Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2008

ea0015p1 | Bone | SFEBES2008

Presentation of primary hypoparathyroidism during pregnancy: maternal and fetal effects

Lindsay John , Brown Dessie , O'Kane Maurice

Introduction: Newly diagnosed primary hypoparathyroidism during pregnancy has been reported rarely. We recently encountered a first presentation of maternal hypoparathyroidism that was complicated by acute maternal and fetal hypocalcaemia.Clinical presentation: A 36-year-old lady presented with hypocalcaemia at delivery of her third child. While early antenatal progress was uncomplicated she was admitted at 36 weeks gestation with pre-eclampsia and supra...

ea0015p2 | Bone | SFEBES2008

Hypocalcaemia in pregnancy: vitamin D deficiency and pseudohypoparathryoidism type 1b

Lawrence Christopher , Mapplebeck Sarah , Harnett Patrick , Almond Mike

FH, a 36-year-old female of Afghan origin, resident in the UK for 4 years, was referred to the medical services by her obstetrician 9 days postpartum with symptomatic hypocalcaemia. Biochemical investigations confirmed a low corrected calcium (1.43 mmol/l, 2.1–2.6 mmol/l), elevated phosphate (1.76, 0.8–1.45 mmol/l) and alkaline phosphatase (156, 30–130 U/l). Twenty-five hydroxy vitamin D was 16 nmol/l (15–100) with elevated PTH (21.76 pmol/l, 1.05–6.83...

ea0015p3 | Bone | SFEBES2008

Voracious bones: an unusual case of hungry bone syndrome

Gopalappa Jagannath , Majumdar Kalpita , Platts Julia

A 34-year-old Caucasian male with type 1 diabetes, diabetic nephropathy and secondary hyperparathyroidism was electively admitted for parathyroidectomy. He is on regular peritoneal dialysis and is on the renal transplant list.On admission his PTH was 215.3 and corrected calcium was 2.01. Other biochemical parameters remained stable. He uneventfully underwent a total parathyroidectomy. No implantation of any of the parathyroid glands was done. He did not ...

ea0015p4 | Bone | SFEBES2008

Why do we need to think of differential diagnosis?

Myint Thaung , Srinivasan Ram , Randall Jo , Huston Nigel

Fourth-two years old female patient was diagnosed with carcinoma left breast in 2003. She had mastectomy of left breast and axillary clearance followed by adjuvant radiotherapy and chemotherapy. Histology showed ER positive. She was commenced on anastrozole. She suffered from back pain in 2005. Investigations revealed she had spinal metastases as well as left ureteric stone and hydronephrosis of left kidney. She had a left ureteric stent and her back pain was relived. USG kidn...

ea0015p5 | Bone | SFEBES2008

Clinical characteristics of patients with osteoporosis in the coeliac clinic

Venables Zoe , Gillett Helen , Adamson Karen

Introduction: Coeliac disease (CD) is associated with an increased risk of osteoporosis. The aim of this study was to determine the efficacy and relevance of screening for osteoporosis in CD and to determine possible risk factors in the coeliac population. There has been no conclusive study concerning the efficacy of such screening programmes to date.Method: All Coeliac patients who attended a 2003 Coeliac clinic were reviewed by questionnaire, clinical ...

ea0015p6 | Bone | SFEBES2008

Sunlight deficiency: a reversible cause of low serum phosphate?

Chambers Thomas , Heald Adrian , Radford Daniela , Waldron Julian , Davies Marten , Baines Malcolm

Background: Vitamin D3 is generated in the skin of humans from 7-dehydrocholesterol by ultraviolet light. Vitamin D3 is hydroxylated to its metabolically active form in the liver and kidneys. The hydroxylated form of Vitamin D3, is required for both phosphate and calcium absorption in the gut and reabsorption from the kidneys. Vitamin D deficiency is associated with a low circulating calcium and phosphate.Case report: A 5...

ea0015p7 | Bone | SFEBES2008

Uncommon cause of refractory hypercalcaemia in a patient with bladder tumour

Thirumurugan Ethirajan , Clay Sarah , Knight Paul , Murray Robert

A 50-year-old man presented with a week history of feeling unwell and urinary symptoms. He was confused. His wife gave H/O 2 stone weight loss. Recent investigation for haematuria showed 3.6 cm bladder tumour. He underwent TURBT and the histology was awaited. No other significant PMH or family H/O. Not on any medication and was an ex-smoker.Initial investigations showed leucocytosis and evidence of UTI. CXR showed chronic fibrotic changes. As a part of c...

ea0015p8 | Bone | SFEBES2008

A rare complication of a rare disease: case report of an indolent metastatic parathyroid cancer

Sathyapalan Thozhukat , Masson Ewan A , Cattermole Helen R , Aye Mo

A 15-year-old boy presented with a spiral fracture of left tibia and fibula in 1980. Adjusted serum calcium was 3.38 mmol/l. He had biochemical primary hyperparathyroidism and a superior parathyroid adenoma was removed. His calcium normalised and he was well for next 13 years until 1993 when his calcium began to rise with multiple palpable cervical lymph nodes. He underwent extensive neck dissection. Lymph node histology showed metastases from poorly differentiated parathyroid...

ea0015p9 | Bone | SFEBES2008

Estrogen augments shear stress-induced signaling and gene expression in osteoblasts by integrins highly expression

Yeh Chiuan-Ren , Chiu Jeng-Jiann , Cheng Cheng-Kung

Estrogen plays an important role on bone metabolism. However, the lacking of estrogen is proven a high risk to induce OP in post menopause women associated with bone metabolism problems. Furthermore, bone metabolism is strongly correlated with mechanical forces. It is proposed that mechanical forces, such as fluid shear stress and stretch, can modulate the function of bone cells. The OP patients’ bone seems lose this major function about functional adaptation and bone str...

ea0015p10 | Bone | SFEBES2008

Management of pseudohypoparathyroidism type 1b in pregnancy: a case report

Widdowson Matthew , McGowan Anne , Gibney James

Pseudohypoparathyroidism type 1b is a disorder of calcium metabolism resulting from renal resistance to PTH, the genetic basis caused by abnormal imprinting and thus expression of the gene encoding the Gs alpha-subunit (GSα) of the stimulatory G protein.For patients with PHP 1b, pregnancy raises issues regarding management of calcium and vitamin D homeostasis as well as more difficult aspects such as genetic counselling.<p class="abst...

ea0015p11 | Bone | SFEBES2008

A retrospective audit of the use of pamidronate for fibrous dysplasia

Russell Lin , Cooper Mark

Fibrous dysplasia (FD) is a relatively uncommon condition presenting with combinations of focal bone abnormalities, cutaneous hyperpigmentation and endocrinopathy. It is caused by a post-zygotic mutation in a G-protein coupled receptor (GNAS1) leading to constitutive activation of several hormone signaling pathways. Severely affected patients present in childhood with extensive bone lesions+endocrine disorder e.g. premature puberty (McCune–Albright syndrome) but less seve...

ea0015p12 | Bone | SFEBES2008

Pre-operation imaging of parathyroid gland in primary hyperparathyroidism

Malik Isha , Chapman John , Ray Subir

Aim: To study those factors which influence the sensitivity and positive predictive value of combined MIBI scintigraphy and ultrasound scan in the localisation of parathyroid adenomas.Method: A retrospective review of notes was done of 150 patients with hypercalcaemia referred to the Endocrine outpatients’ clinic, between the years 2002–2005.Notes of 135 patients with biochemical evidence of primary hyperparathyroidism (P...

ea0015p13 | Bone | SFEBES2008

Calcium and vitamin D supplementation in elderly care home residents

Mayne Debbie , Fenwick Sean , Chapman A John , Aspray Terry

Introduction: Calcium and vitamin D (CaD3) supplementation is routinely offered to care home residents in the UK to treat prevalent vitamin D insufficiency. However, blanket prescribing may be ineffective where secondary hyperparathyroidism is due to chronic kidney disease (CKD) and dangerous if undiagnosed primary hyperparathyroidism is present. In this base-line audit, we aimed to estimate the frequency and appropriateness of CaD3 prescription, and the prevalence of primary ...

ea0015p14 | Bone | SFEBES2008

Effects of 6 months strontium ranelate administration on phosphocalcium metabolism in postmenopausal women with reduced bone density

Joshi AA , Ahmad AM , Whittingham P , Gupta V , Hamilton A , Durham BH , Fraser WD , Vora JP

Introduction: Strontium ranelate (SR) is a dual action bone agent that increases bone formation and reduces bone resorption. Previous long term studies with SR have demonstrated minimal reductions in parathyroid hormone (PTH) and adjusted calcium (ACa) levels with increase in phosphate (PO4) concentrations, but the exact mechanism of action of SR remains unclear. Postmenopausal women with low bone mineral density (BMD) have relatively high circulating PTH concentrat...

ea0015p15 | Bone | SFEBES2008

Vitamin D status in pregnancy in four ethnic groups

Sethi Mieran , Yu Christina , Newton Lynne , Teoh TG , Robinson Stephen

Background: Vitamin D deficiency in pregnancy is a growing public concern amongst ethnic minority groups in the UK. This is related to both skin colour and clothing.Aim: To investigate vitamin D status in four ethnic groups in an inner city obstetric practice. This was part of an ongoing study of vitamin D deficiency and supplementation in pregnancy.Subjects: Women from St Mary’s Hospital, London were recruited at 28 weeks ges...

ea0015p16 | Bone | SFEBES2008

Adenosine is an important regulator of mesenchymal stem cell differentiation into osteoblasts

Gharibi Borzo , Lewis Barbara Mary , Elford Carole , Ham Jack , Evans Bronwen Alice James

Pluripotent mesenchymal stem cells (MSCs) have the capacity to differentiate into osteoblasts, adipocytes and chondrocytes and are characterised by expression of CD105, CD90 and CD73. CD73 is the enzyme that dephosphorylates AMP to adenosine. The role of adenosine in MSCs is unknown and we have thus investigated whether it plays a role in the differentiation process to osteoblasts.MSCs, obtained from the bone marrow of 10 week old male rats, were expande...

ea0015p17 | Bone | SFEBES2008

Prevalence of vitamin D deficiency in a London population diagnosed with active tuberculosis

Bravis Vassiliki , Al-Hadithy Huda , Mak Vincent

Introduction: Epidemiological evidence suggests that vitamin D (25(OH)D3) deficiency is an acquired risk factor for tuberculosis (TB). Lack of sunshine during the winter reduces 25(OH)D3 levels markedly, but darker skin pigmentation reduces 25(OH)D3 synthesis in African and Asian populations wherever they live.Aims: To examine 25(OH)D3 deficiency and its associations in TB patients in a regional population.Methods: Serum 25(OH)D3 c...

ea0015p18 | Bone | SFEBES2008

Expression and function of gut hormone receptors in osteoblast cell lines

Pacheco-Pantoja Elda , Wilson Peter , Ranganath Lakshminarayan , James Gallagher , Fraser William

The gastro-entero-pancreatic hormones are involved in the regulation of postprandial nutrient homeostasis. Food intake or fasting triggers the release of these hormones. A direct connection between food intake and bone turnover, assessed by biochemical markers of bone resorption and formation, has been demonstrated in animals and humans.The aim was to study the expression of receptors for the gut hormones, glucose-dependent insulinotropic polypeptide (GI...