Searchable abstracts of presentations at key conferences in endocrinology

ea0086pl10 | Clinical Endocrinology Trust Lecture | SFEBES2022

Why don’t we cure all patients with Graves’ disease?

Pearce Simon

Graves’ disease is characterised by an autoimmune response to the TSH receptor leading to circulating stimulatory TSH receptor antibodies (TRAbs) which directly cause hyperthyroidism and goitre. Patients with thyroid eye disease, children and teenagers, and those with large goitre, severe hyperthyroidism or high TRAb titres have unmet clinical needs and frequently have unsatisfactory outcomes with current therapies. In common with all other antibodies, TRAbs are secreted ...

ea0037s23.2 | Adrenal insufficiency: advances in diagnostics and therapy (<emphasis role="italic">Endorsed by the European Journal of Endocrinology</emphasis>) | ECE2015

Regenerative therapy in autoimmune Addison's disease

Pearce Simon

It is obvious that adrenal cortex is plastic, with adrenal atrophy and functional hypoadrenalism during exogenous glucocorticoid therapy; yet adrenal hyperplasia and hyperfunction during stimulation from ACTH during Cushing’s disease. This is owing to subcapsular adrenocortical stem cells that regenerate the zones of adult adrenal cortex throughout life.We have performed a series of experimental medicine trials in order to explore the idea that auto...

ea0036s2.2 | Symposia 2 Recent advances in adrenal disease | BSPED2014

Curing Addison’s disease

Pearce Simon

Addison’s disease is a good therapeutic target for regenerative medicine, as adrenal cell mass and steroidogenesis have clear intrinsic plasticity, as determined by circulating ACTH concentrations. With the advent of the biological agents as disease-modifying therapy for inflammatory arthritis and their experimental use in several other autoimmune conditions including type 1 diabetes, we undertook a pilot study of immunomodulatory therapy in patients with autoimmune Addis...

ea0028cmw4.4 | How do I approach... | SFEBES2012

Endocrine evaluation in a patient with coeliac disease

Pearce Simon

Endocrine management of the patient with coeliac disease (CD) can be divided between management of the long-term consequences of malabsorption and timely identification and treatment of associated autoimmune disorders. CD patients have chronic calcium and vitamin D malabsorption at diagnosis, leading to secondary hyperparathyroidism, which is frequently associated with hypocalcaemia, low BMD and osteopenia. In many cases these will improve following institution of a gluten-fre...

ea0020s9.2 | Addison's disease from genetics to clinical outcome | ECE2009

Genetics of autoimmune Addison’s disease

Pearce Simon

Autoimmune Addison’s disease (AAD) can be divided into two distinct genetic aetiologies. The childhood onset type 1 polyendocrinopathy (aka APECED) syndrome is a monogenic autosomal recessive trait. Whereas the common-or-garden AAD that may be found as an isolated endocrinopathy, or in association with thyroid disease or type 1 diabetes as part of the autoimmune polyendocrinopathy type 2 syndrome (APS2). Isolated AAD (IAD) and APS2 can be considered as very similar from t...

ea0019s25 | What is the TSH set point? Does it matter? | SFEBES2009

Pathological consequences of altered HPT axis set-point: subclinical thyroid disease?

Pearce Simon

Subclinical thyroid diseases are common, affecting around 5% of the general population, and rising in prevalence with advancing age. While some people have a congenital abnormality of the hypothalamic–pituitary–thyroid axis set point, for instance due to germline mutations that cause loss of TSH-receptor function, this does not appear to account for the majority of cases of subclinical thyroid disease. There is a change in the reference range for TSH (which is the de...

ea0013d1 | This house believes that all patients with sub-clinical thyrotoxicosis should be treated | SFEBES2007

This house believes that all patients with subclinical thyrotoxicosis should be treated: For the motion

Pearce Simon

Subclinical thyrotoxicosis, due to endogenous hyperthyroidism, affects about 1% of the older population and is predominantly caused by indolent progression to a state of autonomous thyroid function in people with nodular thyroid disease. For more than a decade, it has been known that subclinical hyperthyroidism is associated with a three-fold increased risk of atrial fibrillation (Sawin et al.) over 10 years of follow-up. More recently, three separate...

ea0077lb38 | Late Breaking | SFEBES2021

An interesting case of Hypophosphataemia: Oncogenic Osteomalacia

Pervez Muhammad Hassaan , Pearce Simon , Artham Satish

Introduction: Causes of hypophosphataemia include reduced intestinal absorption, inadequate intake, transcellular shifts (refeeding syndrome, glucose/insulin infusion), renal loss which is either FGF23 mediated (inherited forms or tumour induced osteomalacia) or non-FGF23 mediated (hyperparathyroidism, drugs)Case report: We present a case of 51 years old female referred to us with multiple fractures during her half marathon. She suffered from bilateral m...

ea0038p332 | Pituitary | SFEBES2015

Loperamide-induced hypopituitarism

Napier Catherine , Pearce Simon H S

Loperamide is a poorly absorbed opioid μ-receptor agonist that is the most commonly used anti-diarrhoeal medication in the UK. Prescription cost analysis from the Department of Health and Social Care Information Centre reported that 1.79 million prescriptions of the drug were issued in 2014 and it is also freely available ‘over the counter’. It is widely believed to be very safe, with constipation as the main side-effect.A 45-year-old man ...

ea0038p432 | Thyroid | SFEBES2015

Peripheral blood microRNA markers in patients with papillary thyroid cancer

Perros Petros , Mallick Ujjal , Pearce Simon

Monitoring patients with thyroid cancer for recurrent disease relies heavily on measuring serum thyroglobulin (Tg). Tg cannot be assessed reliably in the presence of anti-thyroglobulin antibodies for analytical reasons, this being the case in about a third of patients. There has been recent interest in microRNA profiling of fine needle aspiration biopsies of thyroid nodules, with encouraging results. The objective of this pilot was to explore microRNAs in peripheral blood of p...