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Background: Conventional management for thyrotoxicosis includes anti-thyroid medications, radioactive iodine and/or surgery. However, in some cases patients are resistant to first line drugs and need second line treatment to normalize thyroid function tests (TFTs) before considering definitive therapy. We present a case of Graves disease where patient didnt respond to first line anti-thyroid medications and required Lithium and Cholestyramine to achieve euthyroid s...

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ea0094p327 | Bone and Calcium | SFEBES2023

Hypercalcaemia due to hypervitaminosis D

Muhammad Zubair Ullah Hafiz , Graveling Alex

Background: Vitamin D supplements are readily available without prescription. Although vitamin D toxicity is infrequent, rising use may lead to an increase in reported cases. We present a case of hypercalcemia and acute kidney injury due to excess vitamin D intakeCase: A 46-year-old woman was admitted with three-month history of lethargy, reduced oral intake, and constipation. She also experienced intermittent nausea and...

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ea0077p119 | Thyroid | SFEBES2021

Conundrum of Thyroid Function Tests

Zubair Ullah Hafiz Muhammad , Brown Jade , Roy Chowdhury Sharmistha

This case highlights the lessons learnt from a patient who was diagnosed 37 years following presentation with abnormal Thyroid Function Tests (TFTs). Mrs ID had a subtotal thyroidectomy in 1983 for thyrotoxicosis and was started on levothyroxine. She was referred to endocrine services in 2003, and was noted to have a small goitre and abnormal TFTs. Follow up consultations concentrated on thyroxine dose adjustment and querying compliance. She had a background of COPD, CVA (2018...

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ea0094p310 | Adrenal and Cardiovascular | SFEBES2023

Unilateral nonhemorrhagic adrenal infarction presenting as acute abdomen in a pregnant woman

Muhammad Zubair Ullah Hafiz , Fisher Stephen , Littlewood Gail , Watson Wendy

Introduction: Diagnosing acute abdominal presentations in pregnant women poses challenges due to the physiological and anatomical changes during pregnancy. The differential diagnosis is broad, encompassing both obstetric and non-obstetric causes. Among the rare occurrences, nonhemorrhagic adrenal infarction presents a particularly unusual scenario, lacking established guidelines for management and follow-up. We discuss a case of nonhemorrhagic adrenal infarcti...

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ea0077cc9 | (1) | SFEBES2021

A Puzzling Set of Thyroid Function Tests: Thyroid storm or Secondary Hypothyroidism?

Zubair Ullah Hafiz Muhammad , Davies Sioned , Muhammad Sadiqi Rana , Cozma Lawrence

We report the case of a previously healthy, 40 years old obese male, who was admitted in emergency with complaints of chest pain, shortness of breath and loose stools. His physical examination was relatively unremarkable except for sinus tachycardia and restlessness. He had no history of ischemic heart disease. He was admitted under cardiologists and had various investigations (echocardiogram, stress test and coronary angiogram), all normal. Due to the presentation, thyroid fu...

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ea0086p92 | Neuroendocrinology and Pituitary | SFEBES2022

Natural history of non-functioning pituitary microadenomas – results from the UK NFA consortium

Hamblin Ross , Fountas Athanasios , Lithgow Kirstie , Loughrey Paul Benjamin , Bonanos Efstathios , Khalid Shinwari Shah , Mitchell Kirsten , Shah Syed , Grixti Lydia , Matheou Mike , Isand Kristina , McLaren David , Surya Ashutosh , Zubair Ullah Hafiz , Klaucane Katarina , Jayasuriya Anuradha , Bhatti Sumbal , Mavilakandy Akash , Ahsan Masato , Mathew Susan , Hussein Ziad , Jansz Thijs , Wunna Wunna , Ayuk John , Abraham Prakash , Drake William , Brooke Antonia , Baldeweg Stephanie E. , Sam Amir H. , Martin Niamh , Higham Claire , Reddy Narendra , Ahluwalia Rupa , Newell-Price John , Vamvakopoulos Joannis , Krishnan Amutha , Lansdown Andrew , Murray Robert D , Pal Aparna , Bradley Karin , Mamoojee Yaasir , Purewal Tejpal , Panicker Janki , Marie Freel E , Hasan Faisal , Kumar Mohit , Jose Biju , Hunter Steven , Karavitaki Niki

Background: The published data on the natural history of (presumed) non-functioning pituitary microadenomas (micro-NFAs) is possibly compromised by small sample sizes, short follow-up and inclusion of cases with other pathologies in the analyses.Objective: To clarify the long-term outcomes of micro-NFAs in a large cohort of patients.Methods: We conducted a multi-centre, retrospective, cohort study involving 22 UK endocrine departme...

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ea0094oc3.2 | Neuroendocrinology and Pituitary | SFEBES2023

Long-term outcomes of non-operated non-functioning pituitary macroadenomas – results from the UK NFPA consortium

Fountas Athanasios , Lithgow Kirstie , Benjamin Loughrey Paul , Bonanos Efstathios , Khalid Shinwari Shah , Mitchell Kirsten , Mavilakandy Akash , Ahsan Masato , Matheou Mike , Isand Kristina , Hamblin Ross , McLaren David S. , Zubair Ullah Hafiz , Grixti Lydia , MacFarlane James , Jayasuriya Anuradha , Bhatti Sumbal , Wunna Wunna , Shah Syed , Hussein Ziad , Mathew Susan , Klaucane Katarina , Ayuk John , Vamvakopoulos Joannis , Krishnan Amutha , Higham Claire , Abraham Prakash , Baldeweg Stephanie E. , Purewal Tejpal , Panicker Janki , Martin Niamh , Drake William M. , Ahluwalia Rupa , Newell-Price John , Gurnell Mark , Mamoojee Yaasir , Brooke Antonia , Lansdown Andrew , Murray Robert D. , Bradley Karin , Pal Aparna , Reddy Narendra , Levy Miles J. , Marie Freel E. , Jose Biju , Hunter Steven J. , Karavitaki Niki

Background: Large series of patients elucidating the natural history of conservatively managed non-functioning pituitary macroadenomas (macroNFPAs) and relevant prognostic factors are not available.Objectives: Clarify long-term outcomes of macroNFPAs in large cohort of patients.Methods: Multi-centre [21 UK endocrine departments-UK NFPA consortium], retrospective, cohort study of ca...