Searchable abstracts of presentations at key conferences in endocrinology

ea0077hdi2.2 | How do I. . .? 2 | SFEBES2021

A low testosterone level in a man with obesity – what to advise based on current evidence

Quinton Richard

Male Hypogonadism (MH) is a clinical and biochemical diagnosis, comprising pathologically low serum testosterone (T) levels and clinical features of androgen deficiency, of which low muscle mass and increased fat mass are features. The diagnosis is most secure when framed in the context of a recognised clinical syndrome, or with male factor infertility from impaired gonadal function. Testosterone levels in individual males are subject to considerable v...

ea0044cmw1.2 | Workshop 1: Endocrinology at the edge of the reference range (Supported by Endocrinology, Diabetes & Metabolism Case Reports) | SFEBES2016

Low testosterone and normal gonadotrophins: Who, when and how to treat?

Quinton Richard

Hypogonadotrophic hypogonadism (HH) in males is defined both biochemically – low serum testosterone (T) level with LH+FSH levels in or below the lower half of the reference range – and clinically. ie. the person is actually hypogonadal. This clinical criterion is crucial for an accurate diagnosis adult-onset HH in men, because biochemical features are common to other scenarios for which T treatment is presently not indicated. These include afternoon-, or non...

ea0059s9.2 | Introduction and prevention of gonadal function | SFEBES2018

Induction of Spermatogenesis

Quinton Richard

Hypogonadotrophic hypogonadism (HH) is the only form of infertility that is directly treatable with hormone replacement, either in the form of gonadotrophin injections, or pulsatile GnRH if the underlying defect is hypothalamic and pituitary function is intact. However, men with HH face a complex and confusing journey to access treatment: misinformed that they are irredeemably infertile, struggling to find a clinician with relevant experience and authorisation to prescribe gon...

ea0038sk1.1 | Skills 1: Working with the media | SFEBES2015

Why should we engage with the media?

Quinton Richard

Lord Reith famously characterised the BBC’s purpose as ‘to educate, inform and entertain’ (EIE). News and current affairs is a multibillion dollar industry that is rapidly expanding beyond traditional print, audio and vision formats, allowing the media to reach out even to the most isolated and disadvantaged populations worldwide. The media have an insatiable appetite for stories about medicine, healthcare and related scientific advances, because these strongly ...

ea0034mte3 | (1) | SFEBES2014

Quinton Richard

Klinefelter syndrome (KS) is defined by at least one extra X chromosome in the male karyotope. The phenotype is highly-variable, but a degree of progressive testicular dysfunction is universal. 47XXY is the most common sex chromosome aneuploidy in humans and, together with much rarer forms (e.g. 48XXY and 48XYY) occurs in 0.1–0.2% live male births. However the prevalence of diagnosed KS among adult males in the UK and elsewhere is much lower, indicating only around 25% of...

ea0094ocp1.1 | Outstanding Clinical Practitioner Award | SFEBES2023

Management of pubertal delay in males & females: perspectives from an "adult" Endocrinologist

Quinton Richard

Longstanding Paediatric guidance on the assessment and management of children with undifferentiated pubertal delay is not fit for purpose in relation to patients who are older and/or have obvious "red flag" clinical features to sign-post high risk for congenital hypogonadism. For these individuals, the well-intentioned stock phrases that "constitutional (or self-limiting) delayed puberty is always the more likely diagnosis", "attainment of Tann...

ea0091we1 | Workshop E: Disorders of the gonads | SFEEU2023

Infertile Couple: Spermatogenesis in Congenital Panhypopituitarism

Grixti Lydia , Quinton Richard

A 31-year-old gentleman presented to our Endocrine Services with his 20-year-old fiancée with plans for marriage and to conceive. He was diagnosed with congenital panhypopituitarism and absent pituitary stalk at the age of 4. He was started on replacement growth hormone, desmopressin, levothyroxine, hydrocortisone and testosterone, in this sequence, across the years. He underwent induction of puberty at the age of 13 years. He was noticed to have bilateral cryptorchidism ...

ea0049ep1239 | Thyroid (non-cancer) | ECE2017

Retrospective audit: To investigate the long-term outcome of fixed dose 300 MBq of radioiodine (131-I) treatment for Autonomous Toxic Thyroid Nodule

Lal Vikram , Quinton Richard

Introduction: Radioiodine (131-I) treatment for benign thyroid disease has a 70 year history. Among the radioactive isotopes, (131-I) can be used successfully. The intention of radioiodine treatment is primarily to induce a euthyroid or hypothyroid state, but in the case of large multinodular goitres, shrinkage represents a secondary aim of therapy. The optimal method for determining iodine-131 treatment doses for Toxic Thyroid nodule is unknown, and techniques have varied fro...

ea0028p292 | Reproduction | SFEBES2012

Periodic exposure to exogenous testosterone is required to maintain long-term integrity of the GnRH pulse-generator in a male with atypical Kallmann syndrome

Santhakumar Anjali , Quinton Richard

Kallmann syndrome is a treatable form of male infertility caused by a congenital defect in the secretion or action of gonadotropin releasing hormone (GnRH). It can permanently remit in around 10% of male cases. We report a patient with atypical Kallman’s syndrome who requires intermittent testosterone replacement to sustain activity of his gonadotrophic axis A 55 year old male presented with erectile dysfunction and decreased libido. He reported normal puberty, with no hi...

ea0081ep145 | Calcium and Bone | ECE2022

Autosomal dominant hypocalcaemia type 1 with intact PTH and relative hypocalciuria.

Rashid Razan Ali , Quinton Richard , Joshi Ashwin

Autosomal Dominant Hypocalcaemia (ADH) type 1 is caused by activating mutations of the calcium-sensing receptor (CaSR) gene. Although a rare condition, the exact prevalence is uncertain as patients are asymptomatic and, historically, were sometimes diagnosed with hypoparathyroidism (HPT) due insensitivity of earlier PTH assays and failure to check urinary calcium. The consequences of an erroneous diagnosis of HPT in patients with ADH can be profound, as treatment with calcium ...