Searchable abstracts of presentations at key conferences in endocrinology

ea0082wd11 | Workshop D: Disorders of the adrenal gland | SFEEU2022

Gabapentin induced low cortisol

Wahid Alam , Srinivasan Ramalingam

A 56 year old man with history of Hypertension, “Pre-diabetes” and Osteoarthritis was noted to have a low morning Cortisol of 31 nmol/l at 0912 hrs and <28 nmol/l at 0741 hrs on the first and 4th postoperative days respectively following a left total knee replacement. His regular medications were Amlodipine 5mg OD, Ramipril 5mg OD, Bisoprolol 3.75mg OD, Atorvastatin 20mg HS, Gabapentin 100mg TDS. Post operatively he was also given Zomorph 10mg BD with Oramorph PR...

ea0094p250 | Neuroendocrinology and Pituitary | SFEBES2023

Hypophysitis secondary to monoclonal antibody treatment

Anand Viswesh , T Srinivasan Balasubramanian

Background: Immunotherapy has become one of the standard interventions to treat various malignancies and auto-immune conditions with favourable responses to the treatment. However, the immune related adverse events of these medications are diverse which may include a variety of endocrinopathies, like Hypo cortisol, Hypophysitis, hypo and hyperthyroid states.Case report: A 62 year old female with a background of Metastati...

ea0086p321 | Bone and Calcium | SFEBES2022

Unusual Association of Hypercalcemia in a Patient with Coeliac Disease

Ramalingam Satheekshan , Wahid Alam , Srinivasan Ramalingam

A female born in 1950, with history of Coeliac Disease since 1985, hypolactasia, pernicious anaemia, osteoporosis, asthma, lymphocytic colitis and non-alcoholic fatty liver disease with portal hypertension was referred to the Endocrinology team in June 2021 as the calcium was noted to be high. She had strongly positive anti endomyseal antibody, high Tissue Transglutaminase tire and duodenal biopsy proved villous atrophy with no evidence of Enteropathy associated T cell Lymphom...

ea0062wc8 | Workshop C: Disorders of the thyroid gland | EU2019

TSHoma: an elusive finding

Khawaja Saher Sultan , Shagali Hind , Srinivasan Balasubramanian

Introduction: TSHomas are rare pituitary tumors that secrete an abnormal amount of a hormone called thyroid-stimulating hormone (TSH). Alternatively given the name thyrotropinoma, only makes up to 1%–2% of all pituitary adenomas. Patients often remain misdiagnosed for years. Many patients undergo treatments that end up destroying the thyroid gland. This case report is to emphasize the rarity of the condition and the importance of diagnosing it early and accurately to ensu...

ea0059p078 | Clinical practice, governance &amp; case reports | SFEBES2018

An audit of vitamin D supplementation in pregnancy in an ante-natal centre in Birmingham

Yamanouchi Liana , Srinivasan Maheshwari , Basu Ansu

Background: Approximately a third of pregnant women in the UK are Vitamin D deficient, which may confer deleterious consequences, including an increased risk of pre-eclampsia, gestational diabetes mellitus, and intrauterine growth restriction. Vitamin D supplementation in pregnancy has shown to be beneficial, including a reduced risk of pre-eclampsia and pre-term birth, compared to placebo. This audit investigated the extent to which women attending an ante-natal centre adhere...

ea0032p996 | Thyroid (non-cancer) | ECE2013

A case of severe hypoglycaemia in a patient with hyperthyroidism

Patwari Pranjali , Narasimhan Anirudhan , Srinivasan Ramalingam

Introduction: Graves’ disease is a common condition which is usually treated with antithyroid drugs like carbimazole and propylthiouracil. Here we present a patient who developed severe hypoglycaemia after treatment with carbimazole for hyperthyroidism which is unusual in Indian population.Case report: A 31-year-old male Indian presented to Endocrine Clinic with typical signs and symptoms of thyrotoxicosis. His biochemistry showed FT3: 28...

ea0025p333 | Thyroid | SFEBES2011

Audit of thyroid function testing in patients on amiodarone

Srinivas Vidya , Srinivasan Ramalingam , Randall Joanne

Objective: Amiodarone is an iodine rich, potent antiarrhythmic drug that is highly lipid soluble and total body iodine stores remain increased for up to 9 months. Abnormal thyroid functions, either thyrotoxicosis or hypothyroidism occur in upto 14–18% of patients receiving long-term amiodarone therapy. Hence regular thyroid function tests are required in patients on long-term amiodarone treatment. The BNF clearly states that thyroid function tests should be done at a mini...

ea0021p12 | Bone | SFEBES2009

Secondary preventative alendronate use in the prevention of fragility fractures in women above 75 years: the implementation of NICE guidance

Srinivasan Ramalingam , Zaidi Mazhar , Devany Adam

Background: NICE has issued the guidelines regarding the use of alendronate in the secondary prevention of osteoportic fragility fracture in women above 75 years in whom DXA scan is clinically inappropriate or not feasible and considered to have osteoporosis by the responsible clinician.Objectives: We conducted an audit on inpatients at the James Paget University Hospital to examine whether patients are receiving the appropriate interventions as stated i...

ea0016p145 | Clinical cases | ECE2008

Hypercalcemic renal failure in splenic sarcoidosis

Srinivasan Ramalingam , Huston Nigel , Myint Thaung

A 46-year-woman was admitted with decreased appetite, weight loss, nausea, constipation, poor concentration, cough and shortness of breath on exertion. She had long standing history of low backache and had been taking paracetamol and codeine in combination, amitriptyline, tramadol, stemetil, diclofenac, and calcichew D3 one tablet/day On examination, blood pressure was elevated, erythematous nodules seen over right shin. Initial investigations showed normocytic anemia, elevate...

ea0013p336 | Thyroid | SFEBES2007

Role of Liothyronine in thyroid replacement therapy – a retrospective audit

Srinivasan BT , Levy MJ , Howlett TA

Introduction: A recent meta-analysis has suggested that combined replacement with Liothyronine (T3) and Levothyroxine (T4) confers no additional benefit to patients with hypothyroidism but patients still occasionally request this treatment approach.Aim: To analyse the indications and biochemical characteristics of patients on T4/T3 combination therapy for Hypothyroidism in our cohort of patients.Methodology: A retrospective search ...