Endocrine Abstracts

Introduction: Parathyroid carcinoma (PC) is an extremely rare, aggressive and life-threatening form of primary hyperparathyroidism (pHPT). PC accounts for less than 1% of cases of pHPT, predominantly diagnosed in the fifth or sixth decades of life. Most parathyroid carcinomas are diagnosed after surgery.Case description: A 51-year old man was admitted to the Hospital of Lithuanian University of Health Sciences, Kaunas clinics due to leg pain and general ...

Introduction: Activating and inactivating mutations of the GNAS gene (encoding the Gsα protein) cause McCune–Albright Syndrome and Albright’s Hereditary Osteodystrophy, respectively. In both, the bone and the endocrine system are often affected. In McCune–Albright Syndrome the most common endocrine manifestation is precocious puberty, but thyroid lesions and hormonal overproduction are also described. In Albright’s Hereditary Osteodystrophy there m...

A 42 year old male patient was admitted to the gastroenterology unit in due to severe abdominal pain and vomiting. He denied any chronic illness and drug usage. His family history was nonsignificant for any endocrine disease. Based on biochemical studies (lipase 2280 U/l, calcium 15.0 mg/dl, phosphorus 1.7 mg/dl amylase 631 U/l, creatinine 1.16 mg/dl, ALP 735 U/l) severe hypercalcemia induced acute pancreatitis was the diagnosis. 25 OH vitamin D was 5 ng/ml and parathyroid hor...

Introduction: Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia, often caused by a single adenoma (85%) or four-gland hyperplasia (15%). Brown tumors are rare erosive bony lesions caused by localised rapid osteoclastic turnover resulting from hyperparathyroidism.Case presentation: A 28-year-old lady presented to the Emergency Department with a 3-day history of fever, dry cough and generalized body aches. She reported sudden ons...

Introduction: Primary hyperparathyroidism (P-HPT) is a common endocrine disorder that occurs as result of adenomas (80–85%), hyperplasia (10–15%), atypical adenoma or carcinomas (<1%). Atypical parathyroid adenoma (APA) is a rare entity and represents intermediate group of parathyroid neoplasms of uncertain malignant potential with some atypical histological features.Case details: We report a case of a 34-year male, with a background of h...

Background: Malignant hypercalcemia (MH) occurs in up to 30% of patients who are diagnosed with cancery, being associated with later stages of the disease and poor prognosis. The physiopathological mechanisms responsible for MH are the production of parathyroid hormone-related peptide by the tumor (PTHrp) (80% of cases), osteolytic cytokine production (20%) and excess of 1,25(OH)2vitamin D production (1%).Case report: We present the case of a ...

Introduction: Primary hyperparathyroidism is nowadays frequently diagnosed due to routine blood calcium measured in the general biochemical profile. Primary hyperparathyroidism may be due to a parathyroid adenoma or parathyroid hyperplasia. Parathyroid adenoma may occur in the area of the parathyroid glands or may be ectopic.Aim: The aim was to describe the differential clinical expression of primary hyperparathyroidism due to an adenoma or hyperplasia i...

Introduction: Fahr syndrome is a rare disease, characterized by bilateral and symmetrical intracerebral calcifications, localized in the central gray nucleus and by the classic association with hypoparathyroidism. We report a case of Fahr syndrome associated with postoperative hypoparathyroidism.Case report: A 58 year old female patient with a history of total thyroidectomy 18 years ago. She complained of chronic paresthesia, muscle cramps complicated so...

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by hypercalcemia due to an unregulated overproduction of parathyroid hormone (PTH). PHPT is most commonly caused by a single adenoma of the parathyroid gland, usually located just behind the thyroid gland. However, in rare cases, they can have an ectopic location, including intrathyroid adenomas. In some cases, the measurement of intact PTH in the wash out fluid obtained by US-Fine Ne...

Introduction: Secondary hyperparathyroidism (sHPT) is a prevailing complication of chronic kidney disease (CKD) caused by the disturbance of calcium, phosphate, and vitamin D, with high concentrations of serum parathormone (PTH) leading to high rates of cardiovascular and bone disease. The incidence and prevalence of chronic kidney disease, including kidney failure requiring renal replacement therapies (RRT) is rising in Europe. The objective of this study is to determine usin...

Introduction: Coexistence of primary hyperparathyroidism and plasma cell dyscrasias such as multiple myeloma and monoclonal gammopathy of uncertain significance (MGUS) is rare. This can cause diagnostic uncertainty regarding the aetiology and relative contribution of each disorder to hypercalcaemia. We present a series of five individuals with this combination.Case series: All five patients were referred to the endocrine clinic with hypercalcaemia. The s...

Introduction: Primary hyperparathyroidism is usually caused by parathyroid adenoma or hyperplasia. Parathyroid carcinoma is a rare cause of hyperparathyroidism with a frequency ranged from 0.3 to 2.1%. Features that increase the likelihood of parathyroid carcinoma in patients with primary hyperparathyroidism are larger tumor size, symptomatic disease, marked hypercalcemia, and very high serum parathyroid hormone (PTH) concentrations. Preoperative localization studies do not re...

Background: Bisphosphonates are effective in malignancy-related hypercalcemia and have been beneficial in parathyroid-hormone (PTH)-dependent hypercalcemia in small randomized-controlled trials. However, data regarding efficacy and safety in PTH-dependent hypercalcemia is limited, and pamidronate is not indicated for this condition.Objective: To evaluate efficacy and safety of pamidronate in moderate-severe PTH-dependent hypercalcemia. Control groups wer...

Introduction: Iron-induced hypophosphatemia is a well-known adverse effect in patients receiving parenteral iron supplementation. Initially thought to be transient and mild, it seems that in certain cases, especially in patients who require repeated intravenous iron administrations, it can lead to spectacular symptomatology and serious complications.Case report: A female patient, aged 61 was referred for intense muscle and bone pain, severe impaired mobi...

Background: Childhood and adolescence are critical periods for the establishment of lifelong bone health. While most studies focus on vitamin-D regardless of PTH levels, Normocalcemic Primary Hyperparathyroidism (NPHPT) has been recognized more than 15 years ago as a variant of primary hyperparathyroidism (PHPT), characterized by persistently elevated PTH with normal albumin-adjusted total and ionized calcium, in the absence of secondary causes of hyperparathyroidism. PPHPT is...

Objective: Postsurgical hypoparathyroidism (HypoPT) is the most common etiology of disease and often occurs after thyroid surgery. However, the differential diagnosis between different forms of HypoPT in some cases remains a challenge. We present the clinical case of postsurgical and functional HypoPT combination.Case description: A 44-year-old female was referred to the Endocrinology Research Centre. She underwent total thyroidectomy for follicular aden...

Background: Vitamin D deficiency is a major public health problem in Ukraine. The aim of this cross-sectional study was to study the status of Vitamin D and parathyroid hormone (PTH) level in women of reproductive age in Carpathian region.Materials and methods: A cross-sectional study was carried on a total of 416 nonpregnant and nonlactating women in the reproductive age group of 19–45 years during summer 2018. Demographic, socioeconomic class, an...

Vitamin D is a large group of structurally similar substances (calciferols) with diverse biological functions. Although approximately 40 different vitamin D metabolites have been determined so far, only 1,25-dihydroxyvitamin D was considered to be biologically active and the determination of 25-hydroxyvitamin D (25-OH D) served a tool to assess vitamin D supply. Recently it was found that also C3-epimers of vitamin D have their biological effect, however these effects differ f...

Background: Primary hyperparathyroidism is more prevalent in women and sometimes the patients are without clinical signs. Parathyroid disorders aren’t uncommon in the general population.Clinical case: A woman 68-year-old was present to the ambulatory visit with multiple joint pains and generalized weakness, constipation and weigh loss since 1 year ago. She hadn’t any history of fever, anorexia, nausea, vomiting or diarrhea. She refered that s...

Background: Sarcoidosis is an inflammatory granulomatous multisystem disorder commonly presenting with noncaseating granulomas in lung and lymphoid tissue. Other organs like skin, eye and joints also involved.Case report: We present a 62-year-old diabetic woman presented to the emergency with progressive alteration in sensorium and left hemiparesis for two days. Patient had lower respiratory tract associated with recurrent hypoglycaemic attacks two weeks...

Introduction: Pseudohypoparathyroidism (PHP) refers to a heterogeneous group of rare metabolic diseases, all characterized by end-organ resistance to the action of different hormones, primarily PTH. Main clinical characteristics are hypocalcemia and hyperphosphoremia associated with elevated parathyroid hormone (PTH) levels, frequently encompassing additional heterogeneous features, known as Albright’s hereditary osteodystrophy. A molecular cause can be identified in 80&...

Endocrine comorbidity is a hot issue in radiation medicine featuring a concomitant radiation injury of several endocrine glands.Objective: Establishing a link of vitamin D deficiency with thyroid and pancreatic disorders among the Chornobyl nuclear power plant (ChNPP) accident survivors.Results: A blind sample (n = 60) of subjects treated at the Radiation Endocrinology department in 2019 were selected for the study. St...

Normocalcaemic primary hyperparathyroidism (NPHPT) is becoming more common nowadays due to the increasing use of screening laboratory methods. In the care of the outpatient office of endocrinology of the 2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University and St. Anne’s University Hospital in Brno in the period between 1 January 2007 and 31 December 2019, there were a total of 304 patients diagnosed with primary hyperparathyroidism. At the time o...

Ca2+ homeostasis has been reported to play important roles in various cell systems. In central nerves system, the dysregulation of Ca2+ homeostasis can induce the excitotoxic and neurodegeneration. NCKX3 (Sodium/potassium/calcium exchanger 3), a novel member of the family of K+-dependent Na+/Ca2+ exchangers, is an important component of intracellular Ca2+ homeostasis. In addition, NCKX3 highly expressed in tha...

Hypercalcemia in hyperthyroidism is usually asymptomatic, and related to a concurrent primary hyperparathyroidism. In this report, we describe a case of symptomatic hypercalcemia secondary to Graves’ disease alone.Case report: A 24-year-old Filipino female presented to the emergency department with generalized weakness, vomiting and abdominal pain. No other symptoms were noted. She was otherwise previously healthy. Family history was unremarkable. ...

A 41 year old male patient presented to the endocrinology unit due to recurrent long bone fractures and teeth decay. His past medical history was nonsignificant for any chronic disease. He was a child of consanguineous marriage; his father and mother were first degree cousins. There were no other family members with similar phenotype or history of recurrent fractures He was 154 cm in height and weighed 58 kg. The arm span was 139 cm. Upper to lower segment ratio was 1.16. He h...

Introduction: Multiple factors have been incriminated in growth retardation in patients with chronic kidney disease (CKD), such as metabolic acidosis, anemia, vitamin D deficiency with secondary hyperparathyroidism, under-nutrition, renal bone disease. The disease compromises vertical growth with up to one-third children having severe growth delay (below the third percentile for height). Optimal care and nutritional therapy alone, can’t help the children with CKD reach t...

Complete or partial edentulism is common in middle age, especially in postmenopausal women. Edentulism may be the result of either dental problems or periodontitis or both. Periodontitis is characterized by systemic inflammation and may be accompanied by osteoporosis. Osteoporotic patients on treatment with anticatabolic agents may develop osteonecrosis of the jaw. The aim was to present the management of osteoporosis in an edentulous patient with severe periodontitis who deve...

Introduction: Besides the amount of bone mineral assesed through bone mineral density (BMD), studies have shown that neck geometry parameters as hip axis length (HAL) and neck-shaft angle (NSA) could also be reliable parameters to be included in the hip fracture assesement. On the other hand, bone geometry is known to be modified in acromegaly in flat bones, thus hip fracture is not a recognized direct complication in acromegaly neither through bone mass or long bone geometry....

Background /aim: Osteoporosis is a generalized bone disease, characterized by impaired bone firmness, resulting in an increased predisposition for fractures. In order to detect the subjects at risk for fractures, one should actively search for them, primarily in a group of postmenopausal women, considering clinical risk factors. Apart from others, the relevant risk factors are lack of estrogen and low body mass index (BMI <19 kg/m2).: The aim of this study was t...

Adrenal adenomas are nowadays frequently diagnosed in the context of abdominal imaging. Osteoporosis may be a presenting manifestation of a cortisol producing adrenal adenoma. The aim was to present two cases of patients diagnosed and treated for osteoporosis who later in the course of the disease were diagnosed with a cortisol producing adrenal adenoma. Two patients, female aged 53 and 56 years, respectively, presented with osteoporosis. T score was −2.8 and &#...

Objectives: The serum levels of 25-hydroxyvitamin D ([25 (OH) D]) is considered to be one of the most reliable biomarkers of vitamin D (VD) nutritional status. VD deficiency/insufficiency is a risk factor for osteoporotic fractures and falls. Even though established clinical significance of maintaining an adequate level of 25 (OH) D, the level of 25 (OH) D is easily fluctuated by diverse factors such as sunlight exposure, VD intake, renal function and body fat content. In addi...

Introduction: Systemic mastocytosis is a form of mastocytosis in which mast cells accumulate in tissues and organs such as liver, spleen, bone and small intestines. Symptoms and signs differ based on which parts of the body are affected and vary from asymptomatic forms to highly aggresive forms with low survival rate. About 16% of patients with systemic mastocytosis have symptomatic fractures, but the presentation of systemic mastocytosis with vertebral fractures as first clin...

Introduction: In patients with human immunodeficiency virus (HIV) infection, the prevalence of osteoporosis is higher in comparison with the general population. Anti-retroviral therapy (ART) use seems to be a possible risk factor there is also high prevalence of vitamin D deficiency among people living with HIV.Objectives: To describe bone mineral density (BMD) status in HIV-infected patients as well as its associated risk factors such as vit D levels.</...

Introduction: We describe a patient with Fibrodysplasia ossificans progressiva (FOP) who developed an osteomyelitic neuropathic toe ulcer. This was treated effectively with conservative measures, but highlighted the need for multiprofessional working in managing patients with FOP.Case: The patient’s toe ulcer occurred in 2017 and was initially managed by community podiatry and orthopaedics. The patient received multiple courses of antibiotics for r...

Purpose: Denosumab is a monoclonal antibody that prevents osteoclast development. The effect of denosumab in solid organ transplant recipients has been elucidated, but the effect of denosumab in hematopoietic stem cell transplantation recipients has not been studied yet. Thus, the aim of this study was to determine the effectiveness and safety of denosumab in hematopoietic stem cell transplantation recipients.Methods: We retrospectively evaluated 27 pati...

Introduction: In 1974, the first case of concomitant thyroid and parathyroid disease was reported. Non-medullary thyroid carcinoma has been reported in 6% of patients with Primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid carcinoma along with non-medullary thyroid carcinoma is extremely rare.Case report: We report a case of 60-year-old woman with a history of Diabetes Mellitus type 2 and hypertension. She had no family hist...

Background: Fahr syndrome is a rare entity characterized by symmetrical bilateral brain calcifications, involving basal ganglia (mainly), thalami, dentate nuclei and the cerebral and cerebellar white matter. Progressive neurologic dysfunction and other neuropsychiatric disorders are characteristic. Endocrine disorders which may present with Fahr syndrome include parathyroid dysfunction (hypoparathyroidism especially, but also pseudohypoparathyroidism, pseudopseudohypoparathyro...

Introduction: Hyperparathyroidism is defined by excessive secretion of parathyroid hormone (PTH) that is responsible for calcium regulation. Hyperparathyroidism can be primary in which the gland is affected and it produces PTH excessively or secondary or tertiary that cause hypersecretion of PTH as a regulatory response. The aim of our study was to describe patients with hyperparathyroidise diagnosed in internal medicine departement.Methods: It was a ret...

Introduction: Gougerot disease is an autoimmune disorder characterized by the lymphoid infiltration of salivary and lachrymal glands leading to the two most common symptoms dry eyes and a dry mouth. Primary hyperparathyroidism (PHPT), one of the most common endocrine disorders, is usually diagnosed by the association of hypercalcemia and parathyroid hormone (PTH) levels that are either elevated or inappropriately normal. The association of PHPT with Gougerot disease is rare, o...

Introduction: Hypocalcemia has been linked to a decreased myocardial performance and even congestive heart failure, while acute chest-pain as leading symptom of hypocalcemia is an unusual presentation.Case report: A 29-year-old Caucasian man presented to the emergency department with relapsing chest-pain since several days, lasting seconds sometimes lasting several minutes, radiating to the left shoulder and combined with mild tingling in the neck. A det...

Background: Although high levels of calcitonin suggest neoplastic proliferations such as medullary thyroid carcinoma, C cell hyperplasia and some neuroendocrine tumors, systemic diseases and drugs may also elevate calcitonin. Although calcitonin is not as effective as PTH, it has got a role in calcium hemoastasis. Supraphysiological calcitonin level can lead to hypocalcemia.Case presentation: A 57-year-old male patient was diagnosed with epilepsy with co...

Introduction: In pregnancy, the incidence of Primary Hyperparathyroidism is 1%; and there are 80% adenoma, 15% parathyroid hyperplasia, 3% multiple adenoma, and 1% parathyroid carcinoma in its etiology. In pregnancy, serum calcium (Ca) levels may not rise as much as expected. This is associated with hypoalbuminemia, GFR increase, placental Ca transfer, and inhibition of PTH–related bone resorption by estrogen. In pregnancy, hyperparathyroidism is asymptomatic at a rate o...

HDR syndrome is a rare condition with an autosomic dominant inheritance, firstly described in 1977. It is due to a mutation of GATA3 gene, a transcription factor expressed in parathyroid, inner ear, kidney, central nervous system and T lymphocytes. The most common manifestation is neurosensorial deaf, secondary to progressive degeneration of coclear cells. Hypoparathyroidism is present in 90% of patients that can be asymptomatic or, sometimes presents with ne...

Introduction: Post-surgical hypoparathyroidism (PSHP) is a frequent complication following ENT surgery. Some patients with head/neck cancers require enteral nutrition (EN) due to dysphagia, mucositis after radiotherapy or chemotherapy, or post-surgical anatomical complications. Formulas of calcitriol are not suitable to be administered via enteral feeding tubes, and side effects of systemic antineoplastic treatment (nausea, vomiting) make calcium and phosphate serum levels dif...

Tertiary hyperparathyroidism reflects parathyroid hyperplasia, with autonomous secretion of parathyroid hormone (PTH), in spite of high plasma calcium concentration. Parathyroidectomy is an efficient therapy for stabilization of calcium and PTH metabolism in patients with end-stage kidney disease.We report a case of a 68-year old man with end-stage kidney disease under hemodialysis for nine years, due to long-standing uncontrolled hypertension. He presen...

Lipoadenoma is an uncommon benign lesión of the parathyroid gland (<1%) and it has most commonly described as non-functional, but also is a very rare cause of primary hyperparathyroidism. Since 1958 scientific literatura had described 54 cases all over the world and only six of that paratyroid lipoadenomas was extended into torax. A case of intrathoracic parathyroid lipoadenoma with hyperparathyroidism is described. A 69–year–old man was refered to our hos...

Background: Parathyroid cancer is a rare pathology, approximately 2 cases per 10, 000, 000 people/year. The five-year survival rate for this disease ranges from 20–85%, and the ten-year survival rate is approximately 15–80%. Timely detection and compliance with algorithms for parathyroid gland cancer diagnostics allows surgical treatment and maximum positive prognosis for patient.Clinical case: Patient 18 y.o., was presented with complaints t...

Introduction: Ectopic PTH secretion is rare, to our knowledge, with only 27 cases reported in the literature and 3, ( a tonsil, a lung and a penile) due to squamous cell carcinoma .In the few cases reported to date it appears to be more common in males and in those over the age of 60. The management of the hypercalcemia in this setting is complicated. We are aware of 2 other case reports in which cinacalcet was used in this context, but as in our case, unsuccessfully.<p cl...

Backgroud: When considering treatment of patients with severe osteoporosis (after previously failed antiresorptive treatment) or patients with glucocorticoid–induced osteoporosis, it is suitable to choose treatment by teriparatide (TPTD, rhPTH 1–34). In contrast to long–term treatment by bisphosphonates (BP) or denosumab (DMAB), the treatment with TPTD increases the volume of trabecular bone and the thickness of cortical bone. The recommended length of treatm...

Purpose: Primary hyperparathyroidism (PHPT) is the third common endocrine disorder which often manifest with skeletal or renal disfunction. In developed countries asymptomatic form is the most common and such severe manifestations as osteofibrosis cystica are very rare.Clinical case: We present the case of 49-years-75 × 66 old caucasian woman, with history of urolithiasis, nephrolithotripsy in 2014. In November 2016 she was diagnosed with left femur...

Patient J, b. 1963 sent to an endocrinologist by a traumatologist due to the lack of consolidation of a fracture of the right ankle with complaints of pain, restriction of movements in the right ankle joint.Medical history: 09/19/2018 suffered a combined fracture of the lower leg bones when falling from a height of their own growth after falling at home falling from a height of their own growth. Reposition was performed, a circular plaster cast was appli...

Introduction: Diabetes mellitus and acromegaly are both associated with an increased risk of fracture caused by altered quality of bone. TBS represents an important tool for assessment of bone microarchitecture.Objectives: The aim of this study is to assess the bone deterioration through the trabecular bone score (TBS) and to compare TBS and Z score between 2 groups of patients: acromegaly and diabetes mellitus.Methods: This retros...

The aim of the study was to evaluate the effect of complex food supplement with calcium and vitamins D3 and B6 intake on muscle strength and balance function during 1-year follow-up after rehabilitation course in patients with osteoporosis and high fracture riskMethods: The study comprised 119 men and women aged 50–80 y.o. with established osteoporosis or high probability of major osteoporotic fracture by FRAX model initiating...

Zoledronic acid (ZA) treatment increases bone mineral density (BMD), decreases bone turnover markers and reduces the risk of fractures in patients with osteoporosis (1).Objective: Observe and quantify the changes in BMD and bone turnover markers in postmenopausal osteoporosis (PO) patients treated annually with zoledronic acid 5 mg intravenously.Material and Methods: Medical records (MR) of PO patients whom received ZA from 2007 to...

Background: Vertebral fractures are the most common type of osteoporotic fractures. Prevalence of osteoporosis and osteoporotic vertebral fractures were not addressed and studied previously in the UAE. This study aims to describe for the first time the demographic and morphological characteristics of patients with fragility vertebral fractures in the UAE.Methods: This is a retrospective medical records review of patients with low-trauma vertebral fractur...

Background: Patients with complete androgen insensitivity syndrome (CAIS) who undergo gonadectomy have evidence of reduced bone mineral density (BMD) and perhaps, higher risk of fragility fractures. Because of this, hormonal replacement therapy (HRT), usually in the form of estrogen, is used as patients with CAIS have 46, XY genotypes having androgen receptor abnormalities making them resistant to the effects of androgen. Tibolone, a “selective tissue estrogenic activity...

Introduction: Hyperparathyroidism is a fairly common pathology that can cause functional and vital complications. Its treatment combines a medical component and a surgical one.The aim of this work is to specify the surgical indications for this pathology.Materials and methods: It is a retrospective study bringing 58 cases of secondary hyperparathyroidism collected over a period of 16 years (from 2001 to 2016).<p class="abstext"...

Background: Vitamin D deficiency is widespread in Ukraine, particularly among older adults. Factors associated with vitamin D deficiency are not well defined.The aim of the study was to evaluate vitamin D status and its correlatation among older adults of 5 communities in Ukrainian Carpathians.Materials and methods: This cross–sectional study was based on study data for 1254 men and women aged 20–82 years. Anthropometri...

Periodontitis is a serious medical condition which may lead to edentulousness in middle aged patients. It is a chronic inflammatory systemic disorder which affects the oral cavity, the maxilla and mandible. It may be associated with osteoporosis. It presents unique problems in the management of osteoporosis. The patients are in the imminent danger of losing teeth. Some of the antiosteoporotic agents may induce osteonecrosis, while they may complicate the implantation of dental...

Parathyroid hormone(PTH) is a peptide hormone that regulates ionized calcium. Primary hyperparathyroidism, in which the bone-building-destruction balance is disturbed, is due to the uncontrolled secretion of parathormone. The systemic inflammation index (SSI) is a variable that has been validated in studies aimed at evaluating the inflammation that has been frequently mentioned recently. The disruption of this bone-making destruction process affects the inflammatory process in...

Sixteen percent of parathyroid adenomas can be situated in an ectopic location. Ectopic parathyroid glands result from aberrant migration during early stages of development, and lack of successful identification may lead to lack of success in parathyroid surgery. These glands are most frequently found in the anterior mediastinum, in association with the thymus or the thyroid gland. Ectopic parathyroid glands are a major cause of persistent and recurrent hyperparathyroidism.</p...

Introduction: Known as a potent anabolic drug, teriparatide has a stimulating effect on bone formation, increasing bone mineral density (BMD) and reducing fracture risk.Methods: 11 Caucasian women (mean age 66 years old) with severe osteoporosis treated with recombinant human parathyroid hormone (1–34) – teriparatide (Forsteo) 20 micrograms daily for 24 months were added to the study.BMD at lumbar spine, total hip and f...

Introduction: Juvenile primary hyperparathyroidism represents more severe form of the disease, often with organ damages. Genetic mutation and paarthyroid hyperplasia are more frequent than in adults.Case report: 20–year–old patient with familial history of kidney stone. She was hospitalized for major hypercalcemia at 3.65 mmol/l (2.2–2.6 mmol/l) discovered on daily chronic vomiting and alteration of the general condition. The biological...

Denosumab is a monoclonal antibody used in the treatment of osteoporosis to prevent bony injuries by increasing bone density. It does so by binding to RANK-L, which is then unable to activate RANK, thereby preventing osteoclast maturation and viability. Although rare, the effect of denosumab can interfere with the body’s calcium homeostasis and lead to a hypocalcemic state. We present a case where a post-menopausal female developed severe, symptomatic hypocalcemia from a...