Searchable abstracts of presentations at key conferences in endocrinology

ea0048wf8 | Workshop F: Disorders of the parathyroid glands, calcium metabolism and bone | SFEEU2017

A case of transient hypercalcemia

Kumar Rakshit , Rodin Andrew

We are presenting a common case of diagnostic dilemma with hypercalcemia.This 66 year female patient was referred to Endocrine clinic with hypercalcemia. She was asymptomatic with blood tests showing C.Calcium of 2.73 mmol/l. This was followed by investigations to rule out primary or tertiary hyperparathyroidism.Blood tests revealed high PTH of 12.2 pmol/l with low 25OH Vitamin D of 37 nmol/l, suggesting a diagnosis of tertiary hyp...

ea0034p416 | Thyroid | SFEBES2014

A case of severe hypothyroidism presenting with multi-organ failure

Chinnasamy Eswari , Rodin Andrew

Myxoedema coma or severe decompensated hypothyroidism is rare but has high mortality; appropriate early recognition and treatment is essential. We present a case of severe hypothyroidism with multi organ failure. A 58-year-old lady with several months’ history of loss of appetite, tiredness and hair loss presented with progressive lethargy, sleepiness and abdominal distension for 1 week. On admission she was very drowsy, had a doughy dry skin and facial puffiness. Large a...

ea0048we4 | Workshop E: Disorders of the gonads | SFEEU2017

Amenorrhoea in disorder of sexual development

Kumar Rakshit , Thurston Layla , Rodin Andrew

We present here a case of diagnostic dilemma in a 34-year female presenting with Amenorrhoea. She was recently married and saw GP for infertility and history of hot flushes, melasma and migraine. Clinic history revealed primary amenorrhoea diagnosed in Brazil at age 15. Patient was told she was born without ovaries and was started on Premarin (oetrogen). She had normal female secondary sexual charcteristics, functional female genitalia and growth. On examination, she had a nor...

ea0044p82 | Clinical biochemistry | SFEBES2016

The management of hypothyroidism in primary care without QOF – can we do better?

Tran Anh , Hyer Steve , Rodin Andrew

Background: In 2014, Thy002 (the proportion of patients with hypothyroidism on the practice register with thyroid function tests recorded in the preceding 12 months) was removed as a Quality Outcome Framework (QOF) target.Aim: To audit the current management of hypothyroidism in primary care two years following the QOF changes.Method: Four local practices (total patient population: 37 200 (range 7300–1300 per Practice)) partic...

ea0065p405 | Thyroid | SFEBES2019

Weekly thyroxine administration to aid diagnosis and improve treatment compliance

Salota Rashim , Johri Nikhil , Rodin Andrew , Hyer Steve

Introduction: The thyroxine absorption test (TAT) is well established to investigate persistently raised TSH in patients on L-thyroxine. We review our experience with this test.Method: Blood was taken for baseline FT4, FT3, TSH measurements and malabsorption screen. A week’s supply of L-thyroxine (1.6 mcg/kg×7) was administered orally under direct supervision and FT4 and TSH measured 2 h later. Patients continued o...

ea0038p71 | Clinical practice/governance and case reports | SFEBES2015

Does the usual time of rising influence the stimulated cortisol response?

Tran Anh , Hyer Steve , Salota Rashim , Johri Nikhil , Rodin Andrew

Aim: To investigate the relationship between baseline and stimulated cortisol responses in relation to the habitual time of rising and time of test.Method: The self-reported habitual rising time and time of cortisol testing were recorded in 63 consecutive patients (47F, 17M, age 18–94) undergoing standard stimulation testing with tetracosactide (SynActhen) 250 μg i.v. In total, 75 tests were analysed. A normal response was defined as a 30 min p...

ea0025p49 | Clinical biochemistry | SFEBES2011

Hyponatraemia: the view from primary care

Tran Anh , Hyer Steve , Manghat Padmini , Lapsley Marta , Rodin Andrew

Introduction: Hyponatraemia is not uncommon in primary care and its management can be complex. It is vital that initial assessment is carried out properly as mismanagement can have serious consequences.Aim: To investigate general practitioners’ views and perceptions on the management of hyponatraemia encountered in primary care.Method: Local general practitioners were surveyed with a questionnaire via email and at local postgr...

ea0021p374 | Thyroid | SFEBES2009

The many faces of hyperthyroidism in primary care

Tran Anh , Nayyar Vidhu , Hyer Steve , Rodin Andrew

Introduction: Hyperthyroidism may mimic many conditions, and there is potential for under-diagnosis if testing is considered only in patients presenting with classical symptoms.Aim: To describe the range of presentations in patients found to have hyperthyroidism and referred from primary care.Method: Consecutive patients diagnosed with hyperthyroidism and referred to the endocrine clinic between Jan 2009 and Nov 2009 were studied. ...

ea0020p262 | Bone/Calcium | ECE2009

Thyrotoxicosis presenting as severe life-threatening hypocalcaemia – a case report

Loh Vooi-Lee , Boston-Griffiths Edney , Rodin Andrew , Hyer Steve

Introduction: Hypocalcaemia is a rare presentation of thyrotoxicosis. We describe a patient with severe life-threatening hypocalcaemia and suggest pathogenic mechanisms.Case report: A 66-year old lady with long-standing insulin-treated type 2 diabetes presented acutely with generalised weakness and a collapse at home. Prior to admission, she had been treated for an infected neuro-ischaemic plantar ulcer with broad-spectrum antibiotics. She had developed ...

ea0050p388 | Thyroid | SFEBES2017

An electronic protocol replicating QOF thyroid alerts improves monitoring but does not help optimise levothyroxine replacement in hypothyroidism in primary care

Tran Anh , Hyer Steve , Johri Nikhil , Rodin Andrew , Hickey Janis , Dayan Colin , Okosieme Onyebuchi

Introduction: Thyroid quality indicators were removed from the Quality Outcome Framework (QOF) targets in 2014, resulting in discontinuation of statutory system alerts to remind GPs to check annual thyroid function in patients with primary hypothyroidism treated with levothyroxine.Aim: To investigate the impact of the discontinuation and reinstitution of the QOF thyroid e-alerts on the management of hypothyroidism in primary care.<p cla...