Searchable abstracts of presentations at key conferences in endocrinology

ea0065ns1.1 | NICE – T3 | SFEBES2019

T3 replacement – What does the evidence suggest?

Vaidya Bijay

Hypothyroidism is one of the commonest endocrine disorders, affecting about 3% of the adult population. Levothyroxine (T4) is the standard treatment for hypothyroidism and is one of the most commonly prescribed drugs in the UK. Whilst most patients with hypothyroidism are satisfied with this treatment, a small subgroup of patients do not feel well on T4 monotherapy. Whether such patients would benefit from Liothyronine (T3), taken either in combination with T4, as a monotherap...

ea0038s8.3 | Fine-tuning of metabolic state for optimal pregnancy outcome | SFEBES2015

Autoimmune thyroid disease before and during pregnancy

Vaidya Bijay

Autoimmune thyroid diseases, including Graves’ disease and autoimmune thyroiditis, are common in women of childbearing age. Poorly controlled Graves’ disease is associated with an increased risk of fetal loss, premature birth, pre-eclampsia, intra-uterine growth retardation, and thyroid storm. Antithyroid drugs, propylthiouracil and carbimazole (or its metabolite methimazole), cross placenta and may cause hypothyroidism and goitre in the fetus. Carbimazole is associa...

ea0044p120 | Neoplasia, cancer and late effects | SFEBES2016

Multiple endocrine neoplasia type 1: ‘Are screening guidelines appropriate?’ The importance of histology and correlation of clinical signs

Redford Christopher , Vaidya Bijay

We describe a 35 year old man who was referred back to the endocrinology service with a chronically raised amylase. He had previously been seen for early onset type 2 diabetes and for primary hyperparathyroidism. He had undergone a single gland parathyroidectomy, aged 32, for primary hyperparathyroidism in 2013 after which his calcium had remained normal. In clinic he was found to be overweight but otherwise well, with normal blood pressure and an HbA1c 49 mmol/mol. The most s...

ea0021p113 | Clinical practice/governance and case reports | SFEBES2009

Is a morning serum cortisol a useful screening test to rule out hypoadrenalism?

Chakera Ali , Vaidya Bijay

Introduction: A short-synacthen test (SST) is routinely used to diagnose hypoadrenalism, however, some authors suggest using morning serum cortisol as an initial screening test to rule out hypoadrenalism. We assessed the utility of a morning cortisol as a screening test when compared with the outcome of SST.Methods: We retrospectively analysed SSTs carried out in our endocrine outpatient clinic in the last 3 years (649 results). Of these, 113 were identi...

ea0034p186 | Neoplasia, cancer and late effects | SFEBES2014

RET genetic screening in patients with multiple endocrine neoplasia type 2 and medullary thyroid carcinoma: experience of the Exeter Molecular Genetics Laboratory

Owens Martina , Vaidya Bijay , Ellard Sian

Introduction: Mutations in the RET gene cause multiple endocrine neoplasia type 2A (MEN2A), MEN2B, and familial medullary thyroid carcinoma (FMTC). The identification of a germline RET mutation aids clinical management, enables the identification and predictive testing of at risk family members and provides reassurance for mutation-negative family members. In the research setting, mutations in exons 5, 8, 10, 11, 13–16 of the RET gene have been ...

ea0013p25 | Clinical practice/governance and case reports | SFEBES2007

Unilateral blindness following transphenoidal hypophysectomy for large non-functioning pituitary adenoma

Watt Alastair , Vaidya Bijay , Pobereskin Lou

We present the case of a 70 year-old man who presented with several months history of tiredness and lethargy. He had a past medical history of ischaemic heart disease. Examination identified a bitemporal hemianopia. Initial investigations demonstrated hyponatraemia, sodium 117 mmol/L (Reference range 132–145) with normokalaemia. Further investigations confirmed hypopituitarism: Short Synacthen Test Cortisol at T=0 min, 125 mmol/L, Cortisol at T=30 mins, 277 mmol/L, free T...

ea0013p78 | Clinical practice/governance and case reports | SFEBES2007

Apparent hypopituitarism secondary to Cushing’s syndrome due to adrenal carcinoma

Revesz Sarah , Knox Andrew , Vaidya Bijay

A 75-year-old lady presented with hypertension, weight gain, ankle oedema and proximal myopathy. She had clinical features of Cushing’s syndrome. Blood pressure was 180/99 mmHg. Her visual fields were normal. Investigations confirmed Cushing’s syndrome with high 24-hour free urinary cortisol levels (2264 nmol/l and 3295 nmol/l; normal range 40–305) and a high serum cortisol level following overnight dexamethasone suppression test (serum cortisol 1,550 nmol/l). F...

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...

ea0038p450 | Thyroid | SFEBES2015

Maternal thyroid function in pregnancy and risk of breech presentation

Knight Bridget , Shields Beverly , Sturley Rachel , Vaidya Bijay

Introduction: A breech presentation occurs in 3–5% of all full-term pregnancies and is associated with increased risk of maternal and foetal morbidity. Factors known to increase the risk of breech presentation include prematurity, low birth weight and multiple pregnancies. Recent studies suggest maternal thyroid hormone deficiency in late pregnancy may also be a risk factor. Our study aims to assess if a breech presentation at 36 weeks gestation in a healthy singleton coh...

ea0032p1021 | Thyroid (non-cancer) | ECE2013

Should subclinical hypothyroidism diagnosed during pregnancy be treated with long-term L-thyroxine?

Vaidya Bijay , Knight Bea , Hill Anita , Hattersley Andrew , Shields Beverley

Background: Subclinical hypothyroidism is common in pregnancy affecting about 5% of all pregnant women, and is associated with adverse pregnancy outcomes. There is a general consensus that subclinical hypothyroidism detected during pregnancy should be treated with L-thyroxine (Stagnaro-green et al. 2011, DeGroot et al. 2012). However, it is unclear whether the treatment should be limited only during the pregnancy or continued long-term. Therefo...