Searchable abstracts of presentations at key conferences in endocrinology

ea0070ep553 | Hot topics (including COVID-19) | ECE2020

Higher HbA1c increases mortality in COVID 19 swab positive hospital inpatients with diabetes

Kumar Mohit

Introduction: In the UK, the North West of England is one of the worst affected regions by COVID 19, with over 275 cases/100,000. We retrospectively looked at the diabetes characteristics of consecutive patients at our trust admitted with COVID 19 and had known diabetes, and assessed whether there was a correlation with the outcome, Clinical Frailty Score (CFS) and age.Methods: 88 continuous patients with a prior diagnosis of diabetes and COVID 19 swab p...

ea0056p258 | Calcium & Vitamin D metabolism | ECE2018

Metabolic encephalopathy following intravenous zolendronate for hypercalcaemia of malignancy: a perfect storm

Kumar Mohit

A 56 year old lady was diagnosed with cancer of unknown primary after the discovery of liver metastases. Prior to the commencement of EOX chemotherapy (epirubicin, oxaliplatin and capecitabine) she was given a dose of 4 mg zolendronic acid for hypercalcaemia of malignancy. Three weeks later she presented to our hospital with a history of rapid decline and reduced oral intake, with associated diarrhoea. She had reduced GCS and hypotension. Initial investigations revealed an acu...

ea0056p1103 | Thyroid (non-cancer) | ECE2018

Cholestyramine: a useful therapeutic adjunct in severe thyrotoxicosis

Kumar Mohit

Case 1: A 32 year old fit and well female presented with symptoms of thyrotoxicosis and goitre. Her initial investigations revealed fT4 45 pmol/l (10–20) and fT3 26 pmol/l (3.5–6.5), with undetectable TSH. TSH receptor antibodies were positive. She was commenced on beta blockers and carbimazole and increased to 60 mg daily, with the fT4 improving only to 34.4 and fT3 to 13.8. Cholestyramine was commenced and titrated to a dose of 4 g twice daily, with resultant norma...

ea0081ep683 | Pituitary and Neuroendocrinology | ECE2022

Pituitary Coma? Discordant pituitary biochemistry after consumption of a commercially available ‘Sleep Activator’.

Phillips Benjamin , Kumar Mohit

We present a case of discordant pituitary biochemistry which resolved after discontinuing a commercially available combination vitamin supplement. A 35 year-old man presented following an episode of headache and dizziness, preceding collapse and possible seizure activity. Investigations revealed deranged pituitary function: TSH 0.02 mU/l (0.35-5.50), fT4 3.6 pmol/l (10.0-20.0), 9 am cortisol 18 nmol/l (200-500), testosterone >52 nmol/l (8.4-28.7), FSH <0.3 U/l (1.0-18....

ea0091oc4 | Oral Communications | SFEEU2023

A rare case of hypergonadotrophic hypergonadism due to mild androgen insensitivity syndrome (MAIS)

Sankar Adhithya , Kumar Mohit

A 29-year-old man presented with an 18-month history of reduced libido and lethargy. His symptoms started after cessation of anabolic steroids for three years. His childhood and development history were unremarkable with normal onset of puberty and development of secondary sexual characteristics. He had no past medical or family history of note. Clinical examination demonstrated normal BMI, musculature, distribution of body hair, testicular volume, and genital size. Biochemica...

ea0063p887 | Diabetes, Obesity and Metabolism 3 | ECE2019

Management of hyperglycaemia risk in patients on medium or long-term glucocorticoid treatment: a retrospective pilot study

Greenfield Helen , Kumar Mohit

Background: Glucocorticoids are used medium and long-term for a variety of inflammatory and autoimmune conditions, with increasing use in the UK. The management of their potential side effects, however, remains suboptimal, and guidelines are not comprehensive. Our institute has had cases of patients presenting with hyperglycaemic emergencies due to steroid induced diabetes.Aims: 1) To obtain an estimate of the frequency of the use of medium and long term...

ea0063p1060 | Pituitary and Neuroendocrinology 3 | ECE2019

Isolated ACTH deficiency secondary to combined immunotherapy-induced hypophysitis: predilection for corticotrophs

Rajgopal Ranjith , Kumar Mohit

Immunotherapy targeting the CTLA-4 and PD-1pathways has revolutionised the treatment of several cancer types, and is under investigation in many others. However, its use is associated with a variety of side effects, many of which associated with immune system activation. In metastatic melanoma, the combination of ipilimumab (an anti-CTLA-4 antibody) and nivolumab (an anti-PD-1 antibody) has been shown to have greater efficacy than either drug as monotherapy, though as expected...

ea0049ep1210 | Clinical case reports - Thyroid/Others | ECE2017

Recurrent Thyroiditis in an Amiodarone treated patient: An Illustrative Case Demonstrating the Spectrum of Abnormalities

Kumar Mohit , Tymms David James

A 65 yo gentleman was referred to the endocrinology department with thyrotoxicosis. He had a history of IHD and recurrent VT necessitating amiodarone for 8 years. Routine TFTs had shown TSH undetectable, fT4 34.1, fT3 8.7. There were no symptoms or signs of thyrotoxicosis or cardiovascular compromise. He had been treated with carbimazole by his GP for the previous 3 weeks, this was discontinued at the initial evaluation due to recurrent vomiting. TPO anti...

ea0075d16 | Diabetes | EYES2021

Hyperosmolar hyperglycaemic state (HHS) in type 1 and type 2 diabetes induced by asymptomatic SARS-CoV-2 infection: 2 case reports

Kumar Mohit , Chu Ka Wing

HHS is a rare hyperglycaemic emergency, typically precipitated by infection in people with T2DM. There are few recorded cases of COVID induced pure HHS. We here by report 2 further cases, including the first known reported case in a person with T1DM.Case 1: 81yo male with T1DM (on glargine and aspart insulin, HbA1c 57 mmol/mol) presentedwith lethargy, general deterioration and a fall.Therewere no new symptoms offever/cough/breathlessness or change in tas...

ea0062wa7 | Workshop A: Disorders of the hypothalamus and pituitary | EU2019

Opioids - yet another cause for Adrenal Insufficiency

Rajgopal Ranjith Kumuda , Kumar Mohit , Tymms James

Opioids –Yet another Cause for Adrenal Insufficiency. Opioid prescriptions have almost doubled in the last decade in the UK. Opioid related hypogonadotropic hypogonadism is a well-recognised clinical entity. Opioid therapy as a cause of adrenal insufficiency is an under-recognised endocrinopathy with potentially lifethreatening adverse effects. We present the case of a 57 year old lady referred to the endocrine clinic with symptoms of generalised fatigue and weakness. Her...