Endocrine Abstracts

Background: Levothyroxine replacement for hypothyroidism is safe and effective but may be associated with reduced quality of life and serious adverse effects if administered inappropriately. We set out to investigate if thyroid hormone profiles in hospitalised patients on levothyroxine are similar to those in inpatients without pre-existing thyroid dysfunction.Methods: We conducted a cross-sectional study in patients admitted for non-endocrine reasons to...

Case history: A 46-year-old female patient presented to A&E with a three day history of diarrhoea and vomiting, after three months of progressive weight loss. Her past medical history included chronic autoimmune thrombocytopaenia and Graves’ disease, which had been diagnosed four years earlier and treated with a brief course of propylthyuracil (PTU). She was clinically in extremis, with signs of severe cardiovascular and respiratory compromise and reduced res...

A prolonged course of antithyroid drugs (ATD) is commonly used as first line treatment in patients with hyperthyroidism, although long term cure rates are poor – 40–50%. We performed a longitudinal analysis of outcomes in patients treated with a complete course of ATD and identified factors predicting remission.583 consecutive patients with newly diagnosed hyperthyroidism presenting between 2005 and 2014 and treated with ATD for a minimum of 6 ...

A 63-year-old woman with a history of bipolar disorder and hypothyroidism under section 3 of the Mental Health Act in a psychiatric centre was admitted with severe hypothermia, bradycardia, hypotension and decreased GCS. She was on procyclidine and haloperidol for bipolar disorder and on intravenous antibiotics for 2 days for recurrent cellulitis in her leg. She was on levothyroxine 50 μg daily but was non compliant with her medications.Thyroid func...

Obesity is a global heath concern and the proportion of overweight and obese people in the UK is rapidly increasing. Patients undergoing treatment for hyperthyroidism frequently express concerns regarding excessive weight gain especially when offered treatment with 131I. We followed 1159 patients with overt hyperthyroidism to determine the extent of weight changes and to identify risk factors for weight gain following treatment. Overall, BMI remained unchanged in 13...

The administration of radioactive iodine (131I) is widely used in the treatment of patients with hyperthyroidism. We have previously reported better cure rates in patients receiving a single dose of 600 MBq 131I compared with those treated with lower doses. We set out to evaluate if baseline patient characteristics predict which patients require multiple doses of radioiodine to induce cure. We compared 42 subjects requiring ≥3 doses with 290 patient...

Introduction: TSH-secreting pituitary adenomas (TSHomas) are rare pituitary tumours treated primarily with surgery; in cases of surgical failure, somatostatin analogue (SSA) or radiotherapy are further options. SSAs are rarely used as monotherapy; if responsive and in the absence of radiotherapy, the requirement of life-long medical treatment, is unknown. Herein, we present a patient with a TSHoma who remains in remission three years after SSA withdrawal.<p class="abstext"...

Introduction: Chronic kidney disease (CKD) is a devastating condition characterised by progressive loss of renal function that leads to end-stage renal disease. In patients with CKD there is increased prevalence of subclinical hypothyroidism. The importance of thyroid hormone (TH) action on kidney development, growth and physiology has been established, however the role of TH on kidney disease progression is not well understood.Aim: To assess the express...

A 22-year-old Caucasian female was referred to thyroid specialist clinic due to difficulties fully suppressing her thyroid stimulating hormone (TSH) despite high dose combination therapy of triiodothyronine (T3) and thyroxine (T4) treatment. She had a well-differentiated thyroid -carcinoma of left thyroid lobe treated with left lobectomy. Several other small primary thyroid carcinoma lesions were detected on further examination of the histology which lead to completion thyroid...

Background: Hyperthyroidism often runs an indolent course and may be undiagnosed for prolonged periods. Most patients are treated in the outpatient setting and the effects of hyperthyroidism on hospitalised patients are poorly studied. We set out to determine the prevalence of hyperthyroidism in a large cohort of inpatients and evaluated their comorbidities, reasons for hospitalisation and rehospitalisation rates.Methods: A case-control study was conduct...