Endocrine Abstracts

Aneurysmal bone cysts (ABCs) are rare pseudotumoral bone lesions with potential aggressive behavior due to the extensive destruction of surrounding bone. Besides surgery, denosumab has been investigated as a treatment for benign fibro-osseous lesions. As for ABCs, pediatric experience is limited, reporting mainly beneficial effects on lesions growth and associated pain. Some reports included well known side effects associated with denosumab, such as the rebound hypercalcemia a...

IntroductionIn primary hyperparathyroidism (PHPT) the chronic overproduction of parathormone (PTH) is mostly due to a solitary adenoma.AimThe aim of our study was to examine the relationship between calcium-phosphate metabolism and the volume of the parathyroid adenoma (PTA) in patients with PHPT.Material and methodsThe study included 195 patients with biochemical...

BackgroundVitamin D has shown to play a role in multiple diseases due to its skeletal and extraskeletal actions (such as immunomodulation). In this sense, vitamin D deficiency has become a worldwide health issue. Few supplementation guidelines mention calcifediol treatment, its optimal dosing and treatment duration, despite being the direct precursor of calcitriol and the biomarker of vitamin D status.Objectives<p class="abstex...

IntroductionA high calcium-phosphate product is thought to increase the risk of soft tissue calcification in hypoparathyroidism, including cataracts. Based on small case series, cataracts in hypoparathyroidism typically develop in the posterior subcapsular region of the lens. However, the mechanism of cataract formation is still not well understood.Materials and methodsIn a large cohort of 1014 patients with ...

BackgroundPrimary hyperparathyroidism (PHPT) is a common endocrine disorder accompanied by low total 25-hydroxyvitamin D [25(OH)D] levels. The 25(OH)D is converted to its biologically active form, 1.25-dihydroxyvitamin D [1.25(OH)2D] that then circulates as bound or free forms. Free 1.25(OH)2D concentrations in patients with PHPT have not previously been examined and understanding this is important to better assess vitamin ...

Hypercalcaemia in pregnancy is a rare but important finding, given the associated potential risks to mother and baby. These include hypertension, pancreatitis, nephrolithiasis and renal failure in the mother and intrauterine growth restriction, neonatal hypoparathyroidism/hypocalcaemia and stillbirth in the baby (1). We present the case of a 26-year-old female with a background of PTH-independent hypercalcaemia of unknown aetiology. This was initially detected at age 6 months ...

IntroductionPrimary hyperparathyroidism (PHPT) is characterized by excessive secretion of parathyroid hormone (PTH) from one or more parathyroid glands. PTH has a central role in the regulation of calcium and phosphate and the classic disorder causes primarily hypercalcemia associated with renal and bone manifestations. Non-classical symptoms are also present including cardiovascular, gastrointestinal, psychiatric, neuro-cognitive disorders. Regarding ca...

IntroductionSimultaneous pancreas-kidney transplantation (PKT) has a beneficial effect on the evolution of chronic complications in type 1 diabetic (T1D) patients with terminal chronic kidney disease (CKD). However, the CKD-mineral and bone disorder (CKD-MBD) remains a frequent complication. There are a few studies addressing the long-term evolution of bone mineral density (BMD) in these patients.AimTo charac...

BackgroundHyponatremia is associated with increased risk of bone fragility and fractures. In vitro studies suggest a role of hyponatremia in stimulating osteoclast activation, whereas other studies rather revealed a possible role of acute hyponatremia in impairing osteoblast function. We aimed to assess whether and how correction of hyponatremia in hospitalized patients with the syndrome of inappropriate antidiuresis (SIAD) has an impact on bone...

IntroductionThe routine assessment of postmenopausal women involves screening for cardiometabolic risk factors and bone health. Evaluation of the liver function is not commonly performed, even though this could be easily performed with the use of indirect markers, such as the Fibrosis 4 score. Recent evidence supports an association between liver cirrhosis and bone turnover, affecting both the trabecular and the cortical bone. Therefore, we aimed to expl...

IntroductionThe incidence of primary hyperparathyroidism (PHPT) increases with age; however, the clinical presentation might change with aging. We aimed to compare the clinical presentation of older and younger patients with PHPT.MethodsWe retrospectively analyzed the biochemical status, renal involvement, and bone mineral density (BMD) of patients who were diagnosed with PHPT at our endocrine clinic from 200...

Primary hyperparathyroidism (PHPT) is being more and more frequently diagnosed.Objectiveto describe the clinical presentation and the main laboratory and imaging findings in a group of patients with PHPT diagnosed during the last 10 years. Materials and Methods: This was a retrospective cross-sectional study with data review from the last 10 years. Secondary causes for elevated PTH were excluded. The symptoms and signs of hypercalc...

BackgroundChronic hypoparathyroidism (hypoPT) predisposes patients to comorbidities such as cardiovascular/cerebrovascular disease, infection, mental illness, and renal impairment often associated with an increased burden to healthcare systems. Suboptimal disease control is common with standard therapy. The objective of this study was to quantify and assess differences in the clinical and economic burden on secondary care among patients with post-surgica...

AimTo assess relationship between serum calcium level and localization studies and management outcome.MethodologyRetrospective analysis of data for patients referred by primary care for hypercalcemia from 1/3/2019 to 1/3/2020 to the Endocrinology department at Royal Berkshire Hospital. The sample size was 63 which excluded normo-calcemic hyperparathyroidism as well as MEN1/2 patients.Re...

ObjectivesHigh-Dose-Intravenous-Steroid-Treatment-(HDIST) represents the first choice of treatment for MS relapses. Although chronic oral GC-administration is associated with bone loss there are still conflicting data regarding HDIST. Methods25 newly-diagnosed MS-patients (10-women) were prospectively enrolled meeting the following eligibility criteria: age 18–45 yrs, fully ambulatory, women with normal ...

IntroductionPrimary hyperparathyroidism (PHPT) is a common endocrine disorder and classically associated with hypercalcemia (HHPT). There is a newest variant of PHPT, defined by normal albumin-corrected calcium levels - normocalcemic PHPT (NHPT) – which may represent an early stage of HHPT. Nevertheless, there is limited data on how this variant presents clinically and biochemically.AimTo evaluate the de...

IntroductionRecent evidence suggests a possible link between prediabetes and lower density in postmenopausal populations. Moreover, earlier data suggest a link between diagnosis of diabetes and lower levels of bone density in women after the menopausal transition. We aimed to evaluate the possible association between insulin resistance and a diagnosis of lumbar or hip osteoporosis and/or prevalent fractures of the lumbar spine. Met...

IntroductionBody composition (BC), adipokines and the fibroblast growth factor-23 (FGF23) - Klotho axis interfere with bone metabolism and also suffer important modifications in acromegaly. We aimed to investigate their influence upon bone in active acromegaly, compared to controls.MethodsWe performed a cross sectional study, investigating the adipokines (leptin, adiponectin, resistin) secretion pattern, BC p...

IntroductionThe ectopic parathyroid adenoma (EPTA) is the most common cause of failed parathyroid surgery. Most often localisations are intra-thymic and intra-mediastinal adenomas. We report a rare presentation of a symptomatic parathyroid adenoma located in ectopic retropharyngeal position diagnosed after surgical treatment of primary hyperparathyroidism (PHPT).ObsevationA 42-year-old female was referred to ...

Denosumab discontinuation leads to loss of bone mineral density (BMD) achieved with treatment and in some patients to multiple vertebral fractures (VFx). Beyond bone, antiresorptive agents such as denosumab may affect breast cancer biology. We report a 69-year-old woman treated with the aromatase inhibitor anastrazole for breast cancer who suffered from five spontaneous vertebral fractures after denosumab cessation. Initially, she received four years of ibandronate followed by...

BackgroundParathyroidectomy (PTE) is the basic treatment for symptomatic primary hyperparathyroidism (PHPT). It is also recommended for some asymptomatic patients. However, PTE can be followed by some complications such as postoperative hypocalcemia.AimTo evaluate association of demographic, clinical, laboratory factors, preoperative cholecalciferol supplementation and hypocalcemia after PTE in patients with ...

Although primary hyperparathyroidism (PHPT) can be successfully cured by parathyroidectomy (PTX) and indications for surgery are well defined, a considerable number of patients do not get operated on. By evaluating referrals for PTX in our academic hospital, we might improve our approach to the care of these patients. We retrospectively reviewed patients’ hospital records with newly diagnosed PHPT between 2014 and 2020. Biochemical and clinical parameters along with resul...

ObjectiveSurgery is the only curative treatment for primary hyperparathyroidism. Minimally invasive parathyroidectomy is superior in terms of cure and complication rates and is less costly than inpatient bilateral cervical exploration. Preoperative localization of parathyroid adenoma by imaging is a requirement for outpatient minimally invasive surgery. One of the most frequently used imaging techniques for parathyroid adenoma localization is Tc99m-sesta...

BackgroudPrimary hyperparathyroidism (PHPT) is associated with impaired bone quality and increased fracture risk. Reliable tools for the evaluation of bone quality parameters are not yet clinically available. Bone Strain Index (BSI) is a new metric for bone strength based on Finite Element Analysis from lumbar spine and femoral neck dual X-ray absorptiometry images.AimTo assess the lumbar spine (LS), femoral ...

IntroductionParaneoplastic hypercalcemia is extremely rare in the pediatric population, requiring urgent treatment. Pediatric malignancy-related hypercalcemia (PMRH) has been associated with rhabdomyosarcoma (RMS). Hypercalcemia with elevated parathyroid hormone (PTH), ectopic PTH secretion, is rarer (< 1% of cases). Reports of the use of Zoledronic Acid (ZA) as a second line bisphosphonate are limited. The monoclonal antibody, Denosumab, which inhib...

BackgroundThe kidney or kidney-pancreas transplantation corrects many of the metabolic or biochemical abnormalities associated with chronic kidney disease (CKD); however, mineral bone disease (MBD) and cardiovascular pathology remain frequent in transplant recipients. This happens especially in patients who have long history of secondary hyperparathyroidism (SHPT), as well immunosuppressive therapy plays an important role in the progression of MBD.<p...

BackgroundAutosomal dominant hypocalcaemia, caused by either inherited or de novo mutations in calcium-sensing receptor gene (CASR), is biochemically characterized by the presence of hypocalcaemia, hypercalciuria and inappropriately low levels of PTH. Receptor-activating mutations induce an increase sensitivity to calcium by parathyroid and renal cells, leading to suppression of PTH synthesis and consequently hypocalcaemia. Clinical manifestations are va...

BackgroundPrimary hyperparathyroidism (PHPT) is the third most common endocrine disorder mainly caused by a single parathyroid adenoma. The localization of the parathyroid adenoma is useful for increasing the recovery rate of PHPT, and reducing the complication rate. Conventional localization techniques include neck ultrasound, Tc99m-MIBI-SPECT and CT. However, each one of those has its limitations; particularly in cases of ectopic, or multiple parathyro...

ObjectiveScanty data about glucose metabolism, hypertension and metabolic syndrome (MS) have been reported in Paget’s disease of bone (PDB) to be related with increased cardiovascular mortality. We aimed to determine prevalence of metabolic syndrome in PDB and to determine the relationship between metabolic syndrome and bone-specific alkaline phosphatase levels.Patients and methodsTwenty three patients w...

IntroductionPost parathyroidectomy cure in primary hyperparathyroidism (PHPT) is defined as normocalcemia six months after surgery. The frequency of persistent or recurrent post-surgical disease according to lengthy follow-up studies varies between 1% and 14%.ObjectiveTo determine if there is a subset of patients with cure criteria 6–12 months after parathyroidectomy that would not require long-term foll...

The commonest cause of hypercalcaemia is primary hyperparathyroidism (PHPTH). The diagnostic work up includes paired blood samples for serum corrected calcium, parathyroid hormone (PTH) and vitamin D levels. But in young patients, rare genetic conditions could be contributing towards hypercalcaemia and hence could produce a diagnostic challenge. We report hypercalcaemia work up in two young females where genetic tests were required.Case 1<p class="ab...

IntroductionPrimary Hyperparathyroidism (PHPT) results from one or more parathyroid glands hyperfunction. It is recommended that the preoperative location of the parathyroid lesion be performed with cervical ultrasonography and sestamibi-scintigraphy. Recently 4-Dimensional Computed Tomography (4D-CT) has revealed anatomic, morphologic and functional precision for detecting those lesions, either for typical or ectopic location. This study evaluates the d...

BackgroundVitamin D and calcium deficiencies is of particular importance in older patients undergoing medical rehabilitation and having a high risk of fractures. Preventing falls and fractures, including during the course of rehabilitation, is an important challenge that can be addressed in these patients, in particular through improved nutrition and vitamin D and calcium supplementation.ObjectivesTo evaluate...

Hypocalcemia has been recently identified as a major biochemical distinctive feature of COVID-19, predicting poor clinical outcomes. Besides the calcium-dependent viral mechanisms of action and the enhanced cellular permeability to calcium ions, we previously hypothesized that hypovitaminosis-D could be a predisposing factor to hypocalcemia. Actually, high prevalence of vitamin D (VD) deficiency in COVID-19 patients (pts) was reported by several studies, but, to date, only few...

IntroductionHypocalcaemia is a complication of total thyroidectomy (TT) and may be more frequent in patients with Graves’ disease. The reason for this increased risk is unclear and its occurrence has been associated with: ophthalmopathy severity, preoperative calcaemia and reimplantation of parathyroid glands.ObjectivesTo evaluate the risk factors for transient hypocalcaemia (TH) and definitive hypoparat...

IntroductionThe European Registries for Rare Endocrine Conditions (EuRRECa) project was launched in February 2018 and aims to support the needs of the endocrine and bone community by facilitating the collaboration between patients, health care professionals and researchers across Europe and beyond. It is closely linked to the European Reference Networks on Rare Endocrine Conditions (Endo-ERN) and Rare Bone Diseases (ERN BOND) with its registry EuRR-Bone....

IntroductionTurner syndrome is one of the most common chromosomal disorders, with a reported prevalence of 1/2500 live females. It is characterized by short stature, ovarian failure, malformative, autoimmune, skeletal and bone abnormalities. The objective of our work is to study the prevalence of skeletal and bone malformations in our Turnerian patients.Material and methodThis is a retrospective descriptive s...

BackgroundThyrotropin Stimulating Hormone Suppression Therapy (TSHST) in Differentiated Thyroid cancer (DTC) patients can result in reduced bone mineral density (BMD) which is a potential serious problem [1]. Studies on the effects of TSHST on BMD have demonstrated conflicting results [2–5]. There is insufficient guidance regarding the degree and duration of TSHST in the context of skeletal effects despite multiple existing guidelines.<p class="...

ObjectiveIllustrate the interest of imaging: Single photo emission tomography or Computed tomography in the topographic diagnosis of parathyroid adenomas.ObservationA 67-year-old man, with renal lithiasis presenting a clinical-biological picture of primary hyperparathyroidism with renal bone and colic pain. PTH was 463.2 pg/ml, calcemia 3.4 mmol/l. Cervical ultrasound objectified a lesion suspected of parathy...

Primary hyperparathyroidism is a common endocrine condition; 80% due to a parathyroid adenoma. We present an unusual case of a 69-year old white European female, who presented first in 2012 with mild hypercalcaemia (< 2.8 mmol/l), osteoporosis, hypertension and type 2 diabetes. Pharmacotherapy included Bendroflumethiazide, but no phosphate supplements. Investigations revealed primary hyperparathyroidism and dual-modality scanning showed no evidence of an adenoma, although ...

Lithium is considered a mainstay treatment option for the management of bipolar affective disorder. However, lithium administration is characterized by endocrine effects. The aim was to present the case of a patient who was on treatment with lithium for many years for the management of bipolar affective disorder and presented with a large parathyroid adenoma causing clinical hyperparathyroidism with severe hypercalcemia who was successfully treated by surgical excision of the ...

Hypercalcaemia due to primary hyperparathyroidism (PHPTH) is fully curable by parathyroidectomy. Occasionally recurrent hypercalcemia presents as a results of either residual adenoma, recurrent disease or an ectopic parathyroid gland. The most challenging cases are those with ectopic glands which are not identified on usual surgical neck exploration. We present a similar case that went through multiple surgeries for recurrent hypercalcemia. A 79-year-old lady initially was dia...

IntroductionFahr’s syndrome (FS) is a rare neurodegenerative disorder. It’s characterized by abnormal calcifications in basal ganglia and cerebral cortex inducing neuropsychiatric disorders and cognitive impairment. The aim of our study was to assess the prevalence of FS, its characteristics, and its associated factors in patients with permanent hypoparathyroidism.MethodsWe conducted a cross-section...

BackgroundHypoparathyroidism is a rare disorder characterized by hypocalcemia and hyperphosphatemia due to absent or inadequate parathyroid hormone secretion. Data on effective treatment strategies and predictors of long-term complications have only recently began to emerge. The epidemiological information regarding chronic hypoparathyroidism in Russia is strictly limited that prompted this research.AimsTo es...

BackgroundThere is no universal consensus regarding vitamin sufficiency status with values either above 20 ng/ml, or 30 ng/ml being quoted as denoting ’sufficient’ status. We have endeavoured to assess the effects of summer sunshine exposure on vitamin D status from a single GP practice in central Poland.Subjects and methodsWe measured concentrations of vitamin D, parathyroid hormone (PTH), creatini...

IntroductionClinical guidelines for the prevention and treatment of vitamin D deficiency in adults were formulated and implemented into clinical practice by the Russian association of endocrinologists in 2014. While having multiple health benefits, in some cases, prescribing vitamin D supplements may be accompanied by its toxicity, which has various manifestations and exert potentially dangerous health consequences.Aim<p class=...

IntroductionThe differential diagnosis between benign and malignant parathyroid neoplasms may be challenging and should always be based on clinical and histological criteria. We are presenting a case series of three patients with clinical, biochemical and imaging findings supporting the presence of a malignant neoplasm but histological findings confirming the diagnosis of a parathyroid adenoma.Case 1A 24-year...

IntroductionThere is evidence of the interaction between the main parameters of calcium-phosphorus metabolism, vitamin D and the course of a new coronavirus infection. Moreover, hypocalcemia is one of the most frequent biochemical disorders and is associated with severity of the disease, increased likelihood of hospitalization, need for mechanical ventilation, and poor prognosis in COVID-19.ObjectiveTo estima...

ObjectivePrimary hyperparathyroidism (PHPT) is a common endocrine disorder affecting 2% of the population aged 55 years or older. Primary hyperparathyroidism is due to parathyroid adenoma in about 85% of cases, parathyroid hyperplasia in about 15% of cases, and parathyroid carcinoma in less than 1% of cases. Familial parathyroid disorders are responsible for 10% of the PHPT cases and include among other disorders caused by parafibromin malfunction. Paraf...

MEN (multiple endocrine neoplasia) I disease represents a compilation of multiple endocrine neoplasms affecting a patient in the course of a life-time. It thus represents a phenotype which has survived over many years. Pituitary neoplasms, lipomas and parathyroid hyperplasia are observed in the disease. The aim was to describe a patient with MEN I disease who presented with lipomas and acromegaly in his early adulthood and developed primary hyperparathyroidism in his senior ye...

Hypercalciuria may represent a challenge during the workup for osteoporosis management. The present study aimed: 1) to describe the phenotype associated with hypercalciuria in vitamin D-repleted (serum 25OHD > 20 ng/ml) osteopenic/osteoporotic patients, focusing on kidney, bone and mineral metabolic features; 2) to analyze the effects of thiazides and anti-resorptive drugs on urine calcium excretion (UCa) and mineral metabolism markers. Seventy patients (67 postmenopausal ...

IntroductionDenosumab (Dab) withdrawal is associated with a quick loss in bone mineral density (BMD) and a high risk of multiple vertebral fractures. It is still not stablished which strategy best prevents BMD loss after Dab discontinuation.AimCompare the use of bisphosphonates for one year after Dab withdrawal versus a tapering Dab regimen in terms of BMD and fracture occurrence.Method...

KeywordsSarcoidosis, serum, 24 h urine, calcium.IntroductionSarcoidosis is a systemic disease of unknown etiology that is defined by the formation of granulomas in different organ systems. Due to these pathologies, there may be an increase in serum and 24 h urine calcium that can have a clinical impact on the course of the disease.AimThe goal of this study was to ...

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome of chronic hypophosphatemia caused by the production of FGF23 in a typically small, benign, mesenchymal tumor. The diagnosis is often delayed and finding the tumor is sometimes challenging. We present a case of a 50 yrs old woman with TIO, referred to our clinic for progressive muscle weakness, diffuse bone pain and fractures, extensively investigated for 3 years. 2 years before admission she had a vertebroplas...

BackgroundMost post-osteoporotic fracture patients do not receive osteoporosis treatment, although it reduces risks for additional fractures. This retrospective, observational study reviewed osteoporosis evaluation and treatment following typical osteoporotic fractures.MethodsWe identified patients with hip, vertebral, humerus or radius fractures, examined in Meir Medical Center, January-December 2017. Exclus...

ContextThe incidence of Type 2 diabetes mellitus (T2DM) is increasing and muscle strength and function are reported to be decreased in patients with T2DM compared to healthy controls.However, the relation between bone and muscle remain unclear.ObjectiveOur aims was to examine bone health parameters [by Dual energy X-ray absorptiometry (DXA) and trabecular bone score (TBS)] and muscle strength (by hand grip) i...

IntroductionHypoparathyroidism (hypoPT) is one of the most complications after thyroid surgery, usually as transient hypocalcemia. Permanent hypoPT due to permanent parathyoid lesion, despite being less frequent, is associated to long term consequences for both objective and subjective well-being and should be prevented. Identifying predictive factors associated with post- thyroidectomy hypoPT is thereby crucial.Aim<p class="ab...

IntroductionHypoparathyroidism still remains the only hormone-deficiency related disorder whose standard treatment is not based on replacing the missing hormone. In the last few years, there has been growing evidence on the use of recombinant human PTH, mostly with subcutaneous injections of rhPTH(1–34). More recently, some clinicians have tried to administer teriparatide through a continuous delivery system using insulin pumps.<p class="abstext...

BackgroundThe nonclassical complications of primary hyperparathyroidism (PHPT) can include metabolic syndrome associated with cardiovascular diseases. According to clinical studies, an increased incidence of diabetes mellitus, insulin resistance, obesity, dyslipidemia and other disorders are observed in patients with PHPT regardless of the severity of the disease. The aim of this study is to estimate metabolic parameters in patients with PHPT compared to...

IntroductionParathyroid crisis (PC) is a very rare yet fatal clinical condition which mandates urgent intervention. We present a case of parathyroid crisis with severe symptomatic hypercalcemia and multi-organ involvement.Case descriptionA 63-year-old male presented with three days of generalized fatigue, abdominal pain and vomiting. Review of systems revealed constipation and symptoms suggestive of depressio...

The incidence of recurrent primary hyperparathyroidism (PHPTH) (> 6 months from initial exploration) has been reported to be between 1–10%. Repeated neck explorations could be challenging for surgeons and ensuring normalised biochemistry is vital for peri-operative safety. Recurrent parathyroid adenomas can present with aggressive hypercalcaemia which can be challenging to control prior to surgery. We report a similar case below. A 72 year old lady had her first prese...

AimTo show that height loss is more correlated with vetebral micoarchitecture than with Bone Mineral Density (BMD).Material and methodA. DEXA. Made with a GE-Lunar Prodigy Pro # 50 0074. Vertebral microarchitecture was investigated by Trabecular Bone Score (TBS). TBS software: TBS iNsight, version 3.0.2.0. B. Patients. 784 patients, 737 (94%) women, 47 men. Only 38 under 50 years. Age average: 66.04 years. Wo...

Parathyroidectomy for hyperparathyroidism can be complicated with development of Hungry Bone Syndrome (HBS), a constellation of profound hypocalcemia with hypomagnesemia and hypophosphatemia. The severity of this potential life-threatening condition is related to the extent of the parathyroid-mediated high-turnover bone disease. We present a case of a 59-year-old woman developing post-surgical HBS as a result of longstanding severe unrecognized primary hyperparathyroidism (PHP...

Primary hyperparathyroidism (PHPT) is a complex endoctinopathy that involves parathyroid glands which secreting too much parathyroid hormone and due to causes hypercalcemia effecting different organs and leading to significant quality of life (QoL) impairment. QoL assessment before and after surgery in patients with PHTP may be useful for comprehensive evaluation of the treatment effect, as well as for monitoring of the patient’ condition after surgery, including in real ...

IntroductionAdjuvant endocrine therapy has an important role in the management of hormone receptor-positive (expressing oestrogen/progesterone receptors) early-stage breast cancer, reducing the risk of recurrence and improving associated mortality. The estradiol depletion produced by hormone therapy has detrimental effects on skeletal health, which can lead to low bone mineral density (BMD), altered bone microarchitecture and increased risk of fracture.<...

IntroductionPrimary hyperparathyroidism is a common disorder of the parathyroid glands and the third most frequent endocrinopathy, especially among elderly women. Secondary hyperparathyroidism is a common complication of chronic kidney disease, associated with high cardiovascular morbidity and mortality. In both primary and secondary hyperparathyroidism, the need to correctly identify the parathyroid glands is mandatory for a better outcome. Elastography...

IntroductionThe diagnosis of primary hyperparathyroidism (PHP) is essentially biological. Current imaging techniques (ultrasound and scintigraphy) make it possible to locate an adenoma in the majority of cases. The objective of this study is to clarify the place of imaging in the topographic diagnosis of hyperparathyroidism.Patients and methodsThis is a retrospective study including 40 patients with PHP who h...

BackgroundCurrently, serious complications of secondary hyperparathyroidism (sHPT) are rare due to early diagnosis and more effective treatments. These complications include osteitis fibrosa cystica, which is characterized by bone resorption and brown tumors. Depending on the location, they can cause pain or compressive symptoms.Case reportWe report a case of a 41-year-old black woman with a past medical hist...

ObjectifBrown tumour is a rare focal bone lesion encountered in patients with uncontrolled hyperparathyroidism (HPT). This disease affects only 1.5% of patients with secondary HPT. This bone lesion can affect any part of the skeleton. The treatment is mainly medical based on reducing the rates of parathyroid hormone (PTH). Surgery is reserved for severe form of brown tumour or in case of uncontrolled level of PTH. The aim of our work is to illustrate the...

Brown tumors (BT) consist of focal bone lesions, caused by increased osteoclastic activity and fibroblastic proliferation. They appear in chronic kidney disease (CKD) as a result of renal osteodystrophy with high bone turnover, due to secondary hyperparathyroidism. BT are composed of mononuclear stromal cells mixed with multinucleated giant cells and hemosiderin deposits, which give the characteristic brown colour. We present the case of a 13-year-old girl, with end-stage CKD ...

IntroductionTumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused mainly by a phosphaturic mesenchymal tumour (PMT) as a consequence of fibroblast growth factor 23 (FGF23) overproduction. The manifestation of TIO is mostly musculoskeletal. Locating the PMT is usually challenging and a successful surgical resection of the tumour leads to complete recovery.Case presentationA 42-year-old, Ca...

BackgroundThere is a high prevalence of osteoporosis (OP) among patients of the older age undergoing rehabilitation. Therefore, it is obvious that physicians working in the field of physical and rehabilitative medicine should be well oriented in this medical problem.Objectivesto study the relevance of the problem of osteoporosis (OP) for physicians working in the field of physical and rehabilitation medicine,...

Clinical vignetteA 65-year-old woman was hospitalized due to severe hypercalcemia (albumin-corrected calcium 16.9 mg/dl) associated with severe renal failure (creatinine 3.48 mg/ml), normal phosphate levels (3.9 mg/dl) and PTH < 5 pg/ml. Her past medical history included total thyroidectomy complicated by chronic hypoparathyroidism, for which she was followed by her primary care physician. One year before hospital admission, renal function was normal...

IntroductionOsteoporosis has generally been considered a female disease; this may explain why this pathology has focused less attention on men. While osteoporosis has been underestimated and poorly treated in female patients, the situation is even worse in male patients, despite the fact that up to one third of hip fractures are suffered by men.GoalTo assess the characteristics and risk factors associated wit...

IntroductionParathyroid carcinoma (PC) occurs in 0.5–5% of cases among patients with primary hyperparathyroidism (pHPT). The prognosis for patients with PC is variable and depends on the presence of local or distant metastases and the completeness of the initial surgery. About 50% of patients become recurrence of the disease and require palliative surgery and/or drug therapy aimed at correcting severe hypercalcemia.Objective</...