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19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

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20-23 May 2017, Lisbon, Portugal Further information

Eposter Presentations: Calcium and Bone

Calcium & Vitamin D metabolism

ea0049ep247 | Calcium & Vitamin D metabolism | ECE2017

Management with Cinacalcet of non-surgical primary hyperparathyroidism in the elderly.

Marti Juan , Salsamendi Jose Luis , Marti-Ayerdi Jon , Jordana LLuis

Primary hyperparathyroidism (PHPT) is a common condition. The prevalence since the introduction of multichannel analysers is approximately 1:1000, with the older female being the typical patient. PHPT is predominantly a sporadic disorder. Surgery remains the only curative approach to most primary hyperparathyroidism (PHPT), medical treatment with cinacalcet has been proven to be an alternative for patients with hyperparathyroidism.Objective: Analyze trea...

ea0049ep248 | Calcium & Vitamin D metabolism | ECE2017

Glucocorticoids regulate expression of lung calbindin-D9k in mouse

An Jin Yong , Lee Jae-Hwan , Park Seon Yong , Jeung Eui-Bae

Introduction: Calbindin-D9k (CaBP-9k), which is a calcium ion buffering and transporter gene, is known to be regulated by the vitamin D and steroid hormones, and is mainly expressed in mammalian intestine, kidney and uterus. However, CaBP-9k expression in lung has not been studied. Maintaining lung structure using pulmonary surfactant is important for pulmonary gas exchange. Steroids are known to accelerate maturation of the fetal lung and secretion of surfactant. Otherwise th...

ea0049ep249 | Calcium & Vitamin D metabolism | ECE2017

Vitamin D intoxication caused hypercalcemia: Case report

Ugur Kader , Artas Hakan , Balin Mehmet , Aykut Esra , Demircan Selcuk , Orhan Bedrettin , Gozel Nevzat

Introduction: Vitamin D is a fat soluble prohormone and can be produced in the body with adequate sunlight exposure or taken up by consumed foods or supplements. Recently vitamin D deficiency has been seen in pandemic. A rare disease, vitamin D intoxication is usually iatrogenic. High levels of 25(OH) vitamin D increases the intestinal calcium absorption and causes severe and refractory hypercalcemia. In this case report we presented a patient with pancreatitis and hypercalcem...

ea0049ep251 | Calcium & Vitamin D metabolism | ECE2017

Gitelman syndrome and primary hyperparathyroidism – a rare association

Rego Teresa , Fonseca Fernando , Agapito Ana

Gitelman’s Syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy of young adults, characterized by secondary hyperaldosteronism, hypokalemia, hypomagnesemia, hypocalciuria and metabolic alkalosis. It is caused by mutations in SLC12A3 gene. Hypercalcemia due to hypocalciuria in these patients is extremely rare and requires further evaluation.A 25-year-old normotensive female was referred to Endocrinology clinic for evaluation o...

ea0049ep252 | Calcium & Vitamin D metabolism | ECE2017

The volume of parathyroid adenoma is related to presurgical PTH and 25OH-D3, but not calcium levels at patients with primary hyperparathyroidism

Velicescu Cristian , Gatu Cristina , Grigorovici Alexandru , Danila Radu , Munteanu Valentin , Mogos Voichita , Vulpoi Carmen , Preda Cristina , Mogos Simona , Branisteanu Dumitru D

Aims: We wanted to evaluate the correlations between the volume of the surgically removed parathyroid adenoma and the presurgical metabolic profile of patients diagnosed with primary hyperparathyroidism.Materials and methods: Prospective multicentric study, enrolling 52 patients with primary hyperparathyroidism from two medical units, proposed for surgery. Serum calcium and PTH were evaluated in all patients before surgery, and 25OH-D3 was measured only ...

ea0049ep253 | Calcium & Vitamin D metabolism | ECE2017

Pseudohypoparathyroidism type Ib: a case of chronic severe hypocalcaemia and seizures diagnosed in adulthood

Claudia Ana , Martins , Bogalho Paula , Agapito Ana

Pseudohypoparathyroidism (PHP) is a rare group of genetic disorders characterised by end-organ resistance to parathyroid hormone (PTH). We describe the case of a 34-year-old Caucasian female with severe hypocalcaemia presenting with a first generalised seizure. Her medical history was significant for bilateral cataract. She had three healthy children, and no family history of note. On examination, she had positive Chvostek’s sign. Biochemical analysis showed serum calcium...

ea0049ep254 | Calcium & Vitamin D metabolism | ECE2017

A practice review of the use of cinacalcet in primary hyperparathyroidism

Tauni Rahat , Ali Nida , Banerjee Ritwik

Background: The treatment of choice for primary hyperparathyroidism (PHPT) is surgical parathyroidectomy. Cinacalcet is the first calcimimetic approved by European Medicines Agency (EMA) in 2008 for use in patients with PHPT who are not fit for surgery or refuse surgery. British National Formulary (BNF) recommends it for hypercalcaemia in PHPT where parathyroidectomy is inappropriate. The main aim of treatment with cinacalcet is to keep calcium levels at safe levels.<p cla...

ea0049ep255 | Calcium &amp; Vitamin D metabolism | ECE2017

Is there a threshold of Vitamin D sufficiency that can prevent secondary hyperparathyroidism?

Amaral Andre , Nunes Tatiana , Anselmo Joao , Cesar Rui

While nonskeletal benefits of vitamin D remain a matter o debate, its importance in bone health is known for decades. Secondary hyperparathyroidism is considered to play a significant role in the pathogenesis of age-related bone loss. In the present study we investigate the association between serum PTH, 25-hydroxyvitamin (25(OH)D) and other clinically related variables in a cross sectional sample of patients followed in an Endocrine consultation during the year 2016. Patients...

ea0049ep256 | Calcium &amp; Vitamin D metabolism | ECE2017

Spontaneous remission of parathyroid adenoma due to parathyroid apoplexy: a case report

Kirac Cem Onur , Baldane Suleyman , Ipekci Suleyman , Kebapcilar Levent

Introduction: Primary hyperparathyroidism (PHPT) is a disease that is characterized by elevated calcium and parathyroid hormone levels. The most common cause of PHPT is the paratiroid adenoma and the first line treatment option is surgical removal of the adenoma. Rarely, the haemorrhage in the lesion may cause the spontaneous remission of the disease.Case report: A 54-year-old woman patient with fatigue was referred to our department due to calcium level...

ea0049ep257 | Calcium &amp; Vitamin D metabolism | ECE2017

Normocalcemic versus Hypercalcemic Primary Hyperparathyroidism: a comparative study

Mokrysheva Natalya , Mirnaya Svetlana , Eremkina Anna , Krupinova Julia , Kovaleva Elena

Introduction: Normocalcemic primary hyperparathyroidism (NPHPT) is defined as a condition in which persistently normal serum calcium levels are observed in the presence of high levels of parathyroid hormone (PTH). NPHPT is a new entity which possibly represents a clinically symptomatic disease and which has generated a considerable scientific interest.Aim: To compare the clinical and laboratory data between the normocalcemic and hypercalcemic forms of PH...

ea0049ep258 | Calcium &amp; Vitamin D metabolism | ECE2017

Parathyroid carcinoma: experience of a Portuguese centre

Bello Carlos Tavares , Donato Sara , Prazeres Susana , Simoes Helder , Leite Valeriano

Introduction: Parathyroid Carcinomas are rare malignant neoplasms, accounting for less than 1% of primary hyperparathyroidism cases. Apart from certain genetic mutations, no additional risk factors are known. Diagnosis is challenging in the absence of metastatic disease since no consensual histological criteria have so far been developed. These neoplasms typically present with severe hypercalcemia and markedly elevated serum PTH levels. Treatment is surgical and despite freque...

ea0049ep259 | Calcium &amp; Vitamin D metabolism | ECE2017

Vitamin D prescribing bias in liver transplant referrals

Gan KJ , O'Sullivan Niamh , Hanley Bernadette , Armstrong Paul , Kilbane Mark , Houlihan Diarmaid , Crowley Rachel

Vitamin D (VD) deficiency (25 OHD < 50 nmol/l) is common is chronic liver disease at 64%–92% regardless of aetiology. The only guidelines for routine VD supplementation are for cholestatic (C) liver disease; a population considered being at high risk of low bone mineral density (BMD). BMD decreases further following orthotopic liver transplant (OLT). To assess VD intake in an at risk population, retrospective analysis of intake was performed in OLT patients with C liv...

ea0049ep260 | Calcium &amp; Vitamin D metabolism | ECE2017

How to differentiate primary hyperparathyroidism with D hypovitaminosis from secondary hyperparathyroidism due to D hypovitaminosis?

Gatu Alina-Andreea , Velicescu Cristian , Preda Cristina , Vulpoi Carmen , Mogos Simona , Mogos Voichita , Zaharia Valentin , Aancute Adrian , Branisteanu Dumitru

Background: D hypovitaminosis and primary hyperparathyroidism frequently coexist. Secondary hyperparathyroidism reactive to D hypovitaminosis is difficult to be differentiated from primary hyperparthyroidism.Aims: To differentiate patients with D hypovitaminosis and secondary hyperparathyroidism.Materials and methods: Prospective study involving 71 patients admitted in our department for 1 year with the initial diagnosis of primary...

ea0049ep261 | Calcium &amp; Vitamin D metabolism | ECE2017

Pseudohypoparathyroidism as an etiological cause for epilepsy: a case report

Gokkaya Naile , Bilen Arzu , Bilen Habib

Introduction: Pseudohypoparathroidism (PHP) is a condition mimics hypoparathyroidism biochemically with a hypocalcemia and hyperphosphatemia but differentiates from it an elevated parathyroid hormone (PTH) levels. PHP characterized by targeted organ unresponsiveness to PTH and mainly subdivided two groups. PHP type 1a an autosomal dominant disease related to mutations of GNAS1. This subtype has biochemical findings and characteristic somatic phenotype known as Albright Heredit...

ea0049ep262 | Calcium &amp; Vitamin D metabolism | ECE2017

Long standing primary hyperparathyroidism consequences after parathyroid surgery: fast recovery not only for bone mass

Stefan Cristina , Arhire Amalia , Cima Luminita , Barbu Carmen

Background: Primary hyperparathyroidism is usually a long evolving disease before the diagnosis, thus patients who are not diagnosed by routine screening tests may have a lot of complications affecting the bone, kidney, bone marrow.Aim: Pointing out the possibility of fast recovery not only for bone mass.Material: We present a case of primary hyperparathyroidism, a female patient 66 years old, sent to emergency room, dehydrated, as...

ea0049ep263 | Calcium &amp; Vitamin D metabolism | ECE2017

Associations of nitric oxide with vitamin D and other serological factors in healthy adolescents

Al-Daghri Nasser , Yakout Sobhy , Aljohani Naji , Al-Saleh Yousef , Al-Attas Omar , Alokail Majed

Nitric Oxide (NO) has been considered a very important molecule in the biological system because of its interaction with other molecules for mediating various bio-pathways. Its interaction with vitamin D in particular studied well in animal models, cell lines and patients with various diseases. However, the relationship between NO and vitamin D has never been studied in healthy adolescents. We aimed to determine the association of NO with vitamin D and other serological factor...

ea0049ep264 | Calcium &amp; Vitamin D metabolism | ECE2017

Primary hyperparathyroidism in pregnancy

Efe Belgin , Yorulmaz Goknur , Alaguney Sevil , Badak Bartu

Introduction: Primary hyperparathyroidism is the most common cause of hypercalcemia in the general population. Hypercalcemia during pregnancy can result in significant maternal and fetal morbidity and mortality.Case: A 30-year-old pregnant female primigravida in the 31 weeks of gestation with complaint of obstinate constipation was admitted to our emergency department. In laboratory tests, hypercalcemia was detected. She was a Syrian refugee and was unab...

ea0049ep265 | Calcium &amp; Vitamin D metabolism | ECE2017

Eucalcemic parathyroid hormone elevation after parathyroid surgery for sporadic primary hyperparathyroidism

Elbuken Gulsah , Ozkan-Gurdal Sibel , Balkan Makbule Begum , Zuhur Sayid Shafi

Introduction: Serum parathormone (PTH) levels may remain elevated in some patients after surgery despite achievement of normal serum Ca levels. The factors contributing to this phenomenon have not been fully elucidated yet. In this study, we retrospectively analysed the data of patients whose serum Ca levels returned to normal after parathyroid surgery in our center.Patients and methods: Computer records of 35 patients who had undergone parathyroid surge...

ea0049ep266 | Calcium &amp; Vitamin D metabolism | ECE2017

Primary hyperparathyroidism mimicking metastatic bone disease

Akyıldız Ali Burkan , Sancak Seda , Okuroğlu Nalan , Abacar Kerem Yiğit , Sakcı Elif , Ozdemir Ali

We would like to present a case of primary hyperparathyroidism presumably present with clinically large cystic parathyroid adenoma with multiple destructive skeletal lesions, which is of course referred to bone metastases.Case: A 58-year-old male patient was admitted to the orthopedy polyclinic with left leg pain and on the MR imaging performed here, multiple lytic lesions compatible with metastasis to the tibia and fibula were detected. He was directed ...

ea0049ep267 | Calcium &amp; Vitamin D metabolism | ECE2017

Acute pancreatitis as the first presentation of primary hyperparathyroidism

Vieira Alexandra , Ferreira Marta , Guelho Daniela , Pereira Teresa , Silva Luis Filipe , Ferreira Estela , Inacio Ana

Background: Hypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5–8%.Clinical case: A 25-year-old male patient was referred to the Endocrinology outpatient clinic for hypercalcemia diagnosed in the context of acute pancreatitis. He had medical and surgical pathological antecedents of: clavicle fracture after car accident, cholecystectomy and appendectomy, gastroesophageal reflux di...

ea0049ep268 | Calcium &amp; Vitamin D metabolism | ECE2017

Gender difference in clinical presentation of primary hyperparathyroidism

Gianotti Laura , Castellano Elena , Tassone Francesco , Baffoni Claudia , Cesario Flora , Magro Gianpaolo , Pellegrino Micaela , Borretta Giorgio

Objective: Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders, with a female to male ratio of 3:1. Currently most patients with PHPT are asymptomatic. However, data about the gender impact on the clinical presentation of PHPT are lacking.Methods: We evaluated the difference in symptoms and biochemical parameters between men and women with PHPT in a single center series of 417 patients.Results: Male PHP...

ea0049ep269 | Calcium &amp; Vitamin D metabolism | ECE2017

Prevalence of hypocalcemia in adults in Minsk, Belarus

Brutskaya-Stempkovskaya Elena , Shepelkevich Alla , Kostin Georg

The prevalence of hypocalcemia among patients non-operated the thyroid and parathyroid glands has increased significantly with the introduction the screening of calcemia. The main reasons for hypocalcemia are hypoproteinemia and hypoparathyroidism.Objective: To study the prevalence of hypocalcemia in the adult in Minsk.Materials and methods: We studed 1207 people, average age 53.9±17.25 (892 women, 315 men) from 18 to 96 years...

ea0049ep270 | Calcium &amp; Vitamin D metabolism | ECE2017

Assessment of changing in the therapeutic attitude in patients with primary hyperparathyrodism in conservative management after the realization of radial densitometry

Porcel Jose Alvaro Romero , Gordillo Guillermo Martinez De Pinillos , Perez Fernando Garcia , Lloclla Eyvee Arturo Cuellar , Pena Jose Ignacio Fernandez , Marin Carmen Carretero , De Quiros Juan Manuel Garcia , Lopez Ignacio Fernandez , Fernandez-Ladreda Mariana Tome , Leon Maria Victoria Cozar

Introduction and objectives: In the 4th Workshop on Primary Hyperparathyroidism, it is recommended to perform BMD by DXA of third radius as well as lumbar spine and hip DXA in the initial assessment and follow up of patients with primary hyperparathyroidism. This test is not available in many centers, which means that only T Score values of the lumbar spine and hip are used to certify the absence of osteoporosis in asymptomatic patients wich conservative management is...

ea0049ep271 | Calcium &amp; Vitamin D metabolism | ECE2017

A rare case: intrathymic parathyroid adenoma

Asoglu Veysi , Celik Mehmet , Bulbul Buket Yilmaz , Ayturk Semra , Tastekin Ebru , Can Nuray , Sezer Atakan , Ustun Funda , Guldiken Sibel

Primary hyperparathyroidism in the most common cause of hypercalcemia. 87% of the cases present with single adenoma, 9% of them have hyperplasia, while multiple adenomas and parathyroid malignancy are detected in 3 and 1% of the cases, respectively. Although it is rare, parathyroid adenomas may be ectopic. The most common locations for ectopic parathyroid adenomas are thymus, tracheaesophageal cleft, carotis sheet, intrathyroidal and paraesophageal area. In this study, we aime...

ea0049ep272 | Calcium &amp; Vitamin D metabolism | ECE2017

Audit of emergency hypercalcaemia management in the acute medical unit

Bejinariu Emanuela , Tauni Rahat , Rathnayake Tharanga , Shah Vinit , Soo Shiu-Ching , Banerjee Ritwik

Introduction: We conducted a retrospective audit of emergency management of hypercalcaemia presenting to the acute medical team and compared our practice against the Society for Endocrinology guidelines September 2016.Method: 53 adult patients with 59 corresponding medical admissions were identified from tracking all biochemistry samples with corrected calcium (cCa) ≥3.0 mmol/l processed between August 2015 and July 2016 trustwide. We conducted a r...

ea0049ep273 | Calcium &amp; Vitamin D metabolism | ECE2017

Higher circulating parathyroid hormone concentration fascilitates preoperative diagnostic imagings for localization in primary hyperparathyroidism

Okamoto Kentaro , Itoh Yoshihiko , Kawashima Akiyuki , Amano Aya , Okazaki Kyoko , Murabe Hiroyuki , Yokota Toshihiko , Yoshimoto Risa , Sahara Akiko , Tomokuni Junko , Hamamatsu Keita

Introduction: For minimally invasive surgery of primary hyperparathyroidism (PHPT), the identification of the accurate localization is required. As preoperative diagnostic imagings, we perform ultrasound, technetium 99m-sestamibi scintigraphy and either or both of megnetic resonance imaging or computed tomography in all cases. The aim of the present study is to evaluate the clinical biochemical factors that fascilitate preoperative diagnostic imagings for localization.<p c...

ea0049ep274 | Calcium &amp; Vitamin D metabolism | ECE2017

Calcifediol is more effective than cholecalciferol in the treatment of severe vitamin D deficiency in a patient submitted to malabsorbitive bariatric surgery: a case report

Brancatella Alessandro , Cappellani Daniele , Vignali Edda , Canale Domenico , Marcocci Claudio

Context: Vitamin D deficiency following malabsorptive bariatric surgery can lead to osteomalacia. We report a patient with severe vitamin D deficiency following malabsorptive bariatric surgery successfully treated with calcifediol but not cholecalciferol.Case description: A 40-year-old woman, submitted to biliopancreatic diversion 20 years before and chronically treated with 50 000 IU cholecalciferol weekly, was admitted to our Endocrine Unit because of ...

ea0049ep275 | Calcium &amp; Vitamin D metabolism | ECE2017

The effect of 1,25(OH)2D3 on interferon i secretion by human mononuclear cells in vitro

Athanassiou Lambros , Nezos Andrianos , Kostoglou-Athanassiou Ifigenia , Mavragani Clio , Athanassiou Panagiotis , Koutsilieris Michael

Vitamin D is a secosteroid hormone known for its skeletal effects. Recently, the extraskeletal effects of vitamin D are under investigation. Vitamin D is thought to exert an immunomodulatory effect, having multiple effects on the immune system. It is known to induce immune tolerance and also to enhance the immune response to bacteria.The aim was to study the effect of 1,25(OH)2D3 on interferon I secretion by human mononuclear cells ...

ea0049ep276 | Calcium &amp; Vitamin D metabolism | ECE2017

The changing face of primary hyperparathyroidism

Kostoglou-Athanassiou Ifigenia , Travlos Alexios , Vogiatzi Evaggelia , Pantazi Eleni

Primary hyperparathyroidism is a disease which nowadays is being diagnosed with increasing frequency. The diagnosis of primary hyperparathyroidism is based on routine calcium measurement, which if detected abnormally elevated leads to the screening of the patient for primary hyperparathyroidism. Therefore, primary hyperparathyroidism is frequently detected early in the course of the disease. Consequently, severe musculoskeletal manifestations may be lacking in the modern world...

ea0049ep277 | Calcium &amp; Vitamin D metabolism | ECE2017

Single center experience of intact parathyroid hormone determination in washout samples of suspicious parathyroid adenomas

Sahin Mustafa , Canpolat Asena Gokcay , Ediboglu Elif , Keskin Cağlar , Canlar Şule , Demir Ozgur , Gullu Sevim , Erdogan Murat Faik , Emral Rıfat , Corapcioglu Demet

Introduction: Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anesthesia complications. Neck ultrasonography and scintigraphy are still the first step tools for localisating parathyroid lesions. Intact parathyroid hormone (PH) determination in washout samples is really very useful when parathyroid lesions can not be easily distinguished from thyroid lesions or sometimes lymph nodes.<p class="abste...

ea0049ep278 | Calcium &amp; Vitamin D metabolism | ECE2017

Primary hyperparathyroidism due to atypical adenoma: clinical, biochemical and histological features of an Italian cohort

Saponaro Federica , Giulio Marina Di , Pardi Elena , Borsari Simona , Materazzi Gabriele , Marcocci Claudio , Cetani Filomena

Primary hyperparathyroidism (PHPT) is mostly due to a benign parathyroid tumor (99%). Some have parathyroid ‘atypical adenomas’, rare tumors with histological features of parathyroid cancer (PC) (fibrous trabeculae, thick fibrous bands, mitotic figures in parenchymal cells), without local invasion or metastasis. We evaluated 20 patients with histological diagnosis of atypical adenomas. Patients were 13 women and seven males (mean age: 55±13 yrs). Nineteen patien...

ea0049ep279 | Calcium &amp; Vitamin D metabolism | ECE2017

Medullary vertebral compression in primary hyperparathyroidism

Saida Fedala , Djamila Meskine , Lamia Kedad , Nadira Fafa , Zakia Toubal

We report the case of an ectopic parathyroid adenoma, revealed by a medullary vertebral compression by a brown spinal tumor in a 44-year-old women. Physical examination revealed a lower limb weakness, paresthesia and radicular lower extremity pain. Magnetic resonance imaging (MRI) showed osteolytic vertebral lesions suggesting metastatic localizations. A thoracic CT scan identified a mediastinal mass measuring 6.2 cm in the major axis. Biological evaluation revealed a hypercal...

ea0049ep280 | Calcium &amp; Vitamin D metabolism | ECE2017

Management of primary hyperparathyroidism: Experience of a large UK teaching hospital

Sagar Rebecca , Longhurst Amy , Abbas Afroze

Background: Primary hyperparathyroidism (PHPT) is a common cause of hypercalcaemia seen in outpatient endocrinology clinic. Diagnosis is based on biochemistry and exclusion of other conditions, such as familial hypocalciuric hypercalcaemia. Symptomatic patients should usually be referred for parathyroidectomy. For asymptomatic patients there are clear guidelines for surgical referral, based on the Fourth International Workshop (2014) recommendations. This study evaluates curre...

ea0049ep281 | Calcium &amp; Vitamin D metabolism | ECE2017

Fahr Syndrome and idiopathic primary hipoparathyroidism – clinical case

Martins Ana Filipa , Martins Joao Martin , do Vale Sonia

Introduction: Fahr syndrome (FS) is a neuropsiquiatric condition due to progressive basal ganglia calcification. Although physiopathology is not completely understood, it may be secondary to infectious, metabolic and genetic diseases.Case report: A 65-year-old male Caucasian was referred to the outpatient endocrine department because of hypocalcaemia. No perioral paresthesia or tingling of the fingers and toes were noticed. He complained of longstanding ...

ea0049ep282 | Calcium &amp; Vitamin D metabolism | ECE2017

Clinical presentations of four patients with familial isolated hyperparathyroidism and hyperparathyroidism-jaw tumor syndrome

Bayraktaroglu Taner , Sentosun Utku , Arpaci Dilek Karakaya , Emre Ali Ugur , Gokce Mertol , Uysal Serkan , Erdemir Rabiye Uslu , Bahadir Burak , Cakmak Guldeniz Karadeniz

Introduction: Primary hyperparathyroidism is commonly treated with targeted parathyroidectomy guided by preoperative imaging and intraoperative parathormone monitoring. Despite advanced imaging techniques, failure of parathyroid localization still occurs. Hyperparathyroidism-jaw tumor syndrome and familial isolated hyperparathyroidism are a rare autosomal dominant tumor syndrome characterized by hyperparathyroidism. In this report, we present four patients with familial isolat...

ea0049ep283 | Calcium &amp; Vitamin D metabolism | ECE2017

When is it worthwhile to perform parathyroid SPECT/CT scintigraphy in primary hyperparathyroidism?

Trofimiuk-Muldner Malgorzata , Skalniak Anna , Kulczynski Lukasz , Zapendowska-Dudek Aleksandra , Budek Aneta , Buziak-Bereza Monika , Sowa-Staszczak Anna , Hubalewska-Dydejczyk Alicja

Introduction: Observed increasing frequencies of asymptomatic or oligosymptomatic PHP cases may increase the rate of false negative imaging results.Aim: To determine the level of PTH and calcium at which an enlarged parathyroid gland can be detected by parathyroid SPECT/CT.Material and methods: A retrospective analysis of 117 patients diagnosed with PHP (100 females and 17 males, aged 16–88 years) was performed. In each patien...

ea0049ep284 | Calcium &amp; Vitamin D metabolism | ECE2017

Parathormone (PTH) as a marker of vitamin D (VitD) deficiency

Trofimiuk-Muldner Malgorzata , Skalniak Anna , Kiec-Klimczak Malgorzata , Hubalewska-Dydejczyk Alicja

Introduction: VitD deficiency, the pandemics of which we currently observe, may result in secondary hyperparathyroidism even if not accompanied by hypocalcaemia.Aim: To assess VitD levels as a cause of secondary hyperparathyroidism.Material and methods: 257 healthy volunteers with normal kidney function (GFR< 60 ml/min) (28.4% males), median age 57 years, were included. In each participant, serum calcium, phosphates, creatinine...

ea0049ep285 | Calcium &amp; Vitamin D metabolism | ECE2017

Pathological basal ganglia calcification in isolated idiopathic hypoparathyroidism: a case report

Pemovska Gordana , Plaseski Tose , Todorova Biljana , Bozhinovska Nadica , Zivkovic Marija , Nesovska Radmila

Introduction: The isolated hyperparathyroidism (IHP) is a metabolism disorder characterized by an absent or low parathormon (PTH) and hypocalcemia. It can be acquired, autoimmune, a result of some syndrome and as a part of a family (FIHP). FIHP is an extremely rear disease which is inherited auto somatic dominant or auto somatic recessive as a result of a mutation of one or several different genes. Pathological calcifications in the cerebrum are a secondary form of calcificati...

ea0049ep286 | Calcium &amp; Vitamin D metabolism | ECE2017

Diseases associated with hypercalcemia

Brutskaya-Stempkovskaya Elena , Shepelkevich Alla , Kostin Georg , Chertko Eduard , Matsiushava Janna

Introduction: According to modern studies, hypercalcemia is associated with an increased risk of urolithiasis, cholelithiasis, gastritis and peptic ulcer.Objective: To study the prevalence of urolithiasis, cholelithiasis, gastritis and peptic ulcer in patients with hypercalcemia in Minsk-city.Materials and methods: we studied 1207 people, average age 53.9±17.25 (892 women, 315 men) from 18 to 96 years. Examination: total calci...

ea0049ep287 | Calcium &amp; Vitamin D metabolism | ECE2017

PTH levels in vitamin D deficiency

Catak Merve , Koseoglu Derya , Baser Ozden Ozdemir , Berker Dilek

Introduction: High level of Parathormone (PTH) impair bone health by increasing the risk of fracture. The aim is to determine the threshold value of PTH elevation to accompany deficiency or failure of Vit D. This may be an important parameter in assessing bone metabolism in clinical practice.Material and method: 931 patients who were referred to the endocrinology clinic were retrospectively studied and 880 patients diagnosed with Vit D deficiency include...

ea0049ep288 | Calcium &amp; Vitamin D metabolism | ECE2017

Renal complications in patients with chronic postoperative hypoparathyroidism treated with oral calcium and active vitamin D metabolites

Cetani Filomena , Meola Antonella , Vignali Edda , Guglielmi Giovanni , Donato Irene , Matrone Antonio , Elisei Rossella , Marcocci Claudio

Patients with chronic hypoparathyroidism (HypoPT) treated with oral calcium and active vitamin D metabolites are at risk of renal complications, because of the lack of action of PTH at the renal tubule. In the present study we evaluated 90 patients (68 females and 22 males; age: 51.8±14.1 yrs) with chronic postoperative Hypo (PO-HypoPT) diagnosed since at least 3 years. All patients were treated with calcitriol and 35 (39%) with oral calcium two patients were also treated...

ea0049ep289 | Calcium &amp; Vitamin D metabolism | ECE2017

The results of parathormone assay in parathyroid aspirates in preoperative localization of parathyroid adenomas for focused parathyroidectomy in patients with negative or suspicious sestamibi scans

Ozderya Aysenur , Temizkan Sule , Cetin Kenan , Ozugur Sule , Gul Aylin Ege , Aydin Kadriye

Objective: In primary hiperparathyroidism (PHPT), increasing the number of patients treated by focused parathyroidectomy should be the main objective of pre-surgical imaging modalities. Suspicious or negative imaging results do not always mean multiglandular disease, most of the patients may single adenoma and therefore these patients may still benefit from focused parathyroidectomy.Methods: Retrospectively, we analyzed the data of 65 patients with PHPT ...

ea0049ep290 | Calcium &amp; Vitamin D metabolism | ECE2017

Weight has a weak influence on calcium-phosphorus metabolism in HIV-patients with vitamin d deficiency

Mateos Carolina Garcia-Figueras , Cayon-Blanco Manuel

Introduction: In contrast to general population, clinical consequences related to low levels of 25-hydroxyvitamin D in HIV-infected patients with overweight are not established. The aim of our study was to investigate the influence of weight on clinical parameters and on calcium-phosphorus homeostasis in HIV-patients with vitamin D deficiency.Methods/design: Prospective study of HIV outpatients treated in our hospital. Vitamin D deficiency (D-DEF) was de...

ea0049ep291 | Calcium &amp; Vitamin D metabolism | ECE2017

Chronic hypoparathyroidism disease profile from 492 patients in the PARADIGHM™ natural history global registry

Clarke Bart L , Ing Steven , Khan Aliya , Mannstadt Michael , McDermott Michael , Piccolo Rebecca , Shanik Michael H. , Vokes Tamara J , Germak John

PARADIGHM™ is a global registry (NCT01922440) of patients diagnosed with hypoparathyroidism (HPT) ≥6 months regardless of aetiology and management. Routine medical care data were entered using electronic case report forms; the 36-item Short Form Health Survey was completed by patients. Baseline-recorded data are reported for 492 patients enrolled as of 1 December 2016 from 41 centres. At baseline, 78% were women, mean (S.D.) age was 49 (17)...

ea0049ep292 | Calcium &amp; Vitamin D metabolism | ECE2017

Prevalence of cardiometabolic risk factors among Saudi Women with vitamin D deficiency

Al Kadi Hanan , Alissa Eman

Vitamin D deficiency is highly prevalent among Saudi women. The aim of this study was to determine the prevalence of cardiometabolic risk factors in apparently healthy Saudi women with vitamin D deficiency. A Retrospective chart review was conducted in the “Center of Excellence for Osteoporosis Research” (CEOR), King Abdulaziz University, Jeddah, Saudi Arabia. Only healthy women 20–40 years old, with no history of previous illnesses and not on any medications we...

ea0049ep293 | Calcium &amp; Vitamin D metabolism | ECE2017

18F-choline PET/MRI in patients with primary hyperparathyroidism and negative sestamibi SPECT/CT – report of two cases

Krcma Michal

Primary hyperparathyroidism is a common disorder which is curable by surgery. Exact localisation of parathyroid adenoma is essential for minimal invasive approach. The gold standard is sestamibi SPECT/CT nowadays - but fails in approximately 10% cases. In last 3 years some case report with 18F-choline PET/CT were published. We describe two cases with SPECT/CT invisible parathyroid adenoma.First case was 36y/o woman, with osteopenia diagnosed after pregna...

ea0049ep294 | Calcium &amp; Vitamin D metabolism | ECE2017

Severe hypocalcemia induced by Denosumab in a patient with Osteroporosis after malabsorptive bariatric surgery

Portilla Ana Jimenez , Soler Guillermo Serra , Planella Juan Ramon Urgeles , Perez Maria Soledad Gogorza , Font Mercedes Noval , Fernandez Honorato Garcia , Jimenez Inaki Arguelles , Macazaga Vicente Pereg

Introduction: Denosumab is a monoclonal antibody indicated in the treatment of postmenopausal osteoporosis. Hypocalcemia is a rare adverse effect.Case report: We present the case of a 58-year-old woman with a clinical history of bariatric surgery in 2001 and osteoporosis with multiple vertebral and hip fractures. Under treatment with Zinc sulphate, Vitamin A, 25-OH-vitamin D, calcium and iron. She came to the A&E for general malaise, generalized weak...

ea0049ep295 | Calcium &amp; Vitamin D metabolism | ECE2017

Performance characteristics of a new Waters MassTrak™ Vitamin D assay

Breen Norma , Davey Leanne , Roche Declan , Lambert Philip , Cullen Danielle , Rossiter Padhraic

The Waters MassTrak Vitamin D Kit is designed for the quantitative determination of serum or plasma 25-hydroxyvitamin D3 (25OHD3) and 25-hydroxyvitamin D2 (25OHD2), which in combination provide the total 25-hydroxyvitamin D concentration as an aid in the assessment of vitamin D sufficiency.The MassTrak Vitamin D Kit is validated for use with the Waters® ACQUITY UPLC® I-Class/Xevo® TQD IVD System and the sample preparation has been validate...

ea0049ep296 | Calcium &amp; Vitamin D metabolism | ECE2017

Vitamin D intoxication complicated with parathormon treatment in elderly: a case report

Boysan S Nur , Altunrende Burcu , Dalar Levent , Acik M Eren , Canpolat I Polat , Akdeniz C Selcan , Gonen M Sait

Parathormon treatment for osteoporosis is rarely complicated with hypercalcemia. Vitamin D treatment with high doses frequently can cause asymptomatic intoxication.We present a case with life-threatening hypercalcemia complicated both parathormon and high-dose vitamin D.A 85-year old woman hospitalized for sudden-onset confusion. In history she had coronary-artery by-pass operation and a serebrovascular accedant. She was treated with teriparatide 20 &#95...

ea0049ep297 | Calcium &amp; Vitamin D metabolism | ECE2017

Tc-99m sestamibi uptake by brown tumours in a patient with primary hyperparathyroidism

Dias Daniela , Macedo Daniel , Santos Rita , Leite Valeriano

Tc-99m sestamibi (MIBI) imaging is able to localize parathyroid adenomas/carcinomas in patients with primary hyperparathyroidism. Brown tumours are one of the skeletal manifestations of long standing hyperparathyroidism and its incidence has been reported to be 3%. Radiological features of these tumors may mimic bone metastasis. There are only a few reports showing brown tumours uptake in the whole-body Tc-sestamibi scan.We report a 72-year-old female wi...

ea0049ep298 | Calcium &amp; Vitamin D metabolism | ECE2017

Thyroid supression in patients with primary hyperparathyroidism may improve pre-surgical scintigraphy localisation

Tome Mariana , de Pinillos Guillermo Martinez , Cuellar Eyvee Arturo , de Quiros Juan Manuel Garcia , Garcia Fernando , Fernandez Ignacio

Introduction: The cause of primary hyperparathyroidism (PHPT) is a single adenoma in 85% of cases. Scintigraphy with technetium-sestamibi (MIBI) is the test of choice for localising adenomas in patients with PHPT, allowing minimally invasive surgery in most patients. Some articles recommend thyroid function supression to improve scintigraphy results.Methods: A prospective study was conducted in which 8 patients were included with diagnosis of PHPT and ne...

ea0049ep299 | Calcium &amp; Vitamin D metabolism | ECE2017

Serum vitamin D in overweight patients with normal and impaired GFR

Tigas Stelios , Kitsos Athanasios , Dounousi Evangelia , Kalaitzidis Rigas , Challa Anna , Siamopoulos Costas

Introduction: Obesity is a strong risk factor for incident chronic kidney disease (CKD). Furthermore, high body mass index (BMI) is consistently associated with low serum vitamin D in the general population. The aims of the present study were to i) compare vitamin D metabolite levels in overweight/obese versus normal weight individuals with normal to severely impaired renal function and ii) to assess the impact of 25(OH)D on the development of secondary hyperparathyroidism (SH...

ea0049ep300 | Calcium &amp; Vitamin D metabolism | ECE2017

The importance of ultrasound in the preoperative evaluation of patients with primary hyperthyroidism: a case report

Marcalo Jose , Araujo Alexandra , Wessling Ana , Carvalho Maria Raquel , Bugalho Maria Joao

Introduction: Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, and a single parathyroid adenoma is usually the culprit. Clinical presentation is commonly dictated by hypercalcemia. Symptoms can range from mild non-specific malaise and gastrointestinal disturbances, through bone disease, kidney stones, cardiovascular and neuromuscular dysfunction to, ultimately, coma and death. However, the vast majority of patien...

ea0049ep302 | Calcium &amp; Vitamin D metabolism | ECE2017

Ectopic production of calcitriol by non-hodgkin lymphoma as a cause of hypercalcemia: case report

Alarcon Elvira , Tome Mariana , Bautista Carmen , Gonzalez Daniel

Introduction: Hypercalcemia of malignancy usually appears in patients with osteolytic metastasis and in those patients with humoral hypercalcemia due to secretion of PTHrp by the tumor. Hypercalcemia due to calcitriol production by the tumor is uncommon (<1% of cases of hypercalcemia of malignancy). It is the cause of virtually all cases of hypercalcemia in patients with Hodgkin’s lymphoma and approximately one third of cases in non-Hodgkin’s lymphoma. It has als...

ea0049ep303 | Calcium &amp; Vitamin D metabolism | ECE2017

Primary hyperparathyroidism: elective parathyroidectomy versus conservative management; results of a retrospective cohort study

Nana Melanie , Morgan Holly , Shrikrishnapalasuriyar Natasha , Kalhan Atul

Background: The optimum management strategy for primary hyperparathyroidism remains debatable especially in patients with mild or asymptomatic disease. We aimed to compare the baseline characteristics and long-term outcomes of patients with primary hyperparathyroidism who were either managed conservatively or underwent elective parathyroidectomy.Methodology: We carried out a retrospective cohort analysis of patients with primary hyperparathyroidism under...

ea0049ep304 | Calcium &amp; Vitamin D metabolism | ECE2017

Calcium metabolism and autoimmune thyroiditis

Khroyan Armine , Toromanyan Edvard , Badalyan Maria , Khachatryan Mariam

Objectives: The objective of our – investigation is to find out the role of D3 vitamin deficiency – and calcium in patients with autoimmune thyroiditis and calcified nodules.Methods: The research has been carried out at “Muratsan” University Hospital and “Armenia” Medical Center, in 2013–2016.80 patients (ages ±4–0, of which 68 women and 12 men) with autoimmune thyroiditis and calcified ...

ea0049ep305 | Calcium &amp; Vitamin D metabolism | ECE2017

Pseudohypoparathyroidism (PHP) and GNAS gene mutations – clinical spectrum from PHP type 1a to pseudopseudohypoparathyroidism

Saavedra Ana , Rodrigues Elisabete , Cunha Filipe , Leao Miguel , Carvalho Davide

Introduction: Pseudohypoparathyroidism (PHP) refers to a heterogeneous group of disorders that have in common end-organ unresponsiveness to parathyroid hormone (PTH). The most frequent form, PHP type 1, results from different genetic/epigenetic changes in the GNAS gene.Case 1: Woman, 25 years-old, sent to Endocrinology from Genetics consultation after her daughter had been diagnosed with PHP type 1a (heterozygous pathogenic variant at exon 13 of...

ea0049ep306 | Calcium &amp; Vitamin D metabolism | ECE2017

Hyperparathyroidism and cardiovascular risk

Amzar Daniela , Balas Melania , Golu Ioana , Vlad Mihaela , Sandu Ramona , Cornianu Maria

Background: Primary and secondary hyperparathyroidism (HP) are associated with increased risk for cardiovascular complications and high mortality. Risk factors correlated with hypertension in HP are hyperlipidemia, glucose intolerance, insulin resistance, vitamin D deficiency, etc. The aim of the study was to assess the incidence of cardiovascular complications in HP.Material and methods: The study included 45 patients (15 men, 30 women), with a mean age...

ea0049ep307 | Calcium &amp; Vitamin D metabolism | ECE2017

Risk factors associated with osteoporosis in beta-thalassaemia major patients

Iancu Elena Mirela , Albu Alice Ioana , Nicolaescu Irina

Beta-thalssaemia major (BTM) is a rare disease that encompasses a vast range of endocrinological complications, despite of the improvement of treatment protocols. The aim of this study was to identify the clinical and hematological parameters associated with osteoporosis, a frequent complication found in beta-thalassaemia patients.Patients with BTM were evaluated in the Endocrinology Department of Elias Hospital between February 2004 and March 2016. Only...

ea0049ep308 | Calcium &amp; Vitamin D metabolism | ECE2017

Giants walk amongst us

Tanday Raj , Grant Bonnie , Ojo Akin , Casey Edel , Nikookam Khash

We present the case of a 51-year-old gentleman who had a giant parathyroid adenoma. He has a past medical history of deep vein thrombosis and hypertension. He is taking amlodipine 10 mg od. He is a non-smoker and drinks alcohol in moderation. He was admitted with right leg swelling found to be a new thrombosis. Incidental finding of extreme hypercalcaemia found on bloods with raised PTH (CorrCa 4.23 mmol/l, PTH 83.1 pmol/l.) Patient was completely asymptomatic. CT imaging of c...

ea0049ep309 | Calcium &amp; Vitamin D metabolism | ECE2017

Hungry bone syndrome after treatment of severe primary hyperparathyroidism

Mghari Ghizlane El , Ansari Nawal El

Introduction: Persistent hypocalcemia after surgery for severe hyperparathyroidism are not uncommon and may be secondary to transient or permanent hypoparathyroidism but may also be due to bone pathology.Observation: Patient of 44 years old was hospitalized for fractures of the pelvis, and shaft of left femur, spontaneous without trauma turned out. Laboratory tests shows severe hypercalcaemia to 156 mg/l, serum phosphorus at 22 mg/l, elevation of PTH to ...

ea0049ep310 | Calcium &amp; Vitamin D metabolism | ECE2017

Clinical review of nine cases of pseudohypoparathyroidism

Barbosa David , Robalo Brigida , Pereira Carla , Sampaio Lurdes

Objective: To analyze the clinicopathological features of pseudohypoparathyroidism (PHP), that would help clinicians to consider this rare condition in children.Methods: A retrospective review of nine patients with PHP (including seven males and three females) admitted to our hospital between 1990 and 2014 was conducted. Clinical and biochemical parameters along with epidemiological data were extracted and analyzed.Results: The mea...

ea0049ep311 | Calcium &amp; Vitamin D metabolism | ECE2017

Severe hypercalcemia revealing an atypical parathyroid adenoma

Ansari Nawal El , Rafiq Bouchra

Introduction: Primary hyperparathyroidism is a common cause for hypercalcemia, however severe hypercalcemia remain a rare complication. The atypical parathyroid adenoma is an uncommon cause to severe hypercalcemia. We report a case of a 40-year-old male with very high serum calcium due to a possible atypical parathyroid diagnosed after a spontaneous fracture.Case report: A 40-year-old male was admitted to the traumatology department for the management of...