Searchable abstracts of presentations at key conferences in endocrinology

ea0086p286 | Thyroid | SFEBES2022

Graves’ thyrotoxicosis and spontaneous coronary artery dissection: Is there a link?

Mulla Kaenat , Avari Parizad , Freudenthal Bernard , Cox Jeremy

Background: Spontaneous coronary artery dissection (SCAD) is a rare condition, which is sometimes underdiagnosed in patients with chest pain and presumably normal coronaries. There have been a few case reports of patients with thyroid dysfunction and arterial dissections.Case: We present a 20 year old female with recent diagnosis of Graves’ thyrotoxicosis managed with methimazole. She initially presented in South Korea with shortness of breath on ex...

ea0065op4.1 | Bone and Calcium | SFEBES2019

Oral calcium loading test can predict the progression of hypercalcaemic primary hyperparathyroidism in patients with normocalcaemic hyperparathyroidism

Oungpasuk Kanapath , Hadjiminas Demetrios , Tolley Neil , Robinson Stephen , Cox Jeremy

Introduction: Normocalcaemic hyperparathyroidism (nHPT) is a persistently elevated parathyroid hormone (PTH) with normal ionised calcium levels in the absence of secondary hyperparathyroidism. nHPT is proposed to be an earlier phase of hypercalcaemic primary hyperparathyroidism (PHPT). nHPT patients can present with progressive complications such as osteoporosis and nephrolithiasis. Currently, there is no diagnostic test to confirm primary hyperparathyroidism in nHPT patients,...

ea0059ep31 | Bone and calcium | SFEBES2018

Multiple vertebral fragility fractures following pregnancy

Sharma Aditi , Agha-Jaffar Rochan , Cox Jeremy , Comninos Alexander N

We present the case of a 35-year-old woman who was well until pregnancy 4y previously in Israel. Her antenatal course was uncomplicated. She breastfed postpartum and a few months into this she experienced acute back pain on reaching for a nappy. MRI demonstrated six vertebral fractures. DEXA scan confirmed osteoporosis (lumbar T-score −4.3, hip T-score −3.3). She received a single dose of denosumab. She moved to the UK 2y later and was referred to our Endocrine Bon...

ea0035p167 | Calcium and Vitamin D metabolism | ECE2014

Unusual case of intrathyroid parathyroid hyperplasia revealed by parathyroid hormone determination in fine-needle aspirate, co-existing with multifocal papillary thyroid carcinoma

Anagnostis Panagiotis , Karras Spyridon , Adamidou Fotini , Christoforidou Varvara , Cox Jeremy

Introduction: Ectopic parathyroid tissue is a rare cause of primary hyperparathyroidism (PHPT). Intrathyroid location has been reported in 18–33% of cases.Case report: A 67-year-old Caucasian female was admitted for evaluation of multi-nodular goiter and normocalcaemic PHPT. The patient was asymptomatic; her medical history was remarkable for hypertension, dyslipidaemia, and albuminuria. Her family history has positive for albuminuria.<p class="...

ea0034p312 | Pituitary | SFEBES2014

Isolated 6th nerve palsy, a surprising complication of acromegaly

Akavarapu Sriranaganath , Pouncey Anna , de Juniac Ali Alexandra , Cox Jeremy

Background: It is estimated that 1-6% of patients with a pituitary adenoma develop ocular nerve palsies. These are primarily due to tumour extension into the cavernous sinus and most commonly affect the 3rd cranial nerve. Because of its sheltered position within the sinus, the 6th cranial nerve is rarely affected. When this does occur, it most commonly results from ischemic neuropathy secondary to diabetes, hypertension or mononeuritis multiplex.<p cl...

ea0025p200 | Endocrine tumours and neoplasia | SFEBES2011

An atypical presentation of primary hyperparathyroidism

Feeney Claire , Hadjiminas Dimitri , Dhawan Ranju , Cox Jeremy

A 62-year-old man was referred from secondary care with a long history of recurrent ureteric colic, borderline hypercalcaemia with parathyroid hormone level in the low-normal range and a normal serum phosphate. There was no family history of kidney stones or osteoporosis and no history of childhood urinary infections.Repeated biochemistry at presentation was as follows: PTH 2.1 pmol/l (1.1–6.8), corrected calcium 2.56 mmol/l (2.15–2.55), phosph...

ea0021p380 | Thyroid | SFEBES2009

Audit of TSH-receptor antibodies and 99m technetium pertechnetate scintigraphy in the diagnosis of thyrotoxicosis aetiology

Amin Anjali , Newlands Louise , Dhawan Ranju , Cox Jeremy , Robinson Stephen

Aim: In the thyrotoxicosis local investigation protocol, Tc99m pertechnetate scintigraphy technetium scan is used to assess the presence of thyroid uptake and both the degree and pattern of uptake. TSH receptor antibodies are used to demonstrate the presence and activity of autoimmune thyroid disease. We audited the utility of these investigations in a series of thyrotoxic patients.Methods: Forty-nine patients (11 men, 38 women, mean age 47.5±38) we...

ea0015p66 | Clinical practice/governance and case reports | SFEBES2008

Sepsis, metabolic acidosis and gestational diabetes: a missing clue

Baburaj Rajashree , Oliver Nick , Cox Jeremy , Teoh TG , Robinson Stephen

A 23-year-old Rwandan lady was 27 weeks pregnant and reported feeling non-specifically unwell for 3 days followed by 24 h of diarrhoea and vomiting. She denied fever, rash, polyuria, polydipsia, weight loss or foreign travel. She has sickle cell trait with no other past medical history. Laboratory glucose at 16 weeks gestation was 5.1 mmol/l.On admission she looked unwell and was tachycardic and dehydrated. Her capillary blood glucose was 17.9 mmol/l and...

ea0094cc4 | Section | SFEBES2023

A rare cause of hypercalcemia, unmasked by over-the-counter vitamin D supplementation

Mateen Abdul , Comninos Alexander , Cox Jeremy , Choudhury Sirazum , Behary Preeshila

Background: Mutation in the CYP24A1 gene can have variable phenotypes including infantile hypercalcemia and adult-onset hypercalcemia, hypercalciuria, nephrocalcinosis, or nephrolithiasis. CYP24A1 gene mutation is a rare but important cause of PTH-independent hypercalcemia.Case Presentation: We describe a case of a 67-year-old gentleman who presented with lethargy, fatigue and weight loss. He was found to have PTH-indepe...

ea0094p322 | Bone and Calcium | SFEBES2023

Osteoporosis in a young male patient

Tsoutsouki Jovanna , Behary Preeshila , Cox Jeremy , N Comninos Alexander

A 58 year-old man presented with backache and was found to have T10-T12 vertebral fractures on spinal-MRI. He was diagnosed with osteoporosis on a DEXA-scan (lumbar-spine T-score-2.6) and was treated with Alendronate and Cholecalciferol at a neighboring hospital. He was referred to the endocrine bone-clinic for a second opinion regarding his osteoporosis. He had a history of multiple small bone fractures and Brucellosis that required a 2-month bed-rest. His family history incl...