Searchable abstracts of presentations at key conferences in endocrinology

ea0044ep66 | (1) | SFEBES2016

Vanishing insulin requirements in patient with type 1 diabetes

Nagi Dinesh , Bachuwar Ravikumar

We describe a case of 31 year young lady with Type 1 Diabetes, who started experiencing reduction in insulin requirement and hypoglycaemia episodes due to an endocrine disorder following Pregnancy. She presented with recurrent episodes of documented hypoglycaemia and amenorrhea following successful pregnancy. Her basal insulin requirements fell from 36 units to 24 units per day and she required little if any insulin as bolus (0.5 unit for every 10 gm). She did not breast feed....

ea0015p172 | Endocrine tumours and neoplasia | SFEBES2008

Hirsutism and hyperandrogenaemia in an 83 years old woman: importance of long term endocrine follow up

Elmalti Akrem , Nagi Dinesh

We present an 83-year-old female who presented with excess body hair growth, worst on her face, arms and abdomen. This was associated with features of virilasation and weight loss. Her past medical history includes; hypertension, Temporal arteritis, Gout and duodenal ulcer disease. Her medications were Felodipine 2.5 mg OD, Captopril 25 mg BD, Bendroflumethiazide 2.5 mg OD, Aspirin 75 mg OD, Ezmoprazole 20 mg OD.On examination, she was found to have deep...

ea0059ep111 | Thyroid | SFEBES2018

Protean Presentations of Severe Hypothyroidism: Decompensated Liver Disease as an Unusual Co-presentation

Costa Ryan D. , Nagi Dinesh

We report a 51-year old lady presenting to hospital with a 3 week history of abdominal and peripheral swelling. Mentation was slow and noted to be pale on admission. She also reported feeling cold, lethargic, reduced exercise tolerance and constipation. She had no prior medical problems, no regular medications and working till the day prior to admission in a garden centre. She was an ex-smoker, teetotal and there was a family history of hypothyroidism. Physical assessment reve...

ea0044ep95 | (1) | SFEBES2016

Thyrotoxicosis resistant to treatment: Graves’ disease or Factitious thyrotoxicosis: A Puzzle

Nagi Dinesh , Holems Simon , Jenkins Richard

We describe an interesting case of a man who poses a significant ongoing management challenge. He presented with mild biochemical evidence of T3 thyrotoxicosis (FT3, 8.2, FT4 13.6, TSH 0.02). Carbimazole 20 mg was started and despite increasing dosage, he deteriorated significantly. He was concordant with medication. His TBII and thyroid auto-antibodies were negative. A Tc uptake scan showed reduced uptake. Prednisolone was added, thinking that he may have thyroiditis. Despite...

ea0025p197 | Endocrine tumours and neoplasia | SFEBES2011

Rare association of simultaneous adrenal Cushing’s and primary hyperparathyroidism in patient with previous Graves disease

Eapen Dilip , D'Costa Ryan , Nagi Dinesh

A 33-year-old lady was referred to the endocrinology clinic with weight gain, hirsuitism and amenorrhea. She had been diagnosed with hypertension a year ago which was difficult to control despite being on three anti-hypertensive agents – Ramipril, Amlodipine and Bendroflumethazide. Past medical history included hypothyroidism secondary to radioactive-iodine therapy for Graves disease aged 22. Her GP organised an ultrasound scan querying polycystic ovaries but this reveale...

ea0021p72 | Clinical practice/governance and case reports | SFEBES2009

A case of hypogonadotrophic hypogonadism due a pituitary stalk tuberculoma

Iliopoulou Amalia , Stolte Joachim , Nagi Dinesh

A 25-year-old Asian man presented with a 6 month history of erectile dysfunction, loss of libido and reduced exercise tolerance. His past medical history included ulcerative colitis, treated with long-term prednisolone and mesalazine for 8 years. He weighed 116 kg and his BP was 144/86 mmHg. He had bilateral gynaecomastia but no galactorrhea. Testicular volumes were 8 ml bilaterally and secondary sexual characteristics were normal. He was clinically euthyroid.<p class="abs...

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...

ea0015p226 | Pituitary | SFEBES2008

Rapidly progressive hypopituitarism and visual failure due to metastatic small cell carcinoma

Jain Ankit , Tun Julie Kyaw , Maguire Deirdre , Jenkins Richard , Nagi Dinesh

An 82-year-old man presented with weight loss and lethargy. Thyroid function tests showed a fT4 7.6 pmol/l and TSH 0.08 mU/l. Short synacthen test confirmed hypoadrenalism with baseline cortisol of 34 nmol/l and 30 min sample 156 nmol/l. He had low gonadotrphin levels and Prolactin was 551 μ/l. He was commenced on hydrocortisone and levothyroxine treatment with symptomatic improvement. An urgent CT scan revealed multiple enlarged lymph nodes above and below the diaphragm ...

ea0015p388 | Thyroid | SFEBES2008

Fine needle aspiration biopsy (FNA) of the thyroid gland: a district general hospital experience

Elmalti Akrem , Nagi Dinesh , d'Costa Ryan , Andrews Julia , Ajjan Ramzi , Moisey Rob , Jenkins Richard

FNA of the thyroid is used for fast and early assessment of thyroid nodules, however it is sensitivity as a useful diagnostic test depends largely on the technique, experience of the aspirator and expertise of the cytologist. We undertook a retrospective audit of FNA to evaluate our results and compliance with the national guidelines.We examined 121 patients had FNAs at Pinderfields Hospital from October 2000 to June 2007. The cohort was comprised of 106...