Endocrine Abstracts

Background: Success of Graves’ orbitopathy (GO) immunosuppression treatment is highly variable; patients relapse and a debilitating residual disease burden often remains with current therapies. This study describes the outcomes of immunosuppression in a multi-ethnic GO cohort treated in accordance with pre-2021 European Group on GO (EUGOGO) guidelines with first-line intravenous-methylprednisolone (IVMP). This study aims: (1) To evaluate the effect of first-line and addit...

Background: Early diagnosis and surveillance of Graves’ Orbitopathy (GO) is essential to prevent severe, sight-threatening complications and long-term disability; therefore, it is highly desirable to identify risk factors and early predictors of severe disease. GO is clinically assessed using the Clinical Activity Score (CAS) and the EUGOGO Severity Scale (ESS), which are subjective, qualitative tests that are used to evaluate the activity and severity at the anterior orb...

Purpose: Early diagnosis and treatment of Graves’ orbitopathy (GO) are essential to prevent physical and psychological burdens of advanced disease. MRI diffusion weighted imaging (DWI) is an emerging modality to assist with timely diagnosis. We investigated the value of DWI in early diagnosis and monitoring and its relationship with the clinical activity score (CAS) and quality of life (QoL) scores in a joint endocrine/ophthalmology clinic.<p class="abst...

Purpose: Early diagnosis and treatment of Graves’ orbitopathy (GO) are essential to prevent physical and psychological burdens of advanced disease. MRI diffusion weighted imaging (DWI) is an emerging modality to assist with timely diagnosis. We investigated the value of DWI in early diagnosis and monitoring and its relationship with the clinical activity score (CAS) and quality of life (QoL) scores in a joint endocrine/ophthalmology clinic.<p class="abst...

A 62-year-old man was referred from secondary care with a long history of recurrent ureteric colic, borderline hypercalcaemia with parathyroid hormone level in the low-normal range and a normal serum phosphate. There was no family history of kidney stones or osteoporosis and no history of childhood urinary infections.Repeated biochemistry at presentation was as follows: PTH 2.1 pmol/l (1.1–6.8), corrected calcium 2.56 mmol/l (2.15–2.55), phosph...

A 46-year-old Columbian man, with a previous history of pulmonary sarcoid and renal calculi in 2001, was referred to the Endocrinology clinic in 2005 with persistent hypercalcaemia despite successful treatment of the sarcoid. The initial hypercalcaemia work-up results were as follows: adjusted calcium 2.96 (2.15–2.60), parathyroid hormone (PTH) 9.0 pmol/l (1.1–6.8), 25-(OH)2 vitamin D 71 nmol/l (>50), magnesium 0.99mmol/l (0.65–1.00), creatinine 97 umol/l...

A 31-year-old male presented to A&E with confusion, lethargy, polyuria and blurred vision. The previous month he had been diagnosed with diabetes and started on metformin by his GP. On examination he was cachectic (BMI 17 kg/m2), dehydrated and hypotensive (88/56). Baseline investigations revealed a metabolic acidosis (pH 7.30), with capillary glucose 20 mmol/l and moderate ketonuria. Treatment for diabetic ketoacidosis was commenced. Further results revealed he...

Purpose: There are sporadic reports illustrating more severe TED and complications in those with diabetes mellitus (DM) and from local experience these patients have poorer outcomes as seen in other diseases, such as cardiovascular disease. However, the relationship between glycaemia and clinical activity/severity and disease course are not well described.Methods: A multi-centre retrospective patient-cohort study of 236 patients referred to three TED mul...

Purpose: There is increasing evidence that a multidisciplinary (MDT) approach optimises diagnosis and management in active Thyroid Eye Disease (TED) and is recommended by current TEAMeD-5 guidelines1. Here we aim to describe the clinical and endocrine characteristics of a large cohorts of patients with TED seen in 3 MDT clinics in London.Methods: A retrospective patient-cohort study of 236 patients with suspected TED referred to these services...

Pituitary dysfunction is a common, treatable consequence of traumatic brain injury (TBI), and is associated with poorer outcomes. Identifying prognostic factors that allow targeted endocrine testing will ensure that patients at higher risk of pituitary dysfunction are identified and screened.Analysis of 176 adults at least 6 weeks after TBI attending the multidisciplinary Imperial TBI clinic found an overall prevalence of pituitary dysfunction of 13.7% (...