Endocrine Abstracts

We present a 71-year-old gentleman who was referred with a 3-month history of tiredness and proximal myopathy, diarrhoea, rapid weight loss and new onset diabetes mellitus.On examination, he had features consistent with cortisol excess including thin skin, abdominal striae, proximal muscle wasting and peripheral oedema to his thighs. Neck examination revealed a palpable 2-cm right-sided thyroid nodule.Laboratory investigations show...

A 67-year-old lady with a 3-year history of Graves’ hyperthyroidism complicated by florid Graves’ ophthalmopathy attended the thyroid clinic at University Hospital Birmingham for routine follow up. Her thyrotoxicosis had been managed with long-term carbimazole treatment with good control. Her past medical history included coeliac disease and hypertension. On clinic review, she appeared acutely confused and disorientated and had evidently lost weight. Her family repor...

Routine thyroid function testing (TFT) in hospitalised patients is not recommended; however, delayed management of thyroid dysfunction may have significant consequences. We quantified the rate of TFT in hospitalised patients and identified factors influencing the likelihood of finding significantly abnormal TSH (<0.01 or >10 mUI). TFTs were performed during 26 937/280 000 (9.6%) admissions between 2007 and 2011. 57.6% of those tested were female and mean age was 63.8 (...

Thyroid dysfunction is common and the clinical presentation of subjects with abnormal thyroid hormone concentrations varies widely. Whilst acute illness may affect the interpretation of thyroid function tests, delaying diagnosis and treatment of thyroid dysfunction may have significant consequences. We set out to determine the likelihood of thyroid function testing and the factors influencing the probability of serum TSH measurement in hospitalised patients with a recorded dia...

Obesity is a global health 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 I-131. We investigated 1047 patients with overt hyperthyroidism to determine the extent of weight changes and to identify risk factors for weight gain following treatment. Overall, 727 (69.4%) patients gained &#88...

Hyperthyroidism is known to result in excess all-cause and circulatory mortality. We set out to identify which factors predict mortality in 1290 patients (1019 females and 271 males) with overt hyperthyroidism and determined if treatment with antithyroid drugs or radioactive iodine (131I) affect outcome. All individuals were aged ≥40 years (median: 57.5 years) and presented to our clinic between 1989 and 2003. Cause of death was compared with age- and period s...

Introduction: The obesity epidemic is growing at an alarming rate. The body volume index (BVI) scanner is a novel machine that produces a true scale 3D body image of the whole body within 6 s and may have a role in the management of obesity.Method: In a pilot study, we set out to assess the impact of BVI scanning on weight loss during a standard weight loss programme in overweight subjects. Forty-three subjects were given standard dietary and lifestyle a...

We have previously (Allehabadia et al., JCEM, 2001) reported better cure rates for patients treated with a single fixed dose of 370 MBq 131I compared with 185 MBq. We have since increased the standard dose of administered radioiodine to 600 MBq and re-audited our data in 1240 consecutive thyrotoxic patients. We aimed to compare the efficacy of the new dose regimen and to explore factors that might predict outcome. Patients were categorised in 3 diagnostic gro...

Introduction: Ectopic ACTH syndrome (EAS) is a rare condition, accounting for approximately 10% of all Cushing’s syndrome (CS). We assessed the experience managing this condition in our centre.Methods: 171 patients (105 female, 66 male) with elevated plasma ACTH concentrations were identified from local IT systems at a tertiary centre (University Hospitals Birmingham NHS Foundation Trust) between 2002 and 2015. An electron...

Background: Maternal severe iodine deficiency has been associated with pregnancy and neonatal loss but the impact of mild-moderate iodine deficiency on pregnancy is not well-documented. Mild-moderate iodine deficiency during pregnancy is common even in iodine replete countries. In the UK women of reproductive age have been found to be mildly-to-moderately iodine deficient. UI/C is an optimal indicator for iodine status in pregnancy.Aims: We...