Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology Endocrine Update 2019

Clinical Update

Workshop C: Disorders of the thyroid gland

ea0062wc1 | Workshop C: Disorders of the thyroid gland | EU2019

Toxic Thyroid Adenoma in the context of Subclinical Hyperthyroidism

Mangion Jessica , Montebello Annalisa , Vella Sandro

Subclinical hyperthyroidism is defined as low serum thyroid stimulating hormone (TSH) in the setting of normal levels of free T4 (fT4) and free T3 (fT3). Treatment for subclinical hyperthyroidism can be considered when TSH is persistently <0.1, particularly in (i) the presence of hyperthyroid symptoms, (iii) individuals aged >65 years, (iii) the presence of heart disease or osteoporosis. We present a case of a 34-year-old lady who was referred to endocrine outpatient c...

ea0062wc2 | Workshop C: Disorders of the thyroid gland | EU2019

Medics maddened by Myxoedema

Kumuda Rajgopal Ranjith , O'Connell Ian

We present a case of recurrent troublesome hypothyroidism with three pathologies to vex her medical attendants. This 75 year old lady was treated for Grave’s thyrotoxicosis elsewhere when she was 55 years old. She had positive TSH receptor antibodies and high uniform uptake of radioactive iodine. She presented to us age 65 with relapsed thyrotoxicosis and was maintained on carbimazole 5 mg OD for 8 years which was then stopped. She had been off medication for 2 years when...

ea0062wc3 | Workshop C: Disorders of the thyroid gland | EU2019

When TFTs just don’t add up

Li Adrian , Saqib Aaisha , Carroll Paul

A 31-year-old man originally from Ukraine attended the clinic having been started on Carbimazole 20 mg by his GP. His symptoms included intermittent palpitations, sweating and poor sleep and they had improved since starting anti-thyroid therapy. He was originally diagnosed with thyrotoxicosis in Germany in 1999 but was not treated and he re-presented in 2005. This time he was started on Carbimazole but stopped treatment on his own accord after a month because his symptoms impr...

ea0062wc4 | Workshop C: Disorders of the thyroid gland | EU2019

A case of Subclinical Hyperthyroidism

Babu Priya Mohan , Min Thinzar

An 88-year old female was referred to the Endocrine clinic for abnormal thyroid function tests. She had been complaining of intermittent palpitations, being generally unwell, with low mood and some degree of weight loss (3 kg within the last 6 months). Her past medical history includes: osteoporosis, atrial fibrillation, poor mobility and falls. There is no family history of thyroid disease. She is currently on Duloxetine, AdCal-D3 and Alendronic acid. On examination, her hear...

ea0062wc5 | Workshop C: Disorders of the thyroid gland | EU2019

Interpretation of abnormal thyroid function tests

Eid Hatem , Bano G

Background: In the majority of cases, the results of TFTs are straightforward. In significant subgroup of patients, the interpretation of TFTs is more challenging, either because. The results appear discordant with the clinical picture (e.g. normal TSH in a patient with suspected thyrotoxicosis), Or measurements appear to contradict each other (e.g. raised TH concentrations, but with non-suppressed TSH).Case presentation: 29 year old Caucasian female com...

ea0062wc6 | Workshop C: Disorders of the thyroid gland | EU2019

Isolated Thyroxinaemia

Quader Monzoor , Krishnasamy Senthil

A 54 year old male was referred by GP for abnormal TFT. Thyroid function was done routinely. TSH 3.0 (normal 0.5 to 4.5), FT4-25.2. GP repeated the TFT twice, and both of them were similar. There were no clinical features of Thyrotoxicosis. On examination, his heart rate was 78/min regular, wt 79 kg, no thyroid enlargement, no tremor. Cardiovascular examination was unremarkable. He is fit and well gentleman. He does not take any regular medication. No history of taking any oth...

ea0062wc7 | Workshop C: Disorders of the thyroid gland | EU2019

Carbamazepine induced low FT4

Quader Monzoor , Krishnasamy Senthil

This is 66 year old lady was referred by GP for Abnormal TFT. Her TFT was done routinely and showed TSH-2.7, FT4-9.8. Patient did not have symptoms of hypothyroidism, or did not have any weight gain. On examination, thyroid was not enlarged. In view of Low FT4, she was started on Levothyroxine 25 mcg once daily. After taking the medications she felt warm and unsteady and noticed tremour on both hands. The repeat TFT came back as normal. TSH-2.9, FT4-14.2\. In view of pts sympt...

ea0062wc8 | Workshop C: Disorders of the thyroid gland | EU2019

TSHoma: an elusive finding

Khawaja Saher Sultan , Shagali Hind , Srinivasan Balasubramanian

Introduction: TSHomas are rare pituitary tumors that secrete an abnormal amount of a hormone called thyroid-stimulating hormone (TSH). Alternatively given the name thyrotropinoma, only makes up to 1%–2% of all pituitary adenomas. Patients often remain misdiagnosed for years. Many patients undergo treatments that end up destroying the thyroid gland. This case report is to emphasize the rarity of the condition and the importance of diagnosing it early and accurately to ensu...

ea0062wc9 | Workshop C: Disorders of the thyroid gland | EU2019

When thyroid function tests remain deranged despite treatment

Saqib Aaisha , Li Adrian , Carroll Paul

A 60 year old lady was diagnosed with thyrotoxicosis in 1985 (aged 28) five months postpartum. She underwent partial thyroidectomy in 1990 (age 32). Thyroid tests remained abnormal and in 1992, she underwent radio-iodine treatment requiring post-treatment. She remained under endocrine supervision and the TSH was found to be persistently elevated with normal free thyroid hormone levels (whilst on Levothyroxine). Issue with compliance and assay interference were considered. She ...

ea0062wc10 | Workshop C: Disorders of the thyroid gland | EU2019

A case of thyroid hormone resistance due to mutation in THRβ gene

Shah Usman , Hanson Philippa

A 25 year old gentleman was referred to the endocrine clinic for evaluation of abnormal thyroid function tests. He reported symptoms of diffuse abdominal pain associated with loose stool up to six times a day with urgency, frequency and tenesmus. These symptoms had been present since childhood, becoming increasingly troublesome over the preceding two years. He also reported symptoms of tiredness, palpitations and sweating episodes. Thyroid function tests were abnormal. TSH was...