Endocrine Abstracts

Radioiodine is a highly effective and safe treatment for hyperthyroidism, including Graves’ disease. Remission rates for Graves’ hyperthyroidism following medical therapy alone, even with a full course of antithyroid drugs, are poor (∼40% overall), especially in certain groups such as those with severe hyperthyroidism, those with large goitres and probably in males. Furthermore, antithyroid drugs can themselves cause significant morbidity and occasional life th...

Thyroid dysfunction is common. Overt hyperthyroidism is associated with cardiovascular morbidity (especially risk of atrial fibrillation) and all cause and vascular mortality. Our recent studies suggest that excess vascular mortality associated with hyperthyroidism is reduced only by treatment with radioiodine given in sufficient doses to induce hypothyroidism. Subclinical hyperthyroidism is also associated with risk of AF, as well as mortality from all causes and vascular mor...

Jayne Franklyn, Head, School of Clinical and Experimental Medicine,College of Medical and Dental Sciences, University of Birmingham, UK AbstractJayne Franklyn was awarded the MBChB (with Honours) degree at the University of Birmingham, UK in 1979. She was subsequently awarded MD and PhD for research into thyroid hormone action and TSH gene regulation whilst working as a MRC Training Fellow and Wellcome Trust Senior Cl...

Hyperthyroidism is common, affecting up to 3% of the population. The major causes in the UK are autoimmune (Graves’ hyperthyroidism) and toxic nodular goitre. Despite the prevalence of hyperthyroidism, there is relatively little agreement regarding the relative roles of the three principle treatment options – antithyroid drugs, radioiodine and surgery. The presentation will address these roles and specifically will address areas of controversy regarding treatment thr...

Subclinical hyperthyroidism is characterised by low serum TSH with normal free T4 and free T3. Subclinical hyperthyroidism may reflect Graves’ disease or toxic nodular hyperthyroidism, and is found in up to 5% of the over 60’s. In addition, about 20% of patients who are taking T4 therapy have low serum TSH, i.e. biochemical evidence for over-treatment. In those not prescribed T4 it is important to exclude other cause...

Obesity is a global heath concern and the proportion of overweight and obese people in the UK is rapidly increasing. Patients undergoing treatment for hyperthyroidism frequently express concerns regarding excessive weight gain especially when offered treatment with 131I. We followed 1159 patients with overt hyperthyroidism to determine the extent of weight changes and to identify risk factors for weight gain following treatment. Overall, BMI remained unchanged in 13...

The administration of radioactive iodine (131I) is widely used in the treatment of patients with hyperthyroidism. We have previously reported better cure rates in patients receiving a single dose of 600 MBq 131I compared with those treated with lower doses. We set out to evaluate if baseline patient characteristics predict which patients require multiple doses of radioiodine to induce cure. We compared 42 subjects requiring ≥3 doses with 290 patient...

Hyperthyroidism complicates ~1 in 1000–2000 pregnancies, with majority of cases due to Grave’s disease (GD). PTU remains the preferred ATD of choice in pregnancy with carbimazole a reasonable second-line alternative in patients allergic or intolerant to PTU. We present the case of a lady with PTU induced agranulocytosis in pregnancy.A 29-year-old lady was seen in thyroid clinic in May 2006 having had symptoms suggestive of thyrotoxicosis since ...

Background: Hyperthyroidism often runs an indolent course and may be undiagnosed for prolonged periods. Most patients are treated in the outpatient setting and the effects of hyperthyroidism on hospitalised patients are poorly studied. We set out to determine the prevalence of hyperthyroidism in a large cohort of inpatients and evaluated their comorbidities, reasons for hospitalisation and rehospitalisation rates.Methods: A case-control study was conduct...

Routine thyroid function testing (TFT) in hospitalised patients is not recommended; however, delayed management of thyroid dysfunction may have significant consequences. We quantified the rate of TFT in hospitalised patients and identified factors influencing the likelihood of finding significantly abnormal TSH (<0.01 or >10 mUI). TFTs were performed during 26 937/280 000 (9.6%) admissions between 2007 and 2011. 57.6% of those tested were female and mean age was 63.8 (...