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20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

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ECE 2018, 19 - 22 May 2018; Barcelona, Spain

Poster Presentations: Calcium and Bone

Calcium & Vitamin D metabolism

ea0056p202 | Calcium & Vitamin D metabolism | ECE2018

Vitamin D levels in two ethnic groups of patients with diabetes

Papadakis Georgios , Zambelis Thomas , Konstantopoulos Kostas , Chatzipanagiotou Stylianos

Introduction: • Vitamin D deficiency is thought to impair insulin action and glucose metabolism.• Migrants who live in Western countries seem to have lower 25(OH)VitD levels, not only from their white counterparts but also from their native populations in their country of origin.Objectives: • We investigated a cohort of predominantly white Greek Caucasian and Bangladeshi immigrant patients with diabetes mellitus in o...

ea0056p203 | Calcium & Vitamin D metabolism | ECE2018

Effects of steroid hormone on Calbindin-D9k expression in rat cerebellum

Park Seon Young , Lee Bonn , Ly Duc Viet , Vo Thi Bich Thuy , Yoo Yeong-Min , Jung Eui-Man , Jeung Eui-Bae

Introduction: Calbindin-D9k is a 9 kDa polypeptide expressed in the mammalian intestine, uterus, and pituitary gland. Calbindin-D9k increase Ca2+ absorption by buffering intracellular Ca2+. The intracellular concentration of calcium is regulated by calcium related proteins such as calbindin-D9k, TRPV1 and PMCA1. The regulatory effect of steroid hormones and glucocorticoids on calbindin-D9k, TRPV1 and PMCA1 expre...

ea0056p204 | Calcium & Vitamin D metabolism | ECE2018

Effects of glucocorticoid on mucin secretion by calcium-related proteins in mouse lung

An Jin Yong , Ly Duc Viet , Jeon Bo Hui , Nguyen Thi Hoai Thu , Jeung Eui-Bae

Calcium is important for physiological functioning in many tissues and is essential in mucus secretion and muscle contraction. Intracellular concentrations of calcium are regulated by calcium-related proteins such as TRPV4, TRPV6, CaBP-9k, NCX1, and PMCA1. In this study, the relationship between secretion of pulmonary mucus and calcium regulation was investigated. To confirm the effect of steroid hormones, immature mice were injected with estrogen (E2) or progesterone (P4) and...

ea0056p205 | Calcium & Vitamin D metabolism | ECE2018

Effect of endocrine disrupting chemicals on the calcium channel and implantation during implantation period

Tran Dinh Nam , Park Seon Young , Lee Jae-Hwan , Lee Bonn , Vo Thi Bich Thuy , Jeung Eui-Bae

Miscarriage is a very common occurrence in humans, in which blastocyst implantation failure in naturally-occurring and assisted human reproduction occurs in up to 2/3 of all cases. Calcium (Ca2+) has been showed to involve in many cellular signal transduction pathways as well as regulation of cell adhesion, which is necessary for the physiology process of endometrial epithelial cell transformation and stromal cell decidualization during embryo implantation. Previous...

ea0056p206 | Calcium & Vitamin D metabolism | ECE2018

Clinical, paraclinical, etiological and therapeutic particularities of severe hypercalcemia: A comparative study

Oueslati Ibtissem , Rached Amal , Mahfoudhi Madiha , Kaaroud Hayet , Khiari Karima , Turki Sami , Abdallah Nejib Ben , Abdallah Taieb Ben

Background: Severe hypercalcemia, defined as a serum calcium concentration ≥ 3.5 mmol/l or > 3 mmol/l associated with symptoms and signs of acute calcium intoxication, is a rare but a potentially life threatening condition. The aim of this study was to assess clinical, paraclinical, etiological and therapeutic features of severe hypercalcemia and to determine its outcome.Methods: It was a retrospective, descriptive and comparative study conduct...

ea0056p207 | Calcium & Vitamin D metabolism | ECE2018

Genetic characteristics of sensitivity of vitamin D and prevalence of vitamin deficiency among patients of polyclinics

Poluektova Alena , Poteshkin Yuri , Polevyanova Polina

Introduction: Vitamin D deficiency is a global problem worldwide.Purpose of the study: To investigate the incidence of vitamin D deficiency and genetic sensitivity to it among patients in the polyclinic.Materials and methods: A retrospective study was conducted, 6034 medical charts were analyzed, of those who were tested for vitamin D, the study included 567 patients (374 women, 193 men, women average age 40.7±14.1 years, men ...

ea0056p208 | Calcium & Vitamin D metabolism | ECE2018

A Curious phenomenon of Post radioiodine therapy induced hypocalcemia in Graves’ disease: Case series

Panchangam Ramakanth Bhargav , Ramesh B , Rajesh B , Vimaladevi N , Rajkiran Reddy B , Venkateshwara Reddy M , Vignesh D , Chakrapani B

Introduction: Graves’ disease (GD) is often treated with radioiodine therapy for cure. While, post external irradiation and post-radioiodine therapy (RAI) induced hyperparathyroidism after many years of latency is a well known phenomenon, there are only anectodal reports of post-radioiodine hypocalcemia. The factors contributing to this are poorly understood. In this context, we evaluated our own series to look deeper in to this issue.Material and m...

ea0056p209 | Calcium & Vitamin D metabolism | ECE2018

Primary hyperparathyroidism in the elderly

Duskin-Bitan Hadar , Nemirovsky Nina , Slutzky-Shraga Ilana , Robenshtok Eyal , Diker-Cohen Talia , Shimon Ilan , Hirsch Dania , Tsvetov Gloria

Introduction: Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy. Data on PHPT in the elderly are scarce.Objective: To characterize elderly patients with PHTP, clinically and biochemically.Patients: A total of 216 patients (73.6% females) aged≥75 years were diagnosed and followed at a single tertiary medical center for PHPT.Results: Mean follow-up was 11.3±5.5 years. Age at ...

ea0056p210 | Calcium & Vitamin D metabolism | ECE2018

Edentulous jaw and Primary HyperParathyroidism

Mayilvaganan Sabaretnam , Bothra Sapana , Chekavar Aromal , agarwal Amit , Bhargav PrK

Introduction: Primary Hyperparathyroidism usually presents as bone disease, renal or with Gastro Intestinal Symptoms. Dental Symptoms as primary or presenting manifestations are rare. We report two patients who presented with edentulous jaw in young age, which resulted in investigations leading to the diagnosis for primary hyperparathyroidism.Material and methods: We report two patients operated in a tertiary referral Centre from Jan 2017–Dec 2017 f...

ea0056p211 | Calcium & Vitamin D metabolism | ECE2018

Coeliac Disease complicating Autoimmune Hypoparathyroidism with Recalcitrant Hypocalcaemia

Philbey Christopher , Shah Najeeb , Mohammed Kamrudeen , Ibrahim Hiba

We present the case of a 57 year old male that presented to a tertiary centre with a week’s history of lethargy, muscle cramps and peri-oral paraesthesia. He was otherwise fit and well. His examination revealed no evidence of Chvostek’s, Trousseau’s or tetany. His reflexes were not assessed. Initial electrolyte screening confirmed a hypocalcaemia with a serum adjusted calcium of 1.47 mmol/l (2.2–2.6), his phosphate was elevated at 1.64 mmol/l (0.8–1.5)...

ea0056p212 | Calcium & Vitamin D metabolism | ECE2018

The prevalence of Vitamin D deficiency in a Greek and a Cypriot population sample

Xyda Souzana Eirini , Kotsa Kalliopi , Doumas Argyrios , Papanastasiou Manolis , Samoutis George , Garyfallos Alexandros Anastasios

Introduction: The results of this epidemiological study demonstrate the burden of 25-hydroxyvitamin D deficiency in two sunny Mediterranean countries Greece and Cyprus- and some of the related risk factors. These two populations were examined together due to their common phylogenetic origin. Up until now there are no available data for the mean Vitamin D levels of the Cypriot adult population. An early identification of vitamin D deficiency is now considered as the cornerstone...

ea0056p213 | Calcium & Vitamin D metabolism | ECE2018

Epidemiology of primary hyperparathyroidism in Santander, Spain

Ramos Laura , Munoz Pedro , Piedra Maria , Vazquez Luis , Amado Jose Antonio

Background and aims: Primary hyperparathyroidism (PHPT) is a common endocrine disorder with different epidemiological patterns among countries. The incidence of PHPT is unknown in Spain. The aim of our study is to assess the prevalence and incidence of diagnosed PHPT in adults between 1970 and 2014 in Santander, a population of 290.000 inhabitants, located in the north of Spain.Subjects and methods: All patients diagnosed with primary hyperparathyroidism...

ea0056p214 | Calcium & Vitamin D metabolism | ECE2018

Human Chorionic Gonadotrophin (hCG) as a diagnostic test to differentiate between Parathyroid Carcinoma, Primary Benign Hyperparathyroidism and Secondary Hyperparathyroidism.

Valdes-Socin Hernan , Betea Daniela , Daly Adrian , Delanaye Pierre , Souberbielle Jean-Claude , Beckers Albert , Cavalier Etienne

Introduction: Parathyroid carcinoma (PCa) is a rare presentation of primary hyperparathyroidism (PHPT), accounting for less than 1% of cases. Differentiating parathyroid cancer from benign hyperparathyroidism is clinically challenging. Some previous work suggest that there is a paraneoplastic hCG production in parathyroid cancer (Stock et al 1987, Rubin et al 2008). In this study, we aimed to investigate whether the hCG+β kit from Roche Diagnostics could distinguish PCa p...

ea0056p215 | Calcium & Vitamin D metabolism | ECE2018

Reliabilty of serum Calcium to Phosphorus (Ca/P) ratio as an accurate and inexpensive toolto define disorders of Ca-P metabolism: preliminary data

De Vincentis Sara , Monzani Maria Laura , Kara Elda , Guaraldi Giovanni , Rochira Vincenzo , Madeo Bruno

Background: Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder. The Ca/P ratio is an accurate tool to differentiate patients with PHPT (>3.5 if Ca and P are expressed in mg/dl) from healthy subjects [1]. The reliability of this index is based on the fact that serum Ca and P are inversely related together. However, other disorders of the Ca-P metabolism, such as hypophosphoremia (HypoP), might impair the Ca/P ratio.Aim: To ...

ea0056p216 | Calcium & Vitamin D metabolism | ECE2018

Secondary hyperparathyroidism after obesity surgery is associated with serum levels of 25-hydroxyvitamin D and ionized calcium

Hewitt Stephen , Kristinsson Jon , Aasheim Erlend , Blom-Hogestol Ingvild , Aaseth Eirik , Eriksen Erik Fink , Mala Tom

Background: Secondary hyperparathyroidism (SHPT) is common in obesity, and a concern after obesity surgery due to negative impact on bone. Longitudinal data is sparse, and relationships with vitamin D and calcium levels are unclear. We studied the prevalence of SHPT over five years after Roux-en-Y gastric bypass (RYGB) and investigated whether SHPT was associated with serum levels of 25-hydroxyvitamin D (25(OH)D) and ionized calcium (iCa).Methods: 347 of...

ea0056p217 | Calcium & Vitamin D metabolism | ECE2018

The frequencies of persistent hyperparathyroidism and hypercalcemia after kidney transplantation: a single-center experience

Oruc Aysegul , Ersoy Canan , Oz Gul Ozen , Akgur Suat , Cander Soner , Yildiz Abdulmecit , Ersoy Alparslan

Bone mineral disorders usually resolve after successful kidney transplantation. Serum calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) levels tend to normalize within time. Serum Ca levels >10.2 mg/dL and PTH levels >150 pg/mL at 6th−12th months of transplantation is defined as persistent hypercalcemia and persistent hyperparathyroidism (PHPT) in recipients with normal graft function. Reported persistent hypercalcemia prevalence varies in wide range bet...

ea0056p218 | Calcium & Vitamin D metabolism | ECE2018

Prevalence and clinico-epidemiology of vitamin D deficiency in patients with type 2 diabetes mellitus and hypertension – a Pan-India study

Talwalkar P G , Deshmukh Vaishali , Deepak M C , Agrawal Dinesh , Patel Ishan , Hegde Rashmi

Introduction: Vitamin D (vitD) deficiency is a worldwide epidemic health problem, with a prevalence of about 70–100% in general Indian population. The objective of this cross-sectional, clinico-epidemiological, Pan-India study was to evaluate the prevalence of vitD deficiency in patients with Type-2 diabetes mellitus (T2DM) or hypertension (HT) or both T2DM and HT and to understand the management practices in Indian real-world setting.Methods: Adult...

ea0056p219 | Calcium & Vitamin D metabolism | ECE2018

PTH threshold for hyperparathyroidism diagnosis in vitamin D deficiency

Baena-Nieto Gloria , Marquez-Pardo Rosa , Cayon-Blanco Manuel , Garcia-Garcia-Doncel Lourdes

Introduction: Vitamin D insufficiency is very common among Spanish adults. It is well established there is an inverse relationship between vitamin D and PTH levels. The diagnostic approach of an increased serum PTH concentration in a normocalcemic normophosphatemic patient is frequent in routine practice and the deficiency of vitamin D is the major cause of secondary hyperparathyroidism (SHPT). The aims of this study were to evaluate the prevalence of SHPT in a cohort of normo...

ea0056p220 | Calcium & Vitamin D metabolism | ECE2018

Vitamin D status in hospitalized chronic ill patients

Botros Raef , Abdelsalam Mona , Bahaaeldin Ahmed , Aboelyazed Sherihan

Objectives: Vitamin D deficiency is rarely considered or treated in critically ill patients. Deficiency of 25-hydroxy vitamin D (25(OH) D) prior to hospital admission might be a significant predictor of short and long term all cause patient mortality in a critically ill patient. We aimed to investigate the prevalence of vitamin D deficiency in hospitalized patients and its relation to the length of stay and outcome of hospitalization.Methods: Prospective...

ea0056p221 | Calcium & Vitamin D metabolism | ECE2018

Role of 4D–TC in Primary Hyperparathyroidism Diagnosis– case report

Ivo Catarina , Pires Vitoria , Verissimo David , Silva Joao , Serra Filipa , Lopes Luis , Passos Dolores , de Castro Joao Jacome , Marcelino Mafalda

Introduction: Primary Hyperparathyroidism (pHPT) is a calcium metabolism disease, resulting from one or more parathyroid glands hyperfunction. Ultrasonography and Technetium Sestamibi are, nowadays, the first line imaging techniques for diagnosis. Recently, a 4-dimensional computed tomography (4D-TC) protocol has emerged, presented in the last endocrine surgery guidelines. It is a dynamic imaging exam based on the parathyroid contrast uptake pattern, whose sensitivity and spec...

ea0056p222 | Calcium & Vitamin D metabolism | ECE2018

Severe hypomagnesaemia and hypocalcaemia: an uncommon but serious complication with proton pump inhibitor therapy

Tauni Rahat , Kazmi Syed Kashif , Chukwuma Unoma , Ali Nida , Evans Mark

A 73 year old man was admitted to the hospital with a multi-factorial fall. He was otherwise asymptomatic. Past medical history included stage 3 chronic kidney disease (CKD), ulcerative colitis, epidermolysis bullosa and mild cognitive impairment. Examination was unremarkable apart from unilateral leg swelling and deep venous thrombosis was excluded. Investigations showed incidental undetectable magnesium level and severe hypocalcaemia. Potassium level was normal, 25-hydroxy-v...

ea0056p223 | Calcium & Vitamin D metabolism | ECE2018

Hip fractures and vitamin D deficiency

Kostoglou-Athanassiou Ifigenia , Athanassiou Lambros , Giannakopoulos Andreas , Pastroudis Alexandros , Athanassiou Panagiotis

Introduction: Vitamin D deficiency is associated with the development of osteomalacia, as it decreases intestinal calcium absorption and bone mineralization. However, severe vitamin D deficiency may also be correlated with secondary hyperparathyroidism which induces osteoporosis. In addition, it induces muscular dysfunction which along with frailty in old age it may induce falls.Aim: The aim was to present a group of patients with severe vitamin D defici...

ea0056p224 | Calcium & Vitamin D metabolism | ECE2018

Clinical manifestation of Hypoparathyroidism in a monocentric cohort: our experience

Repaci Andrea , Altieri Paola , Dianori Francesco , Salituro Nicola , Vandi Giulia , Pagotto Uberto

Introduction: Hypoparathyroidism (HP) is characterized by low serum calcium and increased phosphate levels associated with inappropriately low serum PTH levels. Clinical manifestations of HP are tingling, muscle cramps, seizures, nephrocalcinosis, kidney stone, kidney failure, depression and anxiety.Objective: Quantify the chronic symptoms and complications of HP in our monocentric cohort.Material and methods: We conducted a retros...

ea0056p225 | Calcium & Vitamin D metabolism | ECE2018

Primary hyperparathyroidism due to a parathyroid adenoma with cystic degeneration presenting as recurrent acute pancreatitis

Lungu Ionela , Silaghi Cristina Alina , Silaghi Horatiu , Cobzac Gheorghe , Nagy Georgiana , Petrescu Denisa , Mirescu Claudiu Stefan , Georgescu Carmen Emanuela

Primary hyperparathyroidism (PHPT) is rarely associated with the development of acute pancreatitis (AP). The incidence of AP induced by hypercalcemia in PHPT varies between 1.5 and 7%. PHPT is most commonly caused by parathyroid adenoma and infrequently by parathyroid hyperplasia, carcinoma or cyst and multiple endocrine neoplasia (MEN) types 1 and 2A. The present case is a 48-year-old man referred to our service for further investigation 1 month after an acute hemorrhagic nec...

ea0056p226 | Calcium & Vitamin D metabolism | ECE2018

Glucose metabolism in primary hyperparathyroidism: The role of parathyroidectomy

Antonopoulou Vasiliki , Grammatiki Maria , Rapti Eleni , Koufakis Theocharis , Karras Spyridon , Yavropoulou Maria , Papavramidis Theodossis , Kotsa Kalliopi

Background: Although primary hyperparathyroidism (PHPT) has been associated with diabetes mellitus (DM), the etiological link is not clear and the effect of parathyroidectomy is controversial.The aim of this observational study was to investigate the metabolic link between calciotropic hormones and glucose metabolism in PHPT patients before and after parathyroidectomy.Methods: Twenty-four consecutive patients with PHPT (Group-A) without DM were included ...

ea0056p227 | Calcium & Vitamin D metabolism | ECE2018

Acquired Fanconi syndrome and hypophosphatemic osteomalacia in two patients treated with adefovir and tenofovir

Saydam Basak Ozgen , Bengi Goksel , Yener Serkan , Comlekci Abdurrahman

Background: Proximal tubule dysfunction in Fanconi syndrome causes impaired reabsorbtion of amino acids, glucose, urate and phosphate, which leads to hypophosphatemic osteomalcia. Adefovir and tenofovir are two nucleoside reverse transcriptase inhibitors, which are used for treatment of patients with hepatitis B infection. Although these drugs are well tolerated with few side effects, patients may rarely suffer from drug-induced Fanconi syndrome and hypophosphatemic osteomalac...

ea0056p228 | Calcium & Vitamin D metabolism | ECE2018

The coexistence of primary hyperparathyroidism with different auto-antibodies and autoimmune diseases

Novakovic-Paro Jovanka , Icin Tijana , Bajkin Ivana , Dejanovic Bozidar , Stepanovic Kristina , Vukovic Bojan , Benc Damir , Tomic-Naglic Dragana , Pejin Radoslav , Milankov Andrijana , Medic-Stojanoska Milica

Introduction: The coexistence of primary hyperparathyroidism with autoimmune diseases is described very rarely in the literature so far. There are only few cases of immune-mediated hyperparathyroidism, associated with anti-calcium- sensing receptor autoantibodies, frequently in context with other immune diseases. Spontaneous remission of primary hyperparathyroidism in anti-TNF therapy of psoriatic arthritis has also been described in one case. Prevalence of positive antithyroi...

ea0056p229 | Calcium & Vitamin D metabolism | ECE2018

Timely and dose assessment of serum parathormone and calcium levels by cinacalcet in patients with primary hyperparathyroidism: an individualized approach

Duntas Leonidas , Tanteles Savvas , Boutsiadis Anastasios , Polyzos Stergios

Objective: To assess the regulation of parathormone (PTH) and serum calcium (s-Ca) in patients, on follow-up over a long time period of four years, who have primary hyperparathyroidism (pHPT) and whose condition is non-operable or who are not willing to undergo surgery.Methods: Initially, 17 patients with documented pHPT were recruited and treated with calcimimetic cinacalcet at a dose calculated according to s-Ca levels (≤11 mg/dl or >11 mg/dl...

ea0056p230 | Calcium & Vitamin D metabolism | ECE2018

Coexistence of a large functioning parathyroid cyst with papillary thyroid carcinoma: a case report

Panagiotou Athanasios , Anagnostis Panagiotis , Rafailidis Savvas , Kita Marina

Introduction: Parathyroid cysts constitute a rare cause of primary hyperparathyroidism (PHPT). PHPT may also rarely coexist with non-medullary thyroid carcinoma (NMTC).Case presentation: A 70-year old woman was admitted to our department for type 2 diabetes mellitus (T2DM) management. She also reported nephritic colics due to kidney stone disease. There were no reports for fractures, symptoms of hypercalcemia or obstructive neck symptomatology. Laborator...

ea0056p231 | Calcium & Vitamin D metabolism | ECE2018

Assessment of calcium and vitamin D medications adherence in patients with hypoparathyroidism after thyroidectomy

Bilginer Muhammet Cuneyt , Aydin Cevdet , Faki Sevgul , Topaloglu Oya , Ersoy Reyhan , Cakir Bekir

Aim: In this study, we aimed to evaluate the vitamin D and calcium treatments adherence in patients with hypoparathyroidism after surgery.Materials and methods: To elucidate the medication adherence, we performed a questionnaire survey using the six item Morisky Medication Adherence Scale for medication of patients with postoperative hypoparathyroidism. These 6 questions were as follows; 1) Do you sometimes have problems remembering to take your medicati...

ea0056p232 | Calcium & Vitamin D metabolism | ECE2018

Preoperative serumvitamin D levels in patients with breast cancer: association with histological characteristics

Panagiotou Grigorios , Komninou Despina , Triantafillidou Sofia , Vagionas Anastasios , Pazaitou-Panayiotou Kalliopi , Tsakalof Andreas

Objective: Vitamin D is a multifunctional hormone with possible antitumor effects. Its exact role in breast carcinogenesis remains largely unknown. We evaluated serum vitamin D levels in female patients with recently identified benign or malignant lesions of the breast and its associations with tumor histology.Subjects-methods: One hundred sixty women with suspicious breast masses that required surgical excision were included in this study. Body composit...

ea0056p233 | Calcium & Vitamin D metabolism | ECE2018

Association of vitamin D status with pulmonary function: potential mediation by physical function and inflammation

Rafiq Rachida , van Schoor Natasja , Lips Paul , den Heijer Martin , Spruit Martijn , de Jongh Renate

Background: Several studies have reported an association between serum 25-hydroxyvitamin D (25(OH)D) concentrations and pulmonary function in the general population. However, results remain conflicting. In addition, the underlying mechanisms by which vitamin D affects pulmonary function are unknown.Objective: To assess the relationship of vitamin D status with pulmonary function and whether this relationship is mediated by physical function and/or inflam...

ea0056p234 | Calcium & Vitamin D metabolism | ECE2018

Quantification of serum 25-hydroxyvitamin D: a comparison between competitive chemiluminescence immunoassay and mass spectrometry coupled to high performances liquid chromatography

Saponaro Federica , Frascarelli Sabina , Saba Alessandro , Prontera Concetta , Clerico Aldo , Scalese Marco , Passino Claudio , Marcocci Claudio , Zucchi Riccardo

Serum 25-hydroxy-vitamin D (25OHD) is considered the most reliable marker of vitamin D status. Adequate levels 25OHD of are necessary for pleiotropic effects of vitamin D, either skeletal or extra-skeletal. Traditional assays based on immunoassay often show an unsatisfactory accuracy and sensibility. A valuable alternative is Tandem Mass Spectrometry coupled to High Performances Liquid Chromatography (HPLC-MS-MS), that offers a good quantification accuracy, as the contribution...

ea0056p235 | Calcium & Vitamin D metabolism | ECE2018

Maximal foot force and plantar pressure distribution assessed by Footscan is not affected in asymptomatic primary hyperparathyroidism patients

Oguz Seda , Unluturk Ugur , Nahit Sendur Suleyman , Erbas Tomris

Background: Primary hyperparathyroidism (PHPT) is associated with various musculoskeletal complaints. It is difficult to evaluate muscle strength as it is hard to extract objective data due to lack of definite methods for measurement.Objective: To assess the differences between PHPT patients and healthy controls regarding maximum foot force and plantar pressure distribution by using platform pressure measuring system [Footscan (RSscan)].<p class="abs...

ea0056p236 | Calcium &amp; Vitamin D metabolism | ECE2018

Primary hyperparathyroidism in Russian Federation: epidemiology according to the online register

Mokrysheva Nataliya , Maganeva Irina , Mirnaya Svetlana , Eremkina Anna

Objective: Primary hyperparathyroidism (PHPT) is one of the most frequently diagnosed endocrine disorders. The Russian Registry of PHPT is an on-line web-based database created in 2016 with the aim to estimate the disease prevalence and improve the quality of health care for such patients in Russian Federation. The Endocrinology Research Centre, Moscow represents The Head organization.Material and methods: We retrieved retrospective data submitted to the...

ea0056p237 | Calcium &amp; Vitamin D metabolism | ECE2018

Intrathyroidal parathyroid carcinoma in a chronic hemodialysis patient: a case report

Mokrysheva Natalya , Krupinova Julia , Kuznecov Sergei , Selivanova lily , Mirnaya Svetlana

Background: Parathyroid carcinoma (PC) is an infrequent pathology, responsible for 0.5–5% of primary hyperparathyroidism cases. Despite the high prevalence of secondary hyperparathyroidism in patients with a chronic kidney disease (CKD), PC among them is extremely rare, with less than 30 cases reported in the literature. The diagnosis of PC in CKD patients is more complex, because of using cinacalcet that reduces the level of calcium and parathyroid hormone (PTH). We repo...

ea0056p238 | Calcium &amp; Vitamin D metabolism | ECE2018

Raloxifene has no efficacy in reducing the risk of spontaneous vertebral fractures after denosumab discontinuation

Rodriguez Elena Gonzalez , Stoll Delphine , Lamy Olivier

Introduction: Denosumab reduces bone resorption, increases BMD, and reduces fracture risk. Denosumab discontinuation (DD) induces an increase of B-crosslaps above baseline values for two years, and a decrease of BMD values. This rebound effect is associated with spontaneous clinical vertebral fractures (SCVF) in close to 15% of patients considering a follow-up of 2 years without taking another osteoporosis treatment. Prescribing a bisphosphonate or SERMs at DD would prevent th...

ea0056p239 | Calcium &amp; Vitamin D metabolism | ECE2018

Prevalence of basal ganglia calcification in patients with pseudohypoparathyroidism

Mazoni Laura , Saponaro Federica , Apicella Matteo , Mantovani Giovanna , Marcocci Claudio , Cetani Filomena

Pseudohypoparathyroidism (PHP) is group of heterogeneous disorders characterized by hypocalcemia, hyperphosphatemia and elevated paratormone (PTH) levels as a result of end-organ resistance to PTH. Basal ganglia calcification (BGC) in states of hypoparathyroidism is not uncommon. In PHP, BGC can occur up to 50%; the pathogenesis is poorly defined. The aim of our study was to evaluate the prevalence of BGC at baseline observation in a series of patients with PHP followed at a t...

ea0056p240 | Calcium &amp; Vitamin D metabolism | ECE2018

Thyroid oncocytes may complicate 18F-fluorocholine PET-CT localization of parathyroid adenomas in primary hyperparathyroidism

Zajickova Katerina

18F-fluorocholine positron emission tomography/X-ray computed tomography (PET-CT) was carried out in our patients with primary hyperparathyroidism (PHPT) and inconclusive preoperative neck ultrasound and 99Tc-sestaMIBI scintigraphy to localize abnormal parathyroid glands before surgery. The results were retrospectively evaluated and compared to postoperative histopathological findings. A total of 9 patients (1 man, 8 women) with sporadic PHPT was enrolled...

ea0056p241 | Calcium &amp; Vitamin D metabolism | ECE2018

Burden of illness among patients with chronic hypoparathyroidism not adequately controlled with standard therapy by self-perception

Siggelkow Heide , Clarke Bart L. , Dahl-Hansen Helen , Glenister Elizabeth , Judge Davneet , Bent-Ennakhil Nawal , Gibson Katie , Germak John , Chen Kristina , Marelli Claudio , Bollerslev Jens

Significant knowledge gaps exist regarding the humanistic effects of chronic hypoparathyroidism (HPT), a rare, debilitating condition. We provide interim results from a global survey conducted to characterise the burden associated with chronic HPT from the patient perspective. An anonymous, self-reported survey (online or paper) was conducted in patients with chronic HPT, not adequately controlled with standard therapy by self-perception, from 12 countries through physicians o...

ea0056p243 | Calcium &amp; Vitamin D metabolism | ECE2018

PTH secretion dynamics in patients with chronic kidney disease stage 3 and stage 4 during 1 year of observation

Karlovich Natalia

Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease (CKD). The aim of the study was to analyze dynamics of PTH secretion during 1 year of observation of patients with CKD stage 3 and 4. We examined 40 patients, 22 f, 18 m; age 55.9±14.5 years. Mean glomerular filtration rate (GFR)? Calculated by MDRD formula was 27.2±15.7 ml/min; 15 patients have CKD stage 3, 25 – stage 4. Serum PTH, 25(OH)D3, calcium (Ca) and phosphorus (P) we...

ea0056p244 | Calcium &amp; Vitamin D metabolism | ECE2018

Biological and endocrine features of Infra Clinical Hypoparathyroidism in Major Beta Thalassemia at adulthood in Algeria, screening and therapeutic management

Belazzouz Abderahman Youssouf , Khouja Ziane , Azzouz Malha , Boudiba Aissa , Nacer Ahmed

Introduction: Major Beta Thalassemia (MBT) is a common hereditary condition in Algeria (2%) and in North Africa it requires repeated transfusions. Life expectancy has improved significantly thanks to advances in chelating treatments that will delay endocrine complications associated with secondary hemochromatosis. The hypoparathyroidism (HPT) continues to be seen (5–20%), its relation with the iron overload is not clearly elucidated.Patients and met...

ea0056p245 | Calcium &amp; Vitamin D metabolism | ECE2018

Impact of vitamin D status in clinical, biochemical, radiological and pathological parameters in primary hyperparathyroidism

Iglesias Paloma , Gutierrez Sonsoles , Barba Raquel , Delgado Miguel Angel , Duran Manuel , Vazquez Clotilde , Guijarro Guadalupe , Pavon Isabel

To determine the effects of 25-hydroxyvitamin D (25-OHD) status on parathyroid adenoma weight, clinical, radiological and biochemical phenotype in patients with primary hyperparathyroidism (HPTP) were studied.Methods: Eighty-two patients with pHPT who underwent surgical treatment and in whom the presence of parathyroid adenoma were confirmed histopathologically were studied retrospectively. Patients were divided into 2 groups: group A patients with 25-OH...

ea0056p246 | Calcium &amp; Vitamin D metabolism | ECE2018

Milk alkali syndrome & soft tissue calcification in a patient with a history of cancer

Mumdzic Enis , Merza Zayd

A 61-year-old female, with a previous history of left nephrectomy for papillary renal cell carcinoma, presented with lethargy. Her initial blood tests revealed an adjusted calcium of 4.26 mmol/l (normal range 2.2–2.6) associated with acute renal impairment (creatinine 432 μmol/l, urea 25 mmol/l) and low PTH of 9 ng/l (normal range 20–75). Following rehydration with IV fluids and IV pamidronate administration, her adjusted calcium normalised to 2.37 mmol/l. The i...

ea0056p247 | Calcium &amp; Vitamin D metabolism | ECE2018

Management of parathyroid adenomas

Chiraz Halwani , Imene Zoghlami , Cyrine Zgolli , Khmaies Akkari , Rania Ben Mhamed

Introduction: Preoperative localization of parathyroid adenomas still remains a problem, despite advances in imaging of the parathyroid gland. The purpose of our presentation was to present our attitude in the diagnosis and the treatment of parathyroid adenomas and in case of recurrence.Method: Our study includes 33 cases of primary hyperparathyroidism treated in our department, during a period of 15 years (2002–2017). All patients ...

ea0056p248 | Calcium &amp; Vitamin D metabolism | ECE2018

Recurrent hyperparathyroidism: parathyroid carcinoma or parathyromatosis?

Alina Isaic , Flore Varcus , Maria Cornianu , Ioana Golu , Mihaela Vlad

Recurrent hyperparathyroidism (HPT) refers to reappearance of hypercalcemia after a normocalcemic period of at least 6 months post-parathyroidectomy. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism (pHPT), accounting for 0.4–5.2% of cases. Parathyromatosis is defined as small nodules of hyperfunctioning parathyroid tissue scattered in the soft tissues of the neck and/or mediastinum. We describe two cases with recurrent hypercalcemia after surgical int...

ea0056p249 | Calcium &amp; Vitamin D metabolism | ECE2018

Prenatal hypophosphatasia with severe skull bone deficits report of a case

Sideri Vassiliki , Karachaliou Feneli , Kapsabeli Helen , Doulgeraki Artemis , Dakalaki Anna , Papaevangelou Vassiliki

Hypophosphatasia (HPP) is a rare inherited disorder caused by loss-of-function mutations in the tissue-nonspecific alkaline phosphatase (TNSALP) gene. HPP B is a multisystemic B disorder with a predominantly B skeletal phenotype, with a clinical spectrum ranging from high lethality in early onset (<6 months) HPP to mild late-onset presentations. HPP skeletal disease in utero was thought to predict a lethal outcome. However a benign prenatal form (PB HPP) with a mild postna...

ea0056p250 | Calcium &amp; Vitamin D metabolism | ECE2018

Clinical outcome in primary hyperparathyroidism: A 10-year tertiary care centre experience in Pakistan

Tabassum Shehla , Naeem Ehsun , Iqbal Javed , Islam Najmul

Background: Primary hyperparathyroidism (PHPT) is characterized by abnormal regulation of PTH secretion by calcium. The most common clinical presentation of PHPT is asymptomatic (80% cases), followed less likely by the classical symptoms of bones, stones, abdominal moans, and psychic groans. The diagnosis of PHPT is usually first suspected because of the finding of an elevated serum calcium concentration along with a rise in Parathyroid hormone (PTH) level. Serum phosphorus le...

ea0056p251 | Calcium &amp; Vitamin D metabolism | ECE2018

Primary hyperparathyroidism-localisation studies’ sensitivity

Oros Sabina Elena , Gongu Robert Andrei , Diaconescu Laura Alina , Ivan Mirela , Grigorie Daniel , Gudovan Emilia , Dumitrascu Anda , Hortopan Dan , Goldstein Andrei

Primary hyperparathyroidism can be caused by adenoma, adenocarcinoma, parathyroid hyperplasia or ectopic parathyroid glands. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism recommends imaging as a helping tool in locating the causative lesion rather than a must for diagnosis. Experienced surgeons rely on the intraoperative localisation of the lesion. Pre surgery localisation helps for a minimally invasive appro...

ea0056p252 | Calcium &amp; Vitamin D metabolism | ECE2018

Characterization of the parathyroid hormone requests and hyperparathyroidism etiologies in a tertiary hospital

Gomes Vania , Matias Sampaio , Ferreira Florbela , Proenca Helena

Introduction: Hyperparathyroidism is a disease characterized by excessive secretion of parathyroid hormone (PTH). There are three main etiologies: primary (PHPT), secondary (SHPT) and tertiary hyperparathyroidism (THPT). PHPT is characterized by abnormal regulation of PTH secretion by calcium, resulting in hypersecretion of PTH relative to the serum calcium concentration. SHPT is the overproduction of PTH in context of hypocalcemia, most frequently because of vitamin D deficie...

ea0056p253 | Calcium &amp; Vitamin D metabolism | ECE2018

Tertiary hyperparathyroidism associated with prolactinoma – case report

Pop-Radu Cristina Corina

Introduction: Tertiary hyperparathyroidism (HPT) occurs most commonly in the setting of renal transplant where patients with secondary HPT continue to have elevated PTH levels after receiving a renal allograft. This disease is observed in up to 30% of kidney transplant recipients. This paper will include a case report and a review of epidemiology and pathophysiology, complications and clinical findings, indications for treatment, and the drugs currently available to treat this...

ea0056p254 | Calcium &amp; Vitamin D metabolism | ECE2018

Effect of bariatric surgery on free vitamin D3 levels

Marques-Pamies Montserrat , Pellitero Silvia , Granada Marisa , Santillan Cecilia Soledad , Lopez Maria , Puig-Domingo Manel

Total vitamin D levels are decreased in obese patients probably due to an increased volume of distribution mechanism. Recently introduced direct assays allow the measurement of free-vitaminD3 levels (fvitD3). Few data are available regarding fvitD3 levels in obese people and the effect of bariatric surgery upon its circulating concentration. We aimed to evaluate fvitD3 in a cohort of obese patients before and after bariatric surgery treatment and its relationship to phosphocal...

ea0056p255 | Calcium &amp; Vitamin D metabolism | ECE2018

Utility of contrast-enhanced ultrasound in preoperative evaluation of primary hyperparathyroidism

Ramirez Paola Parra , Marcos Patricia Martin Rojas , Hernando Antonio Santiago , Catalan Arturo Lisbona , Calvo Alejandro Casto , Escola Cristina Alvarez

Purpose: The aim of this study was to evaluate the sensitivy of contrast-enhanced ultrasound (CEUS) in the detection of pathological parathyroid gland in patients with primary hyperparathyroidism in comparison to the 99m-MIBI-SPECT scintigraphy.Methods: 29 patients consecutive (22 female, 7 male) with biochemically confirmed primary hyperparathyroidism, who underwent preoperative imaging with Technetium 99m-MIBI-SPECT scintigraphy and CEUS and subsequent...

ea0056p257 | Calcium &amp; Vitamin D metabolism | ECE2018

Primary hyperparathyroidism after thyroid surgery and autotransplantion of parathyroid gland

Marques Bernardo , Martins Raquel , Couto Joana , Santos Jacinta , Martins Teresa , Rodrigues Fernando

Introduction: Multiple endocrine neoplasia type 2A syndrome (MEN 2A) is caused by a germline mutation in the RET proto-oncogene and its phenotype includes medullary thyroid cancer, pheochromocytoma and primary hyperparathyroidism (PHPT). Parathyroid reimplantation in the sternocleidomastoid muscle or in the brachioradial muscle can be performed in case of intraoperative lesion of the parathyroid glands. In some cases, PHPT may occur due to the proliferation of autotransplanted...

ea0056p258 | Calcium &amp; Vitamin D metabolism | ECE2018

Metabolic encephalopathy following intravenous zolendronate for hypercalcaemia of malignancy: a perfect storm

Kumar Mohit

A 56 year old lady was diagnosed with cancer of unknown primary after the discovery of liver metastases. Prior to the commencement of EOX chemotherapy (epirubicin, oxaliplatin and capecitabine) she was given a dose of 4 mg zolendronic acid for hypercalcaemia of malignancy. Three weeks later she presented to our hospital with a history of rapid decline and reduced oral intake, with associated diarrhoea. She had reduced GCS and hypotension. Initial investigations revealed an acu...

ea0056p259 | Calcium &amp; Vitamin D metabolism | ECE2018

Primary hyperparathyroidism: a rare cause of hypertension?

Lopes Ana , Palma Isabel , Teixeira Sofia , Cardoso Helena

Backgroud: Primary hyperparathyroidism is the most common cause of hypercalcemia, which is associated with an increased frequency of hypertension. However, there are no data on the prevalence of primary hyperparathyroidism in patients who present with hypertension.Clinical case: We present the case of a 40-year-old woman with a history of hypertension for ten years. In 2017 she was referred for evaluation of hypercalcemia. The patient denied any symptoms...

ea0056p260 | Calcium &amp; Vitamin D metabolism | ECE2018

Atypical Parathyroid adenoma in a young individual, presented with nephrocalcinosis

Kermaj Marjeta , Cadri Vilma , Cakoni Ruden , Ylli Dorina , Fureraj Thanas , Hoxha Edlira , Muco Ermira , Zeqja Anisa , Yll Agron

Introduction: Primary hyperparathyroidism (PHPT) is a rare disorder among young adults. Classic manifestations of PHPT, such as nephrocalcinosis, nephrolithiasis, are rarely seen today.Case report: We refer the case of a young male, 25 years old, presented in emergency unit with: headaches, lumbago, epigastric pain, weight loss (5 kg during six last months), polydipsia-polyuria. Medical history: He has been diagnosed with nephrolithiasis and gastritis a ...