Searchable abstracts of presentations at key conferences in endocrinology

ea0028p76 | Clinical practice/governance and case reports | SFEBES2012

Letrozole induced Hypertestosteronism

Krishnasamy Senthilkumar , Macleod Andrew , Moulik Probal

Background: Letrozole is a potent aromatase inhibitor licensed for use in women with breast cancer. It is also used by body builders for reduction of gynecomastia when taking anabolic steroids. Supply for this unlicensed use is readily available through internet. Testosterone production is regulated by negative feedback of estrogen on the pituitary. The use of letrozole can therefore cause supraphysiological levels of testosterone in men. We present such a case.<p class="a...

ea0028p82 | Clinical practice/governance and case reports | SFEBES2012

Ectopic parathyroid cyst presenting with parathyroid crisis

Krishnasamy Senthilkumar , Moulik Probal , Macleod Andrew

Background: Primary Hyperparathyroidism is mainly produced by an adenoma and it is mostly a benign condition. Most of the patients are asymptomatic. We present a case of ectopic parathyroid cyst presenting with this condition.Case: A 76 yr female presented with new onset confusion, abdominal pain, vomiting, diarrhoea and dehydration. She was currently being treated for a urinary tract infection. Investigations showed acute kidney injury with creatinine 3...

ea0028p98 | Clinical practice/governance and case reports | SFEBES2012

Audit of detection and management of adrenal incidentalomas at a district general hospital

Krishnasamy Senthilkumar , Moulik Probal , Macleod Andrew

Objectives: Increasing use of scanning has led to a significant increase in detection of adrenal incidentalomas. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons have issued guidelines for evaluation of adrenal incidentalomas in 2009. We audited our current practice at Royal Shrewsbury Hospital against the 2009 guidelines.Method: Retrospective audit of patients found to have adrenal masses on imaging st...

ea0028p332 | Steroids | SFEBES2012

Bilateral adrenal enlargement with Hypoadrenalism

Krishnasamy Senthilkumar , Moulik Probal , Macleod Andrew

Background: Primary hypoadrenalism with bilateral adrenal enlargement is a relatively rare condition. We present four such patients. Case 1: 60 year old male presented with malaise, weight loss and hyponatremia. Short synacthen test was abnormal and ACTH was raised (309 ng/L). CT adrenals showed bilateral adrenal enlargement with uniform texture and low attenuation with no change in repeat CT. FNAC of adrenal gland showed infarcts. Further tests confirmed antiphospholipid anti...

ea0075a01 | Adrenal gland | EYES2021

ACTH independent cushing’s syndrome secondary to a right adrenal adenoma masked by pregnancy

Yousuf Quratulain , Krishnasamy Senthilkumar , Singh Sarishka

Cushing’s syndrome can occur as a consequence of prolonged exposure to excessive amounts of circulating free cortisol and the various causes can be broken down into exogenous causes, such as from steroid treatment for chronic illnesses, or endogenous as in this case. Cushing’s syndrome can be further classified into ACTH-dependent and ACTH-independent1, for which the latter accounts for 15–20% of all cases. This report highlights the case of a 35 year old female...

ea0059p206 | Thyroid | SFEBES2018

Iodine restricted diet prior to radioiodine therapy for hyperthyroidism

Nabi Assad , Weekes Joanne , Krishnasamy Senthilkumar , Buch Harit

Background: There has been conflicting evidence on the use of strict dietary iodine restriction prior to Radioiodine (RAI) administration for the management of hyperthyroidism and varying level of restrictions have been used. More recently the Medical Physics team in our institute implemented strict dietary iodine restrictions for 2 weeks pre-RAI administration. Significant inconvenience was reported by patients, which in some instances led to their reluctance to receive a sec...

ea0028p109 | Clinical practice/governance and case reports | SFEBES2012

Postmenopausal hirsutism: Ovarian hyperthecosis or androgen secreting adrenal tumour

Krishnasamy Senthilkumar , Moulik Probal , Macleod Andrew , Richmond Kathy

Background: Post menopausal hirsutism should raise suspicion of androgen secreting tumors. We present a case due to bilateral ovarian hyperthecosis with an adrenal incidentaloma.Case history: 57 year old female patient was referred to us with history of new onset hirsutism over the past 2 years. She went through menopause 6 years back. On examination she had hirsutism affecting all her body, no evidence of virilization and no organomegaly on abdominal ex...

ea0034p123 | Clinical practice/governance and case reports | SFEBES2014

Hypomagnesaemia during proton pump inhibitor therapy causing functional hypoparathyroidism

Krishnasamy Senthilkumar , Abbott Vineet , Kannan Rajendran Bellan , Varughese George , Nayak Ananth , Varadhan Laks , Jose Biju

Proton pump inhibitors (PPI) are widely prescribed. PPI-induced diarrhoea and hypomagnesaemia are well-documented in literature. Hypomagnesaemia is well-known to cause functional hypoparathyroidism. We describe a patient who had transient profound hypoparathyroidism which improved on discontinuing PPI and normalising severe hypomagnesaemia.A 72-year-old male, who was on oral anti-diabetic medications, calcium/vitamin D3 supplements and PPI, presented wit...

ea0034p124 | Clinical practice/governance and case reports | SFEBES2014

Anti-GAD antibody encephalitis: a potentially treatable syndrome

Krishnasamy Senthilkumar , Varughese George , Al-araji Adnan , Varadhan Laks , Nayak Ananth , Natarajan Indira , Jose Biju

Autoimmune encephalitides are being increasingly recognised as important and potentially reversible non-infectious causes of the encephalitic syndrome. Myriad of clinical presentation and lack of symptom specificity leads to a wide differential diagnosis. Failure to diagnose the correct aetiology of an encephalitic syndrome can lead to significant morbidity and mortality. A 57 years old right handed female with no significant medical problems initially presented with left side...

ea0021p15 | Bone | SFEBES2009

A study on accuracy of Sestamibi and ultrasound scanning in identifying a solitary parathyroid adenoma in patients with primary hyperparathyroidism

Krishnasamy Senthilkumar , Manjunatha Reshmi , Vydianath Sanjay , Stouhal Peter , Baskar Varadarajan , Singh Baldev M , Buch Harit

Background: The success of Minimally Invasive Parathyroidectomy (MIP) is closely linked to accurate preoperative localisation of a solitary parathyroid adenoma. Sestamibi/SPECT scan (SS) and ultrasonography (US) are the preferred imaging modalities although their accuracy varies considerably between different centres.Aim: To assess the efficacy of SS and US in identifying a solitary parathyroid adenoma in patients with primary hyperparathyroidism (PHPT) ...