Searchable abstracts of presentations at key conferences in endocrinology

ea0050p251 | Neoplasia, Cancer and Late Effects | SFEBES2017

Endocrinopathies are a frequent Consequence of Immune Checkpoint Inhibitor Therapy, with a Low Recovery Rate of both Thyroid and Pituitary Dysfunction

McGowan Anne , Weatherby Tom , Powlson Andrew , Parkinson Christine , Chatterjee Krishna , Corrie Pippa , Moran Carla

Background: Immune checkpoint (CTLA-4, PD-1) inhibitors are increasingly used to treat cancers including advanced melanoma. Although endocrine immune related adverse events (IRAEs) are now well reported, the frequency and type of thyroid and pituitary dysfunction reported varies considerably, with hypophysitis after CTLA-4 inhibitors reported in 2–16%, and thyroid dysfunction after PD-1 inhibitors in 2–39%. In addition, recove...

ea0050cc04 | Featured Clinical Cases | SFEBES2017

Renin assay interference may conceal the diagnosis of primary aldosteronism

Powlson Andrew S , Oddy Sue , Halsall David J , Moran Carla , Gurnell Mark

Context: Primary aldosteronism (PA) accounts for 5–10% of all hypertension and 20–25% of refractory cases. Diagnosis is important as PA is associated with increased morbidity and mortality compared with ‘essential’ hypertension, and up to 50% of patients may benefit from unilateral adrenalectomy. Screening requires measurement of plasma renin activity (PRA) or concentration (PRC), and plasma aldosterone concentration (PAC), to yield an aldosterone:renin rat...

ea0091wd14 | Workshop D: Disorders of the adrenal gland | SFEEU2023

Life-threatening hypokalaemia heralding the diagnosis of metastatic Adrenocortical Cancer (ACC) with 11-deoxycortisol hypersecretion

McDonnell Tara , Leanne Cussen , Miller Clare , Moran Carla , Dugal Neil , Sherlock Mark , O'Reilly Michael

A 51 year old presented with headaches, fatigue and generalised weakness. She had a background history of hypertension diagnosed one year prior to presentation. Initial laboratory evaluation demonstrated life-threatening hypokalaemia, potassium 0.9mmol/l(R.I. 3.5-5.3). This profound hypokalaemia required ICU admission for replacement of potassium and monitoring. Management of subsequent fluid overload necessitated a brief period of hemofiltration. During the course of evaluati...

ea0069oc10 | Oral Communications | SFENCC2020

Hiding in plain sight: A case of severe refractory primary hyperparathyroidism due to an intrathyroidal ectopic parathyroid adenoma

Glasgow John C , Chatterjee Krishna , Fish Brian , Berman Lol , Marker Alison , Moran Carla , Casey Ruth

Section 1: Case history: A 30 year-old female patient with a background of symptomatic primary hyperparathyroidism diagnosed in 2008 and a history of two failed neck surgeries, was reviewed in clinic complaining of persistent symptoms of hypercalcaemia. Previous pre-operative neck imaging had failed to localise a parathyroid adenoma and the patient had undergone two neck explorations by an experienced ENT surgeon; one which removed thymic tissue and the other which removed a m...

ea0065p403 | Thyroid | SFEBES2019

Iopanoic acid safely, quickly and effectively induces euthyroidism in resistant thyrotoxicosis

Samudrala Havish , Terry Isabelle , Wong Kah Fai , Wood Diana , Chatterjee Krishna , Moran Carla

Introduction: Thyrotoxicosis resistant to the usual treatment is rare, but potentially fatal. In such situations, the optimal next treatment is unclear. Iopanoic acid (IA) was historically used as an oral contrast agent; it’s capacity to treat thyrotoxicosis has been limited in recent years due to its restricted availability.Methods: Retrospective case note review of patients treated with IA for resistant thyrotoxicosis at our institution over the p...

ea0048o3 | Oral Communications | SFEEU2017

Compensated hyperthyrotropinaemia due to partial loss-of-function mutation in TSH receptor gene

McGowan Anne , Moran Carla , Vanderpump Mark , Dattani Mehul , Chatterjee Krishna , Schoenmakers Nadia

Case history: A clinically euthyroid 7-year-old boy was noted to have a persistently elevated TSH 7.35–14 mU/l (NR 0.27–4.2) and normal FT4 15.0 pmol/l (NR 10-24) with negative anti-thyroid peroxidase antibodies. Thyroid ultrasonography revealed a eutopically-located thyroid gland of normal size. Following commencement of levothyroxine, he developed insomnia, irritability and headaches, resulting in cessation of treatment. Growth and development proceeded ...

ea0059cc10 | Featured Clinical Cases | SFEBES2018

Thyroid hormone pattern in Familial Dysalbuminemic Hyperthyroxinemia (R218H mutation) on different assay platforms

Khoo Serena , Lyons Greta , McGowan Anne , Gurnell Mark , Oddy Susan , Halsall David , Chatterjee Krishna , Moran Carla

Introduction: Familial dysalbuminemic hyperthyroxinemia (FDH) is characterized by artefactual hyperthyroxinemia caused by enhanced binding affinity of thyroxine to the mutant albumin. However little is known about how FDH affects the measurement of thyroid hormones, especially FT3, across many assay platforms.Methods: Forty-eight genetically confirmed FDH patients (R218H mutation) had FT4 and FT3 measured with 1-step (ADVIA CENTAUR®, Siem...

ea0031oc5.4 | Pituitary and neoplasia | SFEBES2013

Clinical, metabolic, biochemical and radiological characterisation of patients with thyrotropinomas reveals a highly variable phenotype

Koulouri Olympia , Moran Carla , Kandasamy Narayanan , Halsall David , Chatterjee Krish , Gurnell Mark

Background: Thyrotropinomas (TSHomas) are traditionally considered a rare albeit important cause of thyrotoxicosis, accounting for ∼1% of all pituitary adenomas. Although early case series reported a preponderance of macroadenomas, emerging evidence suggests microadenomas are being increasingly diagnosed. In addition, the clinical/biochemical phenotype appears to be more variable than previously suspected. We therefore examined the clinical, metabolic, biochemical and ra...

ea0031p360 | Thyroid | SFEBES2013

Homozygous resistance to thyroid hormone: can cardiac complications be prevented?

Moran Carla , Al-Johani Amal , Rajanayagam Odelia , Halsall David , Habeb Abdelhadi , Chatterjee V K K

Resistance to thyroid hormone (RTH) is usually due to heterozygous mutations in THRB gene with rare cases being homozygous for receptor defects. We describe an RTH case due to a homozygous TRβ mutation (R243Q).The Proband (male, 8.4 years), was born at term with low birth weight (1.9 kg) to consanguineous parents. He has a prominent nasal bridge, goitre, low body weight (10th centile), recurrent tonsillitis, hyperactivity and has mild hearing impair...

ea0031p365 | Thyroid | SFEBES2013

The challenge of managing refractory amiodarone-induced Graves' disease in resistance to thyroid hormone

Moran Carla , Chatterjee V K K , Page M D , Owen Penny

A 42-year-old man with resistance to thyroid hormone (RTH) and a recognised thyroid hormone receptorβ mutation (R383C) mutation, presented with atrial fibrillation (AF) which was resistant to DC cardioversion until initiation of amiodarone therapy.As expected in RTH, his baseline TFTs were abnormal (FT4 34.6 pmol/l, TSH 2.27 mU/l), but rose further (FT4 45 pmol/l, TSH 0.93 mU/l) following commencement of amiodarone. However, sh...