Searchable abstracts of presentations at key conferences in endocrinology

ea0077cc8 | (1) | SFEBES2021

Atraumatic chylothorax due to Graves’ disease

Edwards Amy , Osman Nadia , Gunganah Kirun

Case presentation: A 40-year-old Caribbean woman presented with sudden onset palpitations. She described 3 months of progressive shortness of breath, non-productive cough and 7kg weight loss. She denied chest pain, fevers or night sweats, but reported increased stool frequency, gritty eyes, and occasional visual blurring. She appeared cachectic and had a fine tremor, left eye proptosis and a visible pulsatile goitre. She was afebrile, tachypnoeic, hypoxic, hypotensive with fas...

ea0074ncc44 | Highlighted Cases | SFENCC2021

Dose-dependent Carbimazole-induced eosinophilic dermatitis: a rare reminder of potentially serious side effects

Edwards Amy , Vathenen Ramu , Gunganah Kirun

Case History: A 23-year-old Bengali woman with a 2-year history of Graves’ disease presented to the endocrine day unit with a widespread, pruritic, vasculitic-looking rash. She was treated with Carbimazole since diagnosis but was poorly compliant. One month prior to presentation, her Carbimazole dose was increased from 20 mg daily to 60 mg daily, as she remained biochemically thyrotoxic (Free T4 79.9 pmol/l, T3 34.8 pmol/l and TSH < 0.01 mU/l). The rash started on her lower...

ea0055p36 | Poster Presentations | SFEEU2018

Severe necrotising pancreatitis secondary to hypertriglyceridaemia in pregnancy

Graham Julia , Gunganah Kirun , Williams David , Lunken Catherine , Srirangalingam Umasuthan

Case history: A 35-year-old woman with known hypertriglyceridaemia presented with a one day history of abdominal pain, vomiting and fever. She was 14 weeks pregnant having conceived spontaneously following a period of infertility. She had discontinued her lipid-lowering medication and was managed with diet alone. On examination, she was pyrexial, tachycardic (HR=100 bpm), normotensive (BP=111/71 mmHg), oxygen saturation was 96% on air and she had a tender distended abdomen. A ...

ea0044p69 | Clinical biochemistry | SFEBES2016

Evaluating the feasibility of using simulation to teach junior doctors the management of endocrine emergencies

Hutchinson Kate , Gunganah Kirun , Ladwa Meera , Gelding Susan

Background: Endocrine emergencies such as hyponatraemia and hypercalcaemia commonly present during unselected medical on-call. However, in our hospital a questionnaire survey of trainees revealed lack of confidence and preparedness in managing endocrine emergencies. 18 trainees responded (12 Foundation Year 1 (FY1), 1 Foundation Year 2 (FY2), 5 Core Medical trainees (CT1) reporting lack of confidence and preparedness in managing endocrine emergencies. 76.92% of FY1 doctors fel...

ea0037gp.04.08 | Steroids | ECE2015

Circadian variation in serum cortisol during hydrocortisone replacement is not attributable to changes in cortisol-binding globulin

Gunganah Kirun , Monson John , Drake William , Chung Teng Teng

Background: Patients taking hydrocortisone replacement for primary or secondary adrenal failure require individual adjustment of their dose. Previous observations in our department suggest that total serum cortisol levels achieved following an afternoon or evening dose of 5 mg hydrocortisone are almost as high as those that result from a 10 mg dose in the early morning; and that the ‘area under the cortisol curve’ (AUC) generated by an evening 5 mg dose is broader th...

ea0028p50 | Clinical practice/governance and case reports | SFEBES2012

Barts Endocrine Telephone Advice Clinic (ETAC): utilisation and outcomes from the first 18 months

O'Toole Sam , Pittaway James , Gunganah Kirun , Druce Maralyn

Background: In May 2010 a dedicated Consultant-delivered Endocrine Telephone Advice Clinic (ETAC) was launched at St Bartholomew’s Hospital as a direct point of access for primary care doctors to obtain endocrine advice about new patients. The proposed benefits of this clinic were to: 1. Reduce unnecessary clinic attendances that could be managed in primary care. 2. Allow for more detailed and less hurried discussions of non-urgent cases than was possible via the on-call ...

ea0028p145 | Neoplasia, cancer and late effects | SFEBES2012

Use of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in the diagnostic pathway for large adrenal lesions

Gunganah Kirun , Moyes Veronica , Druce Maralyn , Drake William , Akker Scott

Introduction: The investigation and management of large adrenal lesions varies widely. It is appropriate to have a low threshold for surgical removal of large adrenal lesions with the possible exception of stable adrenomyelipomata. 18F-FDG PET is increasingly used as an imaging technique to assess these lesions. We would like to highlight the potential benefits and pitfalls of using 18F-FDG PET as part of the diagnostic pathway.Method: Since 2008, 18F-FD...

ea0028p352 | Thyroid | SFEBES2012

Direct access thyroid ultrasound for general practice - clinical indications and frequency of thyroid function assessment prior to making request

Raja Omair , Odedra Bhim , Gunganah Kirun , Druce Maralyn , Richards Polly

Introduction and Objectives: Guidelines are available for the investigation of thyroid nodules. These include a general agreement that patients with abnormal thyroid function tests (TFTs) do not need routine ultrasound (US) assessment. Thyroid US is a common imaging request made by General Practitioners (GPs). This audit was devised to determine the range of clinical indications for GP thyroid US and the frequency with which TFTs are assessed by the GP prior to requesting the ...

ea0031p65 | Clinical practice/governance and case reports | SFEBES2013

Peri-operative α-blockade: efficacy of intravenous phenoxybenzamine vs oral phenoxybenzamine in patients with phaeochromocytoma and paraganglioma

Hussain Shazia , Gunganah Kirun , Ashby Michael , Carpenter Robert , Waterhouse Mona , Druce Maralyn , Drake William , Akker Scott

Introduction: Regimens for pre-operative α and β-blockade for patients with secretory phaeochromocytomas/paragangliomas vary widely between centres. The worldwide lack of availability of intravenous phenoxybenzamine (Goldshield) has removed a useful tool in the management of phaeochromocytoma crisis and has necessitated a change in our institution’s routine pre-operative strategy. We compare pre, peri and post-operative surrogate measures of blockade in a cohort...

ea0028p6 | Bone | SFEBES2012

Recurrent pancreatitis in patient with Familial Hypocalciuric Hypercalcaemia (FHH) sucessfully treated with cinacalcet

Gunganah Kirun , Pittaway James , Raja Omair , O'Toole Sam , Druce Maralyn , Grossman Ashley

Case: A 22 year-old female student presented with a history of recurrent pancreatitis since 2007. The most common causes of pancreatitis, including drugs, gallstones, corticosteroids, excess alcohol and hypertriglyceridaemia were excluded. She was noted to have elevated serum calcium, which was considered to be the cause of her pancreatitis, with a detectable serum PTH level. An initial diagnosis of primary hyperparathyroidism was made. However, two neck explorations failed to...