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Endocrine Abstracts

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Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

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The Society for Endocrinology BES will take place 19-21 Nov 2018 in Glasgow. Come and exchange knowledge, share experiences and strengthen collaborations across our global community of endocrinologists.

ePoster Presentations

Thyroid

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ea0059ep97 | Thyroid | SFEBES2018

The Use of Salvage Radiotherapy and Radioactive Iodine in a Case of Recurrent Metastatic Papillary Thyroid Cancer: A Case Report

Tansey David J , Gibney James , Salib Osama

Background: Thyroid carcinoma consists of just 1% of all malignancies but is the commonest malignant endocrine tumour. Papillary thyroid carcinoma is the most common form of thyroid carcinoma consisting of 80% of all cases. There are very few case reports in the literature of papillary thyroid cancers presenting with distant to the pelvic organs. Distant metastases are noted in 1–3% of patients with thyroid cancer at initial diagnosis.Clinical case:...
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ea0059ep98 | Thyroid | SFEBES2018

Alternatives to surgery for patients with stridor secondary to multinodular goitres?

Adil Maryam , Page Georgina , Richardson Tristan

An 88 year old female presented with gradually worsening stridor and dysphagia. Her past medical history was complex and included included ischaemic heart disease and atrial fibrillation treated with warfarin. She had been initially referred for enlargement of her lonstanding goitre 6 years ago (2012) with investigations demonstrating a suppressed TSH and a normal FNA cytology. Respiratory function tests did not show any significant extra thoracic compression, but her CT scan ...
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ea0059ep99 | Thyroid | SFEBES2018

When locoregional recurrences (LRR) in papillary thyroid carcinoma (PTC) can be repeatedly eliminated by ultrasound-guided percutaneous ethanol ablation (UPEA) and appropriate use of dermatologic surgery, cervical skin metastases (SM) in low risk PTC (LRPTC) can be associated with an excellent long-term prognosis

Iniguez-Ariza Nicole , Brewer Jerry , Hay Ian , Lee Robert

Background: UPEA for LRR in PTC was introduced in 1993 (JCEM 96:2717, 2011). It is not appreciated that such non-invasive ablations can often be repeated over decades (Surgery 154:1448, 2013). Skin metastases (SM) from thyroid carcinoma are typically associated with disseminated disease; average survival after SM diagnosis is 19 months (JAAD 36:531, 1997). Our case provides insights into managing LRR and SM in LRPTC.Clinical case: In 2004, an open biopsy...
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ea0059ep99 (1) | Thyroid | SFEBES2018

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ea0059ep100 | Thyroid | SFEBES2018

Spontaneous Ovarian Hyperstimulation Syndrome in Pregnancy: A Rare Presentation of Hypothyroidism

Johns Emma C , McGrane David J , Gallagher Andrew

Clinical Case: A 27 year-old primigravida was referred for gynaecology assessment after her 12 week booking ultrasound scan showed a multiloculated cystic mass in the Pouch of Douglas. She reported fatigue, dry skin and constipation for several months. She had no past medical history and took no regular medications. She had conceived naturally, and her periods were previously regular. There was a family history of hypothyroidism in her sister. She emigrated from India 3 years ...
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ea0059ep101 | Thyroid | SFEBES2018

Relapse of Graves’ Disease and Severe Thyroid Eye Disease following Total Thyroidectomy

Kurera Isuri , Panahloo Arshia

Total thyroidectomy is one of the definitive treatments for Graves’ disease. This case describes the rare recurrence of thyroid eye disease (TED) and thyrotoxicosis due to thyroid remnant tissue. We present a 58 year old lady with Graves’ disease first seen in 2005 with positive TSH receptor antibodies (TSHRab) level of 2.5 U/l. She had a large multinodular goiter at presentation and this continued to grow with retrosternal extension and subsequent tracheal deviation...
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ea0059ep102 | Thyroid | SFEBES2018

A case of severe Graves’s ophthalmopathy

Yung Paul , Donoghue Danielle , Lee Vickie , Akshikar Rashmi , Aziz Ahmad , Jain Rajni , Robinson Stephen , Bravis Vassiliki

Grave’s orbitopathy typically presents with symptoms of proptosis and diplopia. It is an autoimmune condition of retro-orbital tissues. We present a case in which the management of orbitopathy has been complex and required escalation to immunosuppression and consideration of biological agents. A 34-year-old female presented with 2 weeks of diplopia. She had normal visual acuity with no past medical or family history. She never smoked. Thyroid eye disease was diagnosed, sh...
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ea0059ep103 | Thyroid | SFEBES2018

High dose levothyroxine combined with repetitive transcranial magnetic stimulation for bipolar disorder with DIO2 gene polymorphisms

Zamar Andy , Lulsegged Abbi

23-year-old woman presented with rapid cycling bipolar disorder (RCBPD) with alternating episodes of mixed affective states, hypomania & severe depression. Quetiapine was initiated & discontinued due to side effects. Levothyroxine was started & gradually increased to 500mcg daily. This was coupled with 6 weeks of low frequency (LF) rTMS. She was clinically euthyroid. TSH <0.01 miu/l (0.27–4.2), fT4 37.1 pmol/l (12–22), fT3 8.4 pmol/l (3.1–6.8), r...
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ea0059ep104 | Thyroid | SFEBES2018

Myxoedema coma – importance of early recognition!

Sharma Aditi , Mashayekhi Soudeh , Wadhwani Roshni , Robinson Stephen

A 70-year-old lady, with a background of primary hypothyroidism presented to the Emergency department with a 1 day history of confusion and drowsiness. On examination her HR was 58 bpm, temperature 28 degrees celsius. She was resuscitated with warm fluids and bair hugger, whilst also given broad spectrum intravenous antibiotics. Her blood results showed an AKI with creatinine of 213 and was treated for a NSTEMI with a troponin on admission of 1770, rising to 2190. ECG showed p...
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ea0059ep105 | Thyroid | SFEBES2018

Recovery of thyroid function after 26 years post thyroidectomy for Graves’ disease with evidence of active remnants

Almazrouei Raya , Haboosh Sara , Wernig Florian , Todd Jeannie F.

A 56 years old lady was referred to our endocrine service for further management of levothyroxine replacement. She was diagnosed with Graves’ disease 26 years ago and underwent thyroidectomy as definite treatment. Post-operatively, she was commenced on 100mcg of levothyroxine and continued to have regular follow up with her GP. It was noted that her levothyroxine dose had to be reduced to 50 mcg daily over a period of 10 years due to persistently suppressed TSH levels wit...
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ea0059ep106 | Thyroid | SFEBES2018

A rare case of carbimazole related Rhabdomyolysis

Johnson Emma , Hughes David , Asma Faaiza , Haggan Kate , Ibraheem Nawal

Introduction: There are many causes of rhabdomyolysis, with Carbimazole, the first line treatment for hyperthyroidism, being one of the rarest. Rhabdomyolysis can potentially cause significant morbidity and mortality if left untreated.Case: A 38 year old female presented to the Emergency Department in May 2018 with a 4 day history of severe sudden onset bilateral thigh pain. Her only prior health problem was primary hyperthyroidism for which she had been...
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ea0059ep107 | Thyroid | SFEBES2018

Neonatal thyrotoxicosis caused by persistently high levels of thyroid stimulating antibodies in autoimmune hypothyroidism

Marr Daniel , Abouglila Kamal , El-Kholy Suzanne

Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1–5% of infants born to women with Graves’ disease (GD). We present a case of neonatal thyrotoxicosis due to maternal hypothyroidism secondary to radioactive iodine treatment for Graves’ disease. A new-born female at 13-days of age was readmitted due to maternal concerns. She noted the baby to be jittery, unsettled, tachycardic and tachypnoeic. The infant was born via a spont...
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ea0059ep108 | Thyroid | SFEBES2018

Growth failure due to severe primary hypothyroidism

Khan Haider , Dugal Tabinda

Introduction: Thyroid hormones are critical for early brain development, somatic growth, and bone and pubertal maturation. Primary hypothyroidism is a well-known cause of poor linear growth in children. This case highlights role of thyroid hormone replacement to improve final height in the setting of profound hypothyroidism.Case: We report the case of 16 years old Caucasian girl initially evaluated for primary amenorrhea and delayed growth of 139 cm putt...
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ea0059ep109 | Thyroid | SFEBES2018

A curious case of paralysis

Sharma Kunal , Bawlchhim Zo , Jennings Rob , Tringham Jennifer

A 32 year old Polish gentleman presented following a collapse with preserved consciousness. Preceding this he was noted to have had a rapid deterioration in mobility with worsening weakness in all four limbs. On further questioning the patient had been diagnosed with hyperthyroidism two months previously and was being treated with propylthiouracil. Positive examination findings included tachycardia with upper limb weakness with 2/5 power bilaterally and lower limbs weakness wi...
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ea0059ep110 | Thyroid | SFEBES2018

Use of Carbimazole in a Thyrotoxic Patient known to have Aplastic anaemia

Zaidi Zulfiqar , Elsabbagh Mohamed , Moisey Rob , Haniff Haliza

Introduction: Carbimazole is a first line antithyroid drug for thyrotoxicosis management in UK. Its main but rare complications include allergic reaction and risk of neutropenia. Here we discuss the lesser reported situation in which a thyrotoxic patient who is in a remission from Aplastic anaemia was treated with Carbimazole.Case Report: Out patient was seen in Ambulatory care with symptoms of heart failure along with tachycardia. Thyroid blood test sho...
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ea0059ep111 | Thyroid | SFEBES2018

Protean Presentations of Severe Hypothyroidism: Decompensated Liver Disease as an Unusual Co-presentation

Costa Ryan D. , Nagi Dinesh

We report a 51-year old lady presenting to hospital with a 3 week history of abdominal and peripheral swelling. Mentation was slow and noted to be pale on admission. She also reported feeling cold, lethargic, reduced exercise tolerance and constipation. She had no prior medical problems, no regular medications and working till the day prior to admission in a garden centre. She was an ex-smoker, teetotal and there was a family history of hypothyroidism. Physical assessment reve...
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ea0059ep112 | Thyroid | SFEBES2018

Antibody interference in thyroid assay in a patient with abnormal Thyroid function test

Gunga Claudia , Wei Alys , Pereira Joao , Hussain Syed , Imtiaz Komal

An 88 year-old male was referred to Endocrine Clinic with abnormal thyroid function test (TFT); free T4:fT4: 36.9pmol/L (NR:11-23) and a normal TSH:2.51mU/L (NR:0.35-5). Atrial Fibrilation was diagnosed recently and was on Apixiban and Bisoprolol. He had history of prostate cancer, hypertension, oesophagitis, cervical spondylosis, splenectomy and CKD3. He felt well apart from slight heartburn. He was a retired motor engineer. He had no family history of thyroid disease and nev...
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ea0059ep113 | Thyroid | SFEBES2018

Non-thyroidal illness syndrome in the setting of amiodarone use, a diagnostic challenge

Marie Colon Castellano Janet , Morales-Borrero Walter , Navarro-Torres Mariela , Martino-Morales Alejandro

Non-thyroidal illness syndrome is the alteration in thyroid function tests (TFTs) that occurs in critically ill patients, including those using thyrotoxic medications. Therefore, it is a challenge to interpret thyroid function tests in a critically ill patient on amiodarone. Case of 66-year-old male with history of heart failure with reduced ejection fraction, atrial fibrillation, and hypertension who presented to the emergency room due to progressive shortness of breath. Phys...
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ea0059ep114 | Thyroid | SFEBES2018

Marine Lenhart syndrome: A case report

Ojo Olubukola , Ojo Olalekan , Ajiboye John , Junaid Oladimeji

A 19-year-old male referred from the Ophthalmology clinic on account of staring gaze of 1 year, and an anterior neck swelling which was noticed 3 months before presentation. Anterior neck progressively increased in size. It was not painful. No history of dysphagia, voice changes or yellowness of the eyes. There was positive history of heat intolerance, weight loss despite increased appetite, irritability, restlessness, palpitations and hyperdefeacation. No history of exposure ...
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ea0059ep115 | Thyroid | SFEBES2018

Case Series of unusual presentations of Thyrotoxicosis

Parsad Meenakshi , King Samuel , Lambert Kimberley

Thyrotoxicosis is a relatively common condition affecting 1–2% of women and 0.1–0.2% of men. Common symptoms are usually straightforward and easily identified. Rarer presenting features such as confusion and headache have been published in the literature as case reports. We hereby report two cases of Graves Thyrotoxicosis presenting unusually and therefore misleading the initial diagnostic pathway. The first case is a 45-year-old female with a 4-day history of headac...
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ea0059ep116 | Thyroid | SFEBES2018

Unusual thyroid dysfunction in a patient treated with Alemtuzumab for Relapsing-remitting Multiple sclerosis

Artham Satish , Abouzaid Mona , Joshi Ashwin

Introduction: Alemtuzumab is humanized monoclonal antibody used in the treatment of relapsing–remitting multiple sclerosis (MS). The 5year incidence of thyroid adverse events in phase-3 clinical trials is up-to 40.7%. In most cases, the thyroid dysfunction is mild and easily manageable. Hyperthyroidism, particularly Graves’ disease (GD) is more common. We describe a case of unusual thyroid dysfunction in a patient treated with Alemtuzumab.Case:...
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ea0059ep117 | Thyroid | SFEBES2018

The extreme of graves’ disease

Boharoon Hessa , AlJaberi Asma , Malik Azhar

Graves disease is an autoimmune disorder of the thyroid gland. It is a very rare condition that a Graves patient presents with spontaneous hypothyroidism. Hypothyroidism during the course of Graves’ disease occurs commonly due to radio-iodine (RAI) therapy or thyroidectomy. It may also develop after anti-thyroid drug (ATD) treatment. We present a case of 44 years old Emarati male heavy smoker diagnosed with graves’ disease after thyrotoxic manifestations, associated ...
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ea0059ep118 | Thyroid | SFEBES2018

Goitre with Unusual Thyroid Function Test and Congenital Hypothyroidism Due to DUOX2 Gene Mutation And Iodine Deficiency

Khan Haider , Chong Patrick

Introduction: Dual oxidase 2(DUOX2) is NADPH oxidase complex at the apical membrane of the thyroid follicular cells which produce H2O2 required for thyroid hormone synthesis. DUOX2 gene mutation is a well known cause of congenital hypothyroidism (CH), the phenotype depends on the type of mutation and environmental factors.Case: We present a case of 29 years old female delivered a male baby with large neonatal goitre and severe CH who was started immediat...
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ea0059ep119 | Thyroid | SFEBES2018

Pembrolizumab Induced Thyroiditis in patient with Graves’ Disease Kamal AbouglilaDiabetes centre, University Hospital of North Durham

Abouglila Kamal

New immune-modulatory therapies for malignancies have transformed their management with significantly enhanced survival outcomes. Pembrolizumab is an antibody against the programmed-death-1 molecule that increases the cytotoxic function of T-cells with excellent tumor response rates. Endocrinopathies including thyroiditis are an increasingly recognized side effect of this medication. We describe a unique a case where Thyroiditis occurred as a result of treatment with Pembroliz...
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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