Searchable abstracts of presentations at key conferences in endocrinology

ea0059ep96 | Reproduction | SFEBES2018

Unusual Cause of Severe Hyponatraemia

Hanafy Ahmed , Holmes Simon , Rajeswaran Chinnadorai

Introduction: Testosterone replacement therapy is the standard treatment for hypogonadism. However, there are also serious side effects which clinicians should be aware of. Here we present a case of unusual side effect related to testosterone therapy.Case history: A 90 year-old gentleman attended A&E with gradually worsening confusion and dyspnoea. His breathing had deteriorated in the last week with marked decrease in exercise tolerance. Investigati...

ea0021p377 | Thyroid | SFEBES2009

An unusual presentation of hyperthyroidism

Holmes Simon , Prabhakar V K B

An 83-year-old gentleman was referred to the endocrine clinic with incidentally found abnormal thyroid function tests (TFT): TSH <0.02 (0.2–4.0 mU/l), free T4 20.4 (9–19 pmol/l), and free T3 7.6 (2.5–5.7 pmol/l). His TFT done 6 months previously were normal with TSH 1.21 mU/l and FT4 11.8 pmol/l. His past medical history included BPH, peripheral vascular disease and chronic kidney disease (CKD), and medications were tamsulosi...

ea0053cd1.1 | Case Discussions: complex clinical cases 1.0 | OU2018

A novel way to manage obesity in a patient with poorly controlled Addison’s disease

Rajeswaran Chinnadorai , Holmes Simon , Joseph Vinod , Hanafy Ahmed

Introduction: The reason for weight gain is multifactorial. Effective intervention can only be incorporated if the underlying cause is evaluated correctly. Here we present a lady with Addison’s disease who gain significant weight and was helped to lose weight using a novel approach.Case-Report: 42 year-old lady was referred to our weight-management service as she was unsuccessful in losing weight. Detailed evaluation in the obesity clinic revealed t...

ea0063p406 | Thyroid 1 | ECE2019

Exacerbation of thyrotoxicosis following radioiodine therapy in benign thyroid diseases: can it be predicted?

Hanafy Ahmed , Holmes Simon , Britton Jason , Pereira Olivia

Introduction: Radioactive iodine (RAI) is an effective and widely used treatment for thyrotoxicosis. Post-radioiodine thyrotoxicosis is a well-known side effect of RAI. This is usually mild and easily controlled mostly with beta blockers but sometimes needs anti-thyroid drugs (ATD).Aim of the study: To assess the incidence and predictors of post-radioiodine thyrotoxicosis.Methods: Retrospective analysis of 86 patients who had RAI t...

ea0031p346 | Steroids | SFEBES2013

ACTH independent bilateral macronodular adrenal hyperplasia presenting as subclinical Cushing's syndrome

Thida Myat , Shankaran Vani , Holmes Simon , Rajeswaran C , Srinivasan Bala

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

ea0031p380 | Thyroid | SFEBES2013

Raised TSH: a diagnostic conundrum!

Mohammad Misbah , Thida Myat , Holmes Simon , Srinivasan Bala T

Background: Elevated TSH with raised free T4 (fT4) presents a diagnostic challenge. Symptomatically they vary across the spectrum of thyroid status. We report cases with these dilemmas.Case 1: Seventy four year old was referred with 5 years of TSH ranging between 4.9–7.9 mIU/l (0.2–4.0), fT4 18.5–27 pmol/l (9.0–19) and free T3 (fT3) 4.5–12 pmol/l (2.5–5.7). Thyroid perox...

ea0023oc5.2 | Oral Communications 5 | BSPED2009

Survey on facilities in the local schools for children with type I diabetes (T1D)

Pai Bharathi , Hudson Lizbeth , Holmes Simon , Agwu J Chizo

Introduction: Optimising management of diabetes in school is critical especially with more children being commenced on intensive insulin regimens. Partnership between families, school and caregivers is essential to enhance safety and satisfaction with the educational experience for students.Methodology: We gathered information on facilities in schools for children with T1D from our district hospital by telephonic questionnaire. The questions related to p...

ea0021p190 | Endocrine tumours and neoplasia | SFEBES2009

An unusual presentation of insulinoma with postabsorptive hypoglycaemia?

Stolte Joachim , Iliopoulou Amalia , Holmes Simon , Nagi Dinesh

Insulinomas are rare neuroendocrine tumours with an estimated incidence of up to four new cases per mill./p.a. Most tumours are benign, <2 cm and arise from the islets of Langerhans.Typically patients present with Whipple’s triad: symptoms of hypoglycaemia, caused by fasting or exercise, low plasma glucose and symptoms relieved by Food. The diagnosis is confirmed by high insulin and c-peptide levels, inappropriately high for prevailing glucose.<...

ea0044p9 | Adrenal and Steroids | SFEBES2016

Assesment of Performance of 30 vs 60 min cortisol during SST

Nagi Dinesh , Bachuwar Ravikumar , Holmes Simon , Scoffins Ruth , D'Costa Ryan , Pereira Olivia

Aim: Short Synacthen test has been widely used screening test for assessment of hypothalamo-pituitary-adrenal axis (HPA). The most widely used is 30 min plasma cortisol Post synacthen. We have compared 30 min cortisol with 60 min for assessment of the HPA axis of patients with known endocrine disorders and on long term steroid, opiate use and obesity (non endocrine disorder).Method: Cortisol Response to 30 and 60 min post synacthen were measured in rando...