuchi , Gregory John , Lazarus John , Rees Aled , Ludgate Marian

Objectives: The Controlled Antenatal Thyroid Screening (CATS) study I was a randomised trial investigating the effects of levothyroxine treatment for suboptimal gestational thyroid function (SGTF), evaluating mothers with normal gestational thyroid function (NGTF), SGTF who received (SGTF-T), or didn’t (SGTF-U), levothyroxine during pregnancy. The present follow-up study (CATS II) reports the long-term effects of SGTF and levothyroxine treatment on anthropometric and card...

ea0059p201 | Thyroid | SFEBES2018

Targeted sequencing of dyshormonogenesis-associated genes in Macedonian cases with congenital hypothyroidism and gland-in-situ reveals a low mutation frequency

Zdraveska Nikolina , Kocova Mirjana , Nicholas Adeline K , Anastasovska Violeta , Schoenmakers Nadia

Neonatal screening for congenital hypothyroidism (CH) in the Republic of Macedonia was piloted in 2002 and implemented nationally in 2007, demonstrating a CH incidence of 1 in 1916. 52.7% cases exhibit a normally-located gland-in-situ (GIS CH), however, although this may indicate genetically-mediated dyshormonogenesis, genetic stratification has not previously been undertaken. We selected singleton GIS CH cases (n=22), born at term, with birth weight >3000 g in wh...

ea0059p202 | Thyroid | SFEBES2018

Rate of progression of subclinical hypothyroidism to overt hypothyroidism: a 10-year retrospective study from UAE

Alameri Majid , Wafa Wafic , Moriarty Maura , Lessan Nader , Barakat Maha T

Introduction: Limited data is available on the natural history of thyroid disorders in the Middle East. We aim to report the rate of progression of subclinical hypothyroidism to overt hypothyroidism specifically for the UAE population.Methods: Retrospective analysis was performed on all patients attending Imperial College London Diabetes Centres in the UAE over ten years from 2007 to 2017, with a diagnosis of spontaneous subclinical hypothyroidism (TSH &...

ea0059p203 | Thyroid | SFEBES2018

Characterization of thyroid nodules in acromegalic patients

Trifanescu Raluca , Galoiu Simona , Niculescu Dan , Baciu Ionela , Capatina Cristina , Radian Serban , Poiana Catalina

Background: Thyroid nodules were reported with high prevalence in acromegalic patients.Patients and methods: 63 acromegalic patients (16 males and 47 females), aged at diagnosis 43.6±12.7 years were retrospectively reviewed. Median duration of acromegaly was 8 years. 25 patients were residents in iodine deficient areas. GH, IGF1, TSH, FT4 were measured by chemiluminescence (Liaison). Thyroid ultrasound was performed. In suspected nodules,...

ea0059p204 | Thyroid | SFEBES2018

Evaluation of the Mental Health and Quality of Life of patients with hyperthyroidism attending an Endocrine Clinic

Kalaria Tejaskumar , Chopra Roopa , Gherman-Colic Carolina , Raghavan Rajeev , Viswanath Ananth , Buch Harit , Kar Nilamadhab

There is scant literature on various mental health parameters following treatment of hyperthyroidism. We present our initial results from an ongoing quality improvement project, jointly undertaken by the Endocrinology and Psychiatry teams.Aim: To evaluate anxiety, depression, ability to work and quality of life (QOL) of patients with hyperthyroidism on presentation and after institution of specific therapy.Method: We assessed 68 ne...

ea0059p205 | Thyroid | SFEBES2018

A second course of antithyroid drug therapy is effective in patients with relapsed Graves’ disease

Seejore Khyatisha , Nawaz Fozia , Kelleher Katherine , Kyaw-Tun Julie , Lynch Julie , Murray Robert D

Background: Antithyroid drugs (ATDs) are preferred as a first-line treatment for Graves’ disease (GD). However, around 50–60% of patients relapse following treatment withdrawal. Radioactive iodine (RAI) or thyroidectomy is recommended for these patients, however, repeat ATD therapy is a further option, dependent upon patient choice. The long-term efficacy of ATD in relapsed GD has not been robustly established.Methods: We conducted a retrospect...

ea0059p206 | Thyroid | SFEBES2018

Iodine restricted diet prior to radioiodine therapy for hyperthyroidism

Nabi Assad , Weekes Joanne , Krishnasamy Senthilkumar , Buch Harit

Background: There has been conflicting evidence on the use of strict dietary iodine restriction prior to Radioiodine (RAI) administration for the management of hyperthyroidism and varying level of restrictions have been used. More recently the Medical Physics team in our institute implemented strict dietary iodine restrictions for 2 weeks pre-RAI administration. Significant inconvenience was reported by patients, which in some instances led to their reluctance to receive a sec...

ea0059p207 | Thyroid | SFEBES2018

Can we predict relapse of Graves’ disease after antithyroid drug therapy?

Seejore Khyatisha , Kelleher Katherine , Nawaz Fozia , Kyaw-Tun Julie , Lynch Julie , Murray Robert D

Background: Current therapeutic options for Graves’ disease (GD) include antithyroid drugs (ATD), radioactive iodine (RAI) or thyroidectomy. ATD treatment is widely used but the relatively high recurrence rate (~50%) after ATD discontinuation is a major concern. Identification of risk factors predicting relapse in GD patients after stopping ATD is decisive to guide initial treatment choices.Methods: We conducted a retrospective study to determine th...

ea0059p208 | Thyroid | SFEBES2018

Clinico-pathological correlation of U3 thyroid nodules: A retrospective review

Ellatif Mostafa , Idowu Oluwagbemiga , Khalid Neelam , Darko Daniel , Lingam Ravi , Tran Tan , Tolley Neil , Khatri Pushpa , Muralidhara Koteshwara

Background: The incidence of thyroid cancer is increasing globally mainly due to increased detection of papillary microcarcinoma. The British Thyroid Association (BTA) guideline (2014) recommends the use of U1-U5 classification on ultrasound to assess thyroid cancer risk. U3 nodules have low, but indeterminate risk and therefore need FNAC. This retrospective review analyses the outcome of U3 nodules in an outer London hospital.Methods: Thyroid ultrasound...

ea0059p209 | Thyroid | SFEBES2018

Low dose rituximab for thyroid eye disease: an effective treatment with fall in TSH receptor antibodies (TRAb)

Suarez Annabel , Keren Shay , Norris Jonathan , David Joel , Turner Helen E

Background: Thyroid eye disease (TED) is an autoimmune inflammatory disease associated with Graves’ disease. Rituximab (a monoclonal antibody that depletes B-cells), has recently been shown to be effective in treating TED. There is evidence to support an association with increased TRAbs and TED severity, and one study has demonstrated a fall in TRAbs with rituximab therapy. The aim of this study was to assess the clinical efficacy of low dose rituximab in patients with TE...

ea0059p210 | Thyroid | SFEBES2018

Weight gain with hyperthyroidism therapy: a prospective pilot study

Kyriacou Angelos , Kyriacou Alexis , Syed Akheel A , Perros Petros

Introduction: It is currently unclear how hyperthyroidism and its treatment impact on the weight trajectory of an individual. Anticipated weight gain with the treatment of hyperthyroidism is one of the main concerns of patients.Methods: We prospectively examined the BMI changes that occurred with hyperthyroidism and its therapy and sought risk factors for treatment-related weight gain. An established institutional protocol for the management of hyperthyr...

ea0059p211 | Thyroid | SFEBES2018

Ultrasonographic features and management of thyroid nodules undergoing ultrasound-guided fine needle aspiration

Attard Carol Cardona , Psaila Alison , Buttigieg Lisa , Gruppetta Mark

Introduction: Thyroid nodules can be detected in 50 to 60% of healthy individuals, particularly in the elderly and females. An increase in differentiated thyroid cancer has been noted over the years, especially papillary thyroid cancer.Objectives: To assess different approaches to management and histological nature of thyroid nodules in Malta, as well as to evaluate the association of ultrasound characteristics with biochemical and histological features....

ea0059p212 | Thyroid | SFEBES2018

Low Dose Radioiodine Therapy for Graves’ disease: comparison of outcomes following administration of different doses across two centres

Sawhney Natasha , Diaz-Ortega Carmen , Philip Sam , Gibb Fraser , Abraham Prakash , Graveling Alex

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...

ea0059p213 | Thyroid | SFEBES2018

Outcomes following radioactive iodine therapy (RAI) in hyperthyroid patients with Grave’s disease and toxic nodular disease

Aljenaee Khaled , McDonnell Tara , Cooke Jennie , Phelan Niamh , Pazderska Agnieszka , Healy Marie-Louise

Background: RAI is used as definitive treatment for hyperthyroidism, but administered activities vary between institutions. We used a fixed activity of RAI therapy for Grave’s disease (GD) and toxic multinodular goitre (TMNG), and calculated activity for toxic adenoma (TA). We reviewed treatment outcomes at one year.Methods: Thyroid function tests 1 year post RAI were reviewed retrospectively to asess outcome for 79 hyperthyroid patients divided int...

ea0059p214 | Thyroid | SFEBES2018

Evaluation of a high sensitivity thyroglobulin assay for use in patients following total thyroidectomy and radioiodine ablation treatment

Frank Amy , Smith Karen

Background/aims: Thyroglobulin (Tg) is used for monitoring patients who have undergone total thyroidectomy (TT) and radioiodine (RAI) ablation therapy for thyroid cancer. The current method is the Siemens Immulite assay with limit of quantification of 2 ng/mL following in-house evaluation. Recent guidelines suggest the use of high sensitivity Tg (hs-Tg) as an alternative to TSH stimulated Tg levels. The aim is to evaluate the hs-Tg Beckman Access II assay with a stated functio...

ea0059p215 | Thyroid | SFEBES2018

Utility of fetal thyroid scanning in pregnancy: experience in a single centre

Carty David , Wardall Jennifer , Mackenzie Fiona , Scott Avril , Gardiner Elaine , Lindsay Robert

Background: Guidelines from ATA and the Endocrine society suggest the use of fetal thyroid monitoring in maternal Graves’ disease to detect fetal thyrotoxicosis or hypothyroidism in response to maternal thyroid receptor antibodies (TRAb) or thionamide therapy respectively. The literature examining how effective this policy is remains sparse, since these remain unusual clinical situations for most centres. Here we review our experience of scanning for fetal goitre.<p c...

ea0059p216 | Thyroid | SFEBES2018

Management of ‘Anomalous’ thyroid results

Souza Lezia D , Evans Carol , Lansdown Andrew , Rees D Aled , Premawardhana Lakdasa

Background/objectives: While patients are commonly referred to endocrinology with a low FT4 and normal TSH, there is no consistency in the management of these patients. The aim of this audit was to assess management of these patients including investigation, diagnosis and pharmacological intervention and compare to the current Association for Clinical Biochemistry guidelines.Methods: This was a retrospective audit studying 41 endocrine outpatients at Uni...

ea0059p217 | Thyroid | SFEBES2018

The use of a thyroid telephone clinic (TTC) to follow up thyroid function tests (TFTs) in patients treated with radio-iodine (RAI) for thyrotoxicosis

Aljenaee Khaled , Mcdonnell Tara , Phelan Niamh , Pazderska Agnieszka , Healy Marie-Lousie

The thyroid telephone clinic (TTC) was established to facilitate rapid decision making on timing of introducion of anti-thyroidals or L-thyroxine replacement therapy post RAI so avoiding unnecessary outpatient appointments or leaving patients with untreated hyperthyroidism or hypothyroidism. The TTC is also used to monitor TFTs during pregnancy and to dose-titrate treatment of unstable hypo- or hyperthyroid patients. This service is provided to patients who speak English fluen...

ea0059p218 | Thyroid | SFEBES2018

Early and more frequent monitoring of thyroid function tests (TFTs) post RAI could be clinically beneficial

Aljenaee Khaled , McDonnell Tara , Cooke Jennie , Phelan Niamh , Pazderska Agnieszka , Healy Marie-Loiuse

Background: Radioiodine (RAI) is widely used for the treatment of hyperthyroidism. Most patients respond to RAI therapy with a normalization of TFTs and improvement in clinical symptoms within 4–8 weeks. Hypothyroidism may occur from 4 weeks on, with 40% of patients being hypothyroid by 8 weeks and >80% by 16 weeks. American thyroid association guidelines recommend testing for free T4, total T3, and TSH within the first 1–2 months after RAI. Biochemical monitorin...

ea0059p219 | Thyroid | SFEBES2018

Improvements in monitoring and biochemical control of hypothyroidism in primary care with the use of an electronic protocol: 12-month follow up evaluation

Tran Anh , Hyer Steve , Rodin Andrew , Johri Nikhil , Hickey Janis , Dayan Colin , Okosieme Onyebuchi

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 ...

ea0059p220 | Thyroid | SFEBES2018

Radioiodine therapy in benign thyroid disease

Montebello Annalisa , Xuereb Sara , Spagnol Vince , Brincat Stephen , Magri Claude , Vella Sandro

Introduction: Radioiodine (RAI) is a safe and effective treatment used to treat benign thyroid disease. A review of patients who received RAI in Malta between 2010 and 2018 was carried out to determine their outcome.Methods: Data collection included patient demographics, indication for RAI, amount of RAI doses received, use of antithyroid drugs pre RAI and thyroid function tests (TFTs) at 3, 6 and 12 months post RAI. Cure was defined as euthyroidism or h...

ea0059p221 | Thyroid | SFEBES2018

A retrospective study of outcomes of radioiodine treatment for benign thyroid disease

Htun Htwe , Barton David

Background: As radioiodine therapy is highly effective in curing Graves’ hyperthyroidism and toxic multinodular goitre, the assessment of its efficacy by rendering those patients euthyroid while avoiding the development of permanent hypothyroidism, is important.Aim: To determine the current practice of radioiodine treatment provided at our trust, in line with the recommended guidelines of the Royal College of Physicians and also to compare our succe...

ea0059p222 | Thyroid | SFEBES2018

Assessment of efficacy with radioiodine treatment in Benign Hyperthyroid disease across two centres

Anandappa Samantha , Tharayil Giji , Keech Katie , Keddell Nicholas , Kumar Sathis , Kumar Jesse

Aim: Indications for Radioiodine (131I) in therapy for benign thyroid disease include Graves’ disease, Toxic goitre and euthyroid goitre. There is reduced clinical & financial implication as compared to surgery with absence of anaesthetic/invasive complications, pain, recovery and in-patient stay. The aim of this study was establishing demographics and prevalence of the treatment population, to ensure dosage and indication compliance with national guidelines as well a...

ea0059p223 | Thyroid | SFEBES2018

Assessment of plasma sodium and potassium levels in sudanese patients with hypothyroidism

Babiker Manal , Ibrahim Almigdad , Alsadat Anwar , Yousif Badawi , Ibrahim Eltaf , Abdelgader Eslam , Abbas Mahasin

Background: Hypothyroidism is one of the most common forms of thyroid dysfunction. And it causes disturbance in electrolyte balance. The increase or decrease in plasma sodium and potassium levels were found to be associated with increase mortality.Objectives: The aimed of the study to measure plasma sodium and potassium levels in Sudanese patients with hypothyroidism.Method: The study is retrospective case control study included 50...

ea0059p224 | Thyroid | SFEBES2018

Identification of novel sodium iodide symporter (NIS) interactors which modulate radioiodine uptake

Fletcher Alice , Poole Vikki , Thornton Caitlin , Baker Kate , Thompson Rebecca , Nieto Hannah , Alshahrani Mohammed , Read Martin , Turnell Andy , Boelaert Kristien , Smith Vicki , McCabe Chris

Patients termed to have radioiodine-refractory differentiated thyroid cancer (RR-DTC) cannot accumulate sufficient radioiodine for a therapeutic response due to sodium iodide symporter (NIS) dysregulation via diminished expression and/or altered plasma membrane (PM) localisation. Currently, the regulation of NIS localisation remains poorly defined and despite protein-protein interactions being well-described to modulate trafficking events, the NIS interactome is limited. Previ...

ea0059p225 | Thyroid | SFEBES2018

Using lightsheet microscopy to explore the relationship between NIS and its functional interactors ARF4, VCP and PBF

Thornton Caitlin , Fletcher Alice , Brookes Katie , Alshahrani Mohammed , Read Martin , Boelaert Kristien , Smith Vicki , McCabe Chris

Effective treatment of differentiated thyroid cancer relies on a multifaceted approach often including administration of 131I to ablate residual cancer cells post-surgery. The success of this treatment hinges upon adequate uptake of iodide by malignant thyroid follicular cells. In a subset of patients, dedifferentiation of the carcinoma can result in aberrant expression and trafficking of the iodide transport protein, the sodium iodide symporter (NIS), resulting in ...