Searchable abstracts of presentations at key conferences in endocrinology
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25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

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ECE 2023 will be held in Istanbul, Turkey from 13-16 May 2023. Istanbul is known for its rich culture, historical sites and dynamic nightlife, and we are excited to come together in this city, and look forward to meeting old friends, making new ones, and sharing science, collaborations and ideas.

Eposter Presentations

Calcium and Bone

ea0090ep125 | Calcium and Bone | ECE2023

Application of untargeted metabolomics in primary hyperparathyroidism

Wielogorska-Partyka Marta , Podgorska Beata , Mocarska Karolina , Godzień Joanna , Siemińska Julia , Ciborowski Michał , Kozłowska Gabriela , Szelachowska Małgorzata , Adamska Agnieszka , Popławska-Kita Anna , Dzieciol Janusz , Krętowski Adam , Siewko Katarzyna

Background: The excessive secretion of parathormone by parathyroid glands is a common disorder known as hyperparathyroidism. With a prevalence of 0.1-0.4 percent in the general population and 2-4 percent in post-menopausal women, primary hyperparathyroidism is the third most frequently reported endocrine disorder. According to estimates, the prevalence of primary hyperparathyroidism has escalated in recent years, probably due to the increasing rate of parathormone and calcium ...

ea0090ep126 | Calcium and Bone | ECE2023

Diagnostic efficiency of the fine needle aspirate parathyroid hormone assay in parathyroid adenomas

Diaz Celia Gallego , Jimenez Virginia Hernando , Caballero Manuel J , Martinez-de Pinillos Guillermo , Cuellar Lloclla Eyvee Arturo

Objective: Evaluate the utility of analytical determination of parathyroid hormone assay in fine-needle aspirate as a diagnostic test for parathyroid adenoma in patients with primary hyperparathyroidism.Material and Methods: retrospective observational study of 58 patients diagnosed with primary hyperparathyroidism in our hospital who underwent ultrasound-guided FNA of lesions compatible with parathyroid adenoma with determination of PTH in fine-needle a...

ea0090ep127 | Calcium and Bone | ECE2023

Key factors associated with impaired glucose metabolism in primary hyperparathyroidism

Bibik Ekaterina , Elfimova Alina , Gorbacheva Anna , Dobreva Ekaterina , Karaseva Elena , Gins Nikolay , Eremkina Anna , Mokrysheva Natalia

Background: Primary hyperparathyroidism (PHPT) can present with not only classic complications like bone and kidney pathology but also with different metabolic disorders and cardiovascular diseases. The prevalence of diabetes mellitus type 2 (DM2) in patients with PHPT is higher than in general population but the mechanism of carbohydrate metabolism alteration in PHPT remains unclear.Aim: The aim of this study is to estimate parameters associated with im...

ea0090ep128 | Calcium and Bone | ECE2023

Height loss is almost 5 times more correlated with trabecular bone score than with bone mineral density. Study on over 900 patients (2023)

Peretianu Dan , Sirbu Adrian , Motoiu Serban , Gavrila Catalin , Stanciu Mihaela , Ranetti Aurelian E

Aim: To show that height loss is more correlated with vetebral micoarchitecture than with Bone Mineral Density (BMD). Material and Method: A. DEXA: made with a GE-Lunar Prodigy Pro # 500074. Vertebral microarchitecture was investigated by Trabecular Bone Score (TBS). TBS software: TBS iNsight®, version Patients. 902 patients, 844 (93.6%) women, 58 men. Only 42 under 50 years. Age av...

ea0090ep129 | Calcium and Bone | ECE2023

Prediabetes is associated with lower trabecular bone score (TBS): Comparison of TBS according to the prediabetes phenotype

Choi Yong Jun , Ha Kyounghwa , Kim Dae Jung , Chung Yoon-Sok

Objective: Diabetes mellitus (DM) is known to be associated with a lower trabecular bone score (TBS) and an increased risk of fracture. However, little is known regarding whether it is associated with poor bone results in pre-diabetic individuals. Despite the fact that both IFG and IGT are characterized by insulin resistance and β-cell dysfunction, the metabolic abnormalities are quite distinct between the two disorders. Impaired fasting glucose (IFG) was marked by dysfun...

ea0090ep130 | Calcium and Bone | ECE2023

Tension-free thyroidectomy (TFT) with medial approach to the recurrent laryngeal nerves and parathyroid glands helps to achieve a low rate of permanent postoperative hypoparathyroidism

Sleptsov Ilya , Chernikov Roman , Pushkaruk Alexander , Novokshonov Konstantin , Sablin Ilya , Timofeeva Natalia , Tilloev Tillo , Osokina Yana

Background: Hypoparathyroidism is one of the most important complications of total thyroidectomy. Its treatment with the use of recombinant parathyroid hormone (PTH) is limited now, therefore the prophylaxis of post-surgical hypoparathyroidism is very important. A method of tension-free thyroidectomy (TFT) was proposed in 2021. TFT uses unusual medial approach to the recurrent laryngeal nerves (RLN) and parathyroid glands (PG), together with several principles decreasing tract...

ea0090ep131 | Calcium and Bone | ECE2023

Hypercalcemic hyperparathyroidism after bariatric surgery–primary or tertiary? Case report

Zajickova Katerina

Bariatric surgery significantly reduces obesity-related comorbidities. Secondary hyperparathyroidism (SHPT), due to calcium malabsorption and vitamin D deficiency, has been frequently reported, however, in patients after bariatric surgery. Whether chronic SHPT after bariatric surgery could ultimately evolve into tertiary hyperparathyroidism has not been clarified. Here, we report a 59-old-woman who presented with osteoporosis (T score at the lumbar spine -4.1 and T score at th...

ea0090ep132 | Calcium and Bone | ECE2023

Comparison of the prediction powers of hypercalciuria tests for nephrolithiasis in patients with asymptomatic primary hyperparathyroidia

Ozkan Melek , Yener Serkan

Objective: One of the ways to predict nephrolithiasis, which is one of the surgical indications in patients with asymptomatic primary hyperparathyroidism, is to detect hypercalciuria. A calcium excretion of >400 mg/day in 24-hour urine, >4 mg/kg/day calcium excretion in 24-hour urine or a fractionated calcium excretion (FECa) >0.010 guide us in the detection of hypercalciuria and therefore nephrolithiasis. The aim of our study is which of these three tests is more ...

ea0090ep133 | Calcium and Bone | ECE2023

The Russian Registry of primary hyperparathyroidism, the latest update

Eremkina Anna , Elfimova Alina , Miliutina Anastasiia , Kovaleva Elena , Gorbacheva Anna , Bibik Ekaterina , Mokrysheva Natalia

Introduction: Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders. No major epidemiological research has been previously conducted in the Russia. This served as the basis for the creation of the Russian online registry of PHPT with accessibility from various regions of the country.Aim: Aim of this study was to estimate the clinical profile, surgical and medical therapy of the patients with different forms of PHPT.<p class...

ea0090ep134 | Calcium and Bone | ECE2023

Variations in plasma free 25-hydroxyvitamin D concentrations during intermittent fasting are independently correlated with amino acid intake among meat and non-meat eaters

Karras Spyridon , Koufakis Theocharis , Adamidou Lilian , Dimakopoulos George , Melidou Eirini , Karalazou Paraskevi , Thisiadou Katerina , Zebekakis Pantelis , Makedou Kali , Kotsa Kalliopi

Background: Data on the effects of different dietary patterns on free 25-hydroxyvitamin D [25(OH)D] and vitamin D binding protein (VDBP) concentrations are scarce. Our objective was to prospectively assess changes over time in these parameters and possible correlations with diet composition among overweight adults who followed a pescatarian Orthodox intermittent fasting (OF) regimen and controls who followed a low-fat 12:12 diet for 7 weeks.Methods: Tota...

ea0090ep135 | Calcium and Bone | ECE2023

Acquired Parathyroid Hormone Resistance–a Possible Disease

Świder Grzegorz

Introduction: Acquired PTH Resistance (Acquired Pseudohypoparathyroidism) appears to be an extremely rare disease.Case Report: A 19-year old man with history of brain medulloblastoma treated by surgery, radiotherapy and chemotherapy 9 years earlier was admitted to hospital in 2019 due to new-onset hypocalcemia. Patient presented with muscle cramps in legs, a tingling sensation in hands and feet, numbness around the mouth, and memory disturbances. Previou...

ea0090ep136 | Calcium and Bone | ECE2023

Infection with the human immunodeficiency virus is characterized by a downregulation of the inverse relationship between irisin and parathyroid hormone independently of vitamin D status

Karras Spyridon , Koufakis Theocharis , Dimakopoulos George , Zisimopoulou Eleana , Mourampetzis Petros , Manthou Elena , Melidou Eirini , Karalazou Paraskevi , Thisiadou Katerina , Tsachouridou Olga , Zebekakis Pantelis , Makedou Kali , Metallidis Symeon , Kotsa Kalliopi

Background: Infection with the human immunodeficiency virus (HIV) predisposes to endocrine disorders, manifesting as a metabolic phenotype that affects the entire adipose-musculoskeletal unit (AMS). The present cross-sectional study aimed to investigate differences in irisin and adiponectin concentrations between people living with HIV and healthy controls, as well as to explore potential correlations between the levels of the aforementioned adipokines and markers of calcium h...

ea0090ep137 | Calcium and Bone | ECE2023

Histomorphometric parameters of parathyroid glands after 60 days of sodium benzoate administration

Morozov Vitaly , Luzin Vladyslav

Sodium benzoate (the food additive E211) is widely used as a preservative in the food and pharmaceutical industries. A direct correlation between sodium benzoate intake and the development of sensibilization, nephrotoxicity and hepatotoxicity, disorders of puberty, and genotoxicity has been established. However, the literature does not provide data on changes in morphometric parameters of parathyroid glands after long-term use of sodium benzoate. The aim of this work is to stu...

ea0090ep138 | Calcium and Bone | ECE2023

Clinical characteristics of sporadic and MEN1-associated primary hyperparathyroidism in young patients

Aboishava Lizaveta , Elfimova Alina , Gorbacheva Anna , Salimkhanov Rustam , Eremkina Anna , Karaseva Elena , Mokrysheva Natalia

Introduction: Primary hyperparathyroidism (PHPT) is commonly the most early manifestation of multiple endocrine neoplasia syndrome type 1 (MEN1), but it can also occur in young patients without any inherited disorders. The aim of our study was to compare the clinical characteristics of PHPT in young patients with MEN1 syndrome and with sporadic disease.Patients and Methods: The study included 72 patients with MEN-1 associated PHPT and 168 patients with s...

ea0090ep139 | Calcium and Bone | ECE2023

Differential diagnosis between classic primary-, normocalcemic- and secondary hyperparathyroidism based on PFI and WI

Polymeris Antonis , Psachna Stavroula , Ioannidis Dimitrios , Lilis Dimitrios , Drakou Maria , Papapetrou Peter

Introduction: Patients with primary hyperparathyroidism (PHPT) present high calcium and PTH levels while some patients present also high PTH levels but normal calcium levels (NHPT) and such patients be considered as having normocalcemic hyperparathyroidism. On the other hand vitamin D deficient patients develop secondary hyperparathyroidism (SHPT). Sometimes normocalcemic- and secondary hyperparathyroidism coexist. Therefore in clinical settings it is very difficult to disting...

ea0090ep140 | Calcium and Bone | ECE2023

Patient with Ia pseudohypoparathyroidism and the novel mutation in the GNAS gene

Gorbacheva Anna , Salimkhanov Rustam , Pogoda Tatyana , Bogdanov Viktor , Zakharova Victoriya , Eremkina Anna , Mirnaya Svetlana , Melnichenko Galina , Mokrysheva Natalia

Introduction: Pseudohypoparathyroidism (PHP) is an orphan disease caused by a mutation in the GNAS gene encoding the α-subunit of G-protein. PHP is characterized by multihormonal resistance. A correlation between the genotype and phenotype of patients with GNAS mutations hasn’t yet been described.Clinical Case: Patient T., 19 years old male, admitted to our Centre with general weakness and overweight. Hypocalcemia, hyperphosph...

ea0090ep141 | Calcium and Bone | ECE2023

Risk factors of hypoparathyroidism after total thyroidectomy: A prospective study

Kallel Souha , Chaabouni Mohamed Amin , Haj Kacem Akid Faten , Trigui Majdi , Frikha Hamdi , Abid Mohamed , Charfeddine Ilhem

Objective: Identify the risk factors of hypoparathyroidism (hypoPT) after Total thyroidectomy (TT).Patients and Methods: Our study is a randomised clinical trial. It enrolled patients who underwent total thyroidectomy at the department of ENT surgery at Habib Bourguiba Hospital in Sfax between November 2020 and august 2021. We studied age, gender, type of surgery, duration of surgery, vitamin D level, magnesium level, histopathological exam, inadvertent ...

ea0090ep142 | Calcium and Bone | ECE2023

Chronic hypoparathyroidism: Predictors of complications according to the Russian Registry

Kovaleva Elena , Elfimova Alina , Eremkina Anna , Mokrysheva Natalia

Background: Chronic hypoparathyroidism is a relatively rare disease associated with various complications. The analysis of large databases of patients with chronic hypoparathyroidism is a necessary tool to enhance quality of medical care, as well as to determine the therapeutic approaches and prognostic markers of the disease.Aims: To describe complications associated with chronic hypoparathyroidism and determine predictors of their development according...

ea0090ep143 | Calcium and Bone | ECE2023

Primary hyperparathyroidism in pregnancy: A case report

Bieliauskienė Justina

Introduction: Despite its rarity, the most common cause of hypercalcemia in pregnancy is primary hyperparathyroidism (PHPT). This disorder increases the risk of miscarriages, premature birth, intrauterine growth restriction, severe pancreatitis, preeclampsia, and neonatal hypocalcaemic tetany if not diagnosed and properly managed.Case: A 31-year-old woman with 13 weeks of pregnancy and acute pancreatitis was admitted to the Obstetrics department. Since t...

ea0090ep144 | Calcium and Bone | ECE2023

Differences in the clinical, laboratory, and operative variables between pre-menopausal and post-menopausal primary hyperparathyroid women: a single-center experience

Chauhan Phulrenu , Maldar Aasim , Lala Murad , Shah N. F. , Chadha Manoj

Introduction: Primary hyperparathyroidism (PHPT) is an endocrine disorder wherein enlargement of one or more of the parathyroid glands causes autonomous overproduction of the parathyroid hormone (PTH), which leads to high serum calcium levels.Objective: Comparison of clinical, laboratory, and operative variables between premenopausal (pre-M) and postmenopausal (post-M) women with PHPT.Materials and Methods: A retrospective analysis...

ea0090ep145 | Calcium and Bone | ECE2023

Hypocalcaemia induced dilated cardiomyopathy

Drugda Jan , Gabalec Filip , Hegarova Marketa , Lupinek Petr

Introduction: Dilated cardiomyopathy is the third most common reason for heart failure and transplantation worldwide. The etiology of dilated cardiomyopathy often remains unclear, but in certain cases we can discover the cause, which can then contribute to better and more causal treatment.Observation: We present a case of a 47-year-old man without any significant comorbidities in his medical history. In 2015 he underwent two hemithyroidectomies with a ne...

ea0090ep146 | Calcium and Bone | ECE2023

The calcium-to-phosphorus ratio in the diagnosis of parathyroid disorders

Faten Cherchir , Oueslati Ibtissem , Abid Arige , Aloui Emna , Yazidi Meriem , Chihaoui Melika

Introduction: The diagnosis of primary hyperparathyroidism and hypoparathyroidism is still challenging because of the increasing frequency of non-classical presentations. The calcium-to-phosphorus ratio (Ca/P) (CPR) is an inexpensive biochemical marker that could be useful to diagnose parathyroid disorders.Aim: The aim of this study was to assess the performances of CPR in the diagnosis of primary hyperparathyroidism and hypoparathyroidism.<p class="...

ea0090ep147 | Calcium and Bone | ECE2023

Long-term outcomes of parathyroidectomy in patients with primary hyperparathyroidism from patient’s perspective

Buzanakov Dmitrii , Chernikov Roman , Efremov Sergey , Gladkova Inna , Ionova Tatiana , Nikitina Tatiana , Sleptsov Ilya , Zolotoukho Anna , Bubnov Kirill , Skvortsov Vladimir , Vinogradova Arina , Rusakov Vladimir

Background: A parathyroidectomy (PTX) is the preferred standard treatment for patients with primary hyperparathyroidism (PHPT). the assessment of the surgery success from patient’s perspective is important to provide patient-centered care.Aim: We aimed to evaluate QoL changes in PHPT patients during 2-years follow-up after PTX and to identify preoperative predictors of meaningful QoL improvement after surgery.Materials and Met...

ea0090ep148 | Calcium and Bone | ECE2023

Efficacy and safety of Cinacalcet therapy for patients with primary hyperparathyroidism: A retrospective observational study

Johnsen Hakon , Kalhan Atul

Introduction: Cinacalcet therapy remains the only alternative to elective parathyroidectomy (EP) for lowering serum calcium (Ca) in patients with primary hyperparathyroidism (PHPT). National Institute of health and Care Excellence (NICE), UK support use of cinacalcet in symptomatic patients with PHPT who decline surgery (or deemed unfit for surgery), if serum Ca levels >2.85 mmol/l. The limitation in wider use of cinacalcet remains cost effectiveness apart from limited dat...

ea0090ep149 | Calcium and Bone | ECE2023

The daily calcium profile in patients with chronic hypoparathyroidism depending on different 25(OH) vitamin D level

Kovaleva Elena , Eremkina Anna , Elfimova Alina , Karaseva Elena , Gorbacheva Anna , Aboishava Lizaveta , Mokrysheva Natalia

Introduction: Chronic hypoparathyroidism is a rare disease, which usually treated with active forms of vitamin D and oral calcium. Supplementation with native vitamin D can be useful both for achieving "non-skeletal" effects of vitamin D and for a more stable serum calcium profile.Aim: The aim of this study was to estimate the daily serum calcium and 24-hour urine calcium levels in patients with chronic hypoparathyroidism depending on different 2...

ea0090ep150 | Calcium and Bone | ECE2023

Low 25(OH) vitamin D levels are associated with Long COVID syndrome in COVID-19 survivors

Di Filippo Luigi , Frara Stefano , Nannipieri Fabrizio , Cotellessa Alice , Locatelli Massimo , Rovere-Querini Patrizia , Giustina Andrea

Low vitamin D levels were consistently reported as a risk factor for worse outcomes in hospitalized COVID-19 patients. Emerging evidences suggest that in 50–70% of COVID-19 survivors several post-COVID symptoms can be observed up to 3 months after acute-disease, representing a novel clinical condition defined Long-COVID syndrome. To date, the predisposing factors for this syndrome are still poorly understood. We retrospectively aimed at evaluating the influence of 25(OH) ...

ea0090ep151 | Calcium and Bone | ECE2023

Evaluation of the efficacy and safety of long-term Cinacalcet in primary hyperparathyroidism

Huguet Isabel , Timon Iciar Martin , Moreno-Ruiz Inmaculada , Yannuzzi Vanessa Trivino , Llavero Maria , Meizoso-Pita Olalla , Gargallo Fernandez Manuel Angel , Sevillano-Collantes Cristina

Introduction: Cinacalcet is a positive allosteric modulator of the calcium sensing receptor successfully used to decrease serum calcium in primary hyperparathyroidism (pHPT) patients in the short-term, but long-term data are scarce. In this single-centre retrospective analysis, we investigated the efficacy and safety of cinacalcet in pHPT patients who received more than 5 years of treatment.Methods: Statistical analysis was performed using free online so...

ea0090ep152 | Calcium and Bone | ECE2023

Incidental hypercalcemia during denosumab treatment for osteoporosis: rebound phenomenon or occult primary hyperparathyroidism

Varadhan Lakshminarayanan , Adams Elizabeth , Padmanabhan Nishita , Paskins Zoe

Introduction: Denosumab is an important treatment option for osteoporosis. Rebound hypercalcemia on discontinuation of denosumab is well documented. Denosumab can increase PTH, peaking within 2-4 weeks of administration and subsiding thereafter, therefore making diagnosis of primary hyperparathyroidism (pHPT) difficult. The aim of our case series is to review the calcium fluctuations in relationship to timing of denosumab administration and identify the possibility of rebound ...

ea0090ep153 | Calcium and Bone | ECE2023

Phosphocalcium profile and prevalence of osteoporosis in patients with cushing’s disease at diagnosis

Rachedi Hanae , El Amel Rania , Zerrouki Dounia , Zeryouh Nabila , Bakmizi Hanae , Rouf Siham , Latrech Hanane

Introduction: Cushing’s disease represents the most frequent etiology of endogenous cushing’s syndrome. It is a severe condition associated to many comorbidities and increased mortality that occurs a long-term management to optimize these patients outcomes. This study aims to describe the phosphocalcium profile and to assess the prevalence of osteporosis in patients with cushing’s disease.Materiels and Methods: Retrospective and descriptiv...

ea0090ep154 | Calcium and Bone | ECE2023

Bone mineral metabolism in young hemodialyzed women with prolonged amenorrhea

Kumar Manish , Hans Pankaj

Introduction: Since chronic renal failure is accompanied with bone abnormalities, the term renal osteodystrophy has become widely accepted. In women, chronic renal failure is commonly accompanied by endocrine problems that cause irregular menstruation. The majority of investigations on renal osteodystrophy, however, have not considered the potential impact of these hormonal imbalances on the etiology of the bone changes observed in these patients.Objecti...

ea0090ep155 | Calcium and Bone | ECE2023

A case with late-onset Ornithine Transcarbamylase Deficiency as a possible cause of osteoporosis

İlin Sena , Kuskonmaz Serife Mehlika , Koc Gonul , Fırat Sevde Nur , Omma Tulay , Culha Cavit

Introduction: Ornithine transcarbamylase deficiency (OTCD) is a urea cycle disorder that causes the accumulation of ammonia, which can lead to neurocognitive problems in patients1. Here we report a 21-year-old man who was diagnosed with OTCD during investigation for secondary osteoporosis.Case: The patient applied to the Endocrinology department complaining of widespread muscle-joint pain, shortening in height, nausea/vomiting attacks followed...

ea0090ep156 | Calcium and Bone | ECE2023

Abstract withdrawn...

ea0090ep157 | Calcium and Bone | ECE2023

The role of osteoprotegerin and sclerostin in bone metabolism in children with congenital adrenal hyperplasia

Karaguzel Gulay , Erkul Esra , Aliyazıcıoğlu Yuksel , Beyhun Ercument , Sonmez Bircan

Aim: Serum sclerostin levels as an indicator of bone resorption in children with congenital adrenal hyperplasia (CAH) have not been evaluated to date. The aim of this study was to determine the role of osteoprotegerin (OPG) and sclerostin in bone metabolism in children with CAH.Methods: Thirty-one patients (19 girls, 12 boys) with CAH (aged 11.6&pm;3.7 years) and 31 healthy children (age- and sex-matched) as controls were included in the study. The patie...

ea0090ep158 | Calcium and Bone | ECE2023

Evaluation of biochemical markers of bone metabolism in patients with secondary hyperparathyroidism and chronic kidney disease

Karlovich Natalia , Mokhort Tatsiana

The diagnostic possibilities of using biochemical markers of bone metabolism in patients with secondary hyperparathyroidism (SHPT) and chronic kidney disease (CKD) have not yet been adequately evaluated. The aim of the study: To evaluate biochemical markers of bone metabolism in patients with various stages of CKD, their relationship with SHPT and bone mineral density.Materials and Methods: The study included 452 patients with various stages of CKD and 6...

ea0090ep159 | Calcium and Bone | ECE2023

Atypical parathyroid adenomas and parathyroid carcinomas: Are there any differences?

Machuca Aguado Jesus , Rodriguez de Vera Gomez Pablo , Ocampo Pablo Ferreira , Domingo Alvaro Gutierrez , Idoate Gastearena Miguel Angel , Hernandez Tomas Martin

Introduction: Parathyroid carcinoma (PC) is a very rare neoplasm, which has histopathological features different from those of atypical parathyroid adenomas (APA). However, the clinical course of both tumour types is similar, with the exception of the unusual metastases of the carcinoma. With this study we aim to identify those clinical-analytical and anatomopathological variables that allow us to differentiate PCs from APAs.Material and Methods: Retrosp...

ea0090ep160 | Calcium and Bone | ECE2023

Primary hyperparathyroidism: A rare form of presentation

Lopes Marta Vaz , Rocha Jose Vicente , Peixe Carolina , de Grine Severino Mariana , Gomes Ana Coelho , Bugalho Maria Joao

Introduction: Primary hyperparathyroidism (PHPT) is characterized by parathyroid hormone (PTH) overproduction, causing hypercalcemia. The most common cause is a parathyroid adenoma. PHPT most frequently presents as asymptomatic hypercalcemia or with nonspecific symptoms. Less frequently, it presents with the classical manifestations of bone disease and nephrolithiasis. Acute pancreatitis (AP) as the initial manifestation of PHPT has been reported rarely. Hypercalcemia can caus...

ea0090ep161 | Calcium and Bone | ECE2023

Ectopic parathyroid adenoma of the upper jugulo-carotid region

Sellami Moncef , Sirine Ayadi , Salem Noura , Imen Zouche , Kacem Akid Faten Haj , Abid Mohamed , Charfeddine Ilhem

Introduction: Ectopic location of the parathyroid glands has been described in 10-15% of patients with hyperparathyroidism. Upper cervical localization is exceptional and may be missed by preoperative localization techniques. We report a rare case of parathyroid adenoma of the upper jugulo-carotid region.Observation: A 41-year-old woman with no notable pathological history presented diffuse osteoarticular pain. Physical examination showed a right superio...

ea0090ep162 | Calcium and Bone | ECE2023

Sialolithiasis revealing hyperaparthyroidism: A case report

Sellami Moncef , Chaabouni Mohamed Amine , Werda Majd , Kacem Akid Faten Haj , Abid Mohamed , Charfeddine Ilhem

Introduction: Primary hyperparathyroidism is associated with lithiasis, but this has been universally considered to refer to kidney lithiasis. Sialolithiasis as a comorbidity or result of primary hyperparathyroidism is uncommon. We report a rare case of submandibular lithiasis in a child and discuss the etiological assessment of this condition.Materials and Methods: We report a rare case of submandibular lithiasis in a child revealing primary hyperparath...

ea0090ep163 | Calcium and Bone | ECE2023

Evaluation of ultrasonography and 99mTc-sestamibi scintigraphy in the preoperative imaging study in Primary Hyperparathyroidism

Oleaga Amelia , Santamaria Alejandra , Goni Fernando , Moreno Cristina , Izuzquiza Ana , Espiga Javier , Arosa Vanessa , Monzon Andoni , Rodriguez-Soto Miren Josune , Izquierdo Jon , Iglesias Natalia , Garai Jon , Calles Laura , Hernando Inigo , Lizarraga Aitzol , Ugarte Estibaliz , Paja Miguel

Introduction: Minimally invasive surgery has become the standard surgical procedure in Primary Hyperparathyroidism (PHP). Targeted parathyroidectomy is associated with a shorter operative duration, a lower risk of complications and a greater patient satisfaction. This approach is dependent on precise localization of the abnormal gland. 99mTc-sestamibi scintigraphy and ultrasonography are acceptable imaging modalities to detect parathyroid adenoma prior to operation but discrep...

ea0090ep164 | Calcium and Bone | ECE2023

Effect of calcium and vitamine D supplementation on parathyroid glands function after total thyroidectomy

Chaabouni Mohamed Amin , Kallel Souha , Trigui Majdi , Haj Kacem Akid Faten , Frikha Hamdi , Abid Mohamed , Charfeddine Ilhem

Aim: The purposes of our study are to study the effect of systematic calcium and vitamin D supplementation on parathyroid glands function after total thyroidectomy.Patients and Methods: We conducted a prospective cohort study, including patients undergoing total thyroidectomy. Patients were randomly divided into two groups: group 1: with prophylactic supplementation (24 patients) and group 2: without prophylactic supplementation (23 patients). For each p...

ea0090ep165 | Calcium and Bone | ECE2023

PFI and WI before and after loading with vitamin D in vitamin D deficient patients

Polymeris Antonis , Psachna Stavroula , Ioannidis Dimitrios , Lilis Dimitrios , Drakou Maria , Papapetrou Peter

Aim: To evaluate the change in PFI (Parathyroid Function Index) and WI (Wisconsin Index) after loading with vitamin D in patients with vitamin D deficiency.Patients and Methods: In 41 vitamin D deficient patients (25(OH)2D<17.16&pm;6.07 ng/ml, mean&pm;SD) the PFI (PTHxCa devided by P) and the WI (PTHxCa) were evaluated before and after 3 month loading with Vitamin D 50.000 IU per week for the first 6 weeks and 25.000 IU per week for the ne...

ea0090ep166 | Calcium and Bone | ECE2023

Giant parathyroid adenoma: Report of two cases

Jihene Houas , Heyfa BelHadj Miled , Monia Ghammam , taissir Ben Arfi , Malika El Omri , Mouna Bellakhdher , Yosra Hasni El Abed , Abir Meherzi , Wassim Kermani , Mohamed Abdelkefi

Introduction: Primary hyperparathyroidism is a common disease. It is generally caused by a solitary parathyroid adenoma. Adenomas weighing more than 3.5 g are classified as giant. These giant parathyroid adenomas constitute a rare clinical entity.Patients and Methods: We report two cases of giant parathyroid adenoma observed in our department of otorhinolaryngology and cervicofacial surgery.Results: Case 1: A 54-ye...

ea0090ep167 | Calcium and Bone | ECE2023

Cholecalciferol supplementation effect on vitamin D metabolism parameters in hospitalized covid-19 patients

Mikhailova Arina , Lagutina Daria , Golovatuk Ksenia , Chernikova Alena , Vasilieva Elena Yu. , Karonova Tatiana

Background: Recent studies demonstrated clinical benefits of cholecalciferol supplementation among COVID-19 hospitalized patients. However, features of vitamin D metabolism in the acute phase of SARS-CoV-2 infection remain unclear.Aim: to estimate the level of 25(OH)D and 1,25(OH)2D as well as oral bolus cholecalciferol supplementation effect on the dynamic of vitamin D metabolites in hospitalized COVID-19 patients.Materials and Me...

ea0090ep168 | Calcium and Bone | ECE2023

Menses-associated decline of serum calcium in hypoparathyroid women

Mirnaya Svetlana

Some hypoparathyroid women report the appearance or intensification of hypocalcemia symptoms at the time of menses. It is still unknown whether this is the result of premenstrual syndrome or fluctuations in serum calcium levels. Studies have not found a relationship between fluctuations in levels of sex hormones and serum calcium and phosphorus and it appears probable that they affect neuromuscular excitability through a separate mechanism. Alterations in serum calcium levels ...

ea0090ep169 | Calcium and Bone | ECE2023

Deep vein thrombosis revealing primary hyperparathyroidism

Abid Arige , Oueslati Ibtissem , Bouzidi Mayssa , Yazidi Meriem , Lamloum Mounir , Chihaoui Melika

Introduction: Primary hyperparathyroidism is a common endocrine disease. Its association with inflammatory and thrombotic events was rarely reported in the literature. The pathophysiological mechanisms of this association remain uncertain. Herein, we report a case of hypercalcemia secondary to primary hyperparathyroidism revealed by a deep vein thrombosis.Observation: A 65-year-old patient was referred to our department for primary hyperparathyroidism. T...

ea0090ep170 | Calcium and Bone | ECE2023

Brown tumors complicating hyperparathyroidism

Asfour Mustapha , Nfad Antonio , Errahali Yassine , Chakdoufi Sanae , Issouani Jade , Guerboub Ahmed Anas

Introduction: Brown tumor or osteitis fibrocystica is a benign bone lesion reflecting an abnormality of bone metabolism in the context of hyperparathyroidism. It can affect the entire skeleton, including the pelvis, ribs, clavicles and extremities. Involvement of the maxillary bone is very uncommon. We present a case of multiple brown tumors with an unusual maxillo-mandibular localization, revealed by a disorder of phosphocalcic metabolism and tertiary hyperparathyroidism. Thi...

ea0090ep171 | Calcium and Bone | ECE2023

Approach to a Mediastinal Parathyroid adenoma: A case report

Sonmez Omer , Beydağı Gamze , Akcay Kaan , Selcuk Nalan Alan

Ectopic mediastinal parathyroid adenoma is a rare cause of primary hyperparathyroidism (PHPT), which is reported in 1-1.5% of patients. We present you a case of a 22-year old male, who was suffering from severe itchiness which significantly interferes with his daily activities of life. His laboratory results were suggestive of PHPT (Table 1). His initial scans, including Technetium-99m (Tc-99m) Sestamibi (Mibi) did not reveal any abnormality. Subsequently, increase of PTH leve...

ea0090ep172 | Calcium and Bone | ECE2023

Epidemiological characteristics of cardiovascular diseases in primary hyperparathyroidism according to the Russian Registry

Dobreva Ekaterina , Eremkina Anna , Gorbacheva Anna , Bibik Ekaterina , Kovaleva Elena , Gins Nikolay , Mokrysheva Natalia

Objective: Primary hyperparathyroidism (PHPT) is associated with a higher incidence of different cardiovascular diseases (CVD), but the prevalence of CVD in PHPT remains unclear.Aim: To evaluate the prevalence of CVD in PHPT according to the RussianPHPT Registry.Materials and Methods: The Registry includes a database of patients with PHPT available at the Endocrinology Research Centre (Moscow) since 2007, which was transferred to t...

ea0090ep173 | Calcium and Bone | ECE2023

The effect of Immune Checkpoint Inhibitors (ICIs) in Bone Metabolism: A case series analysis

Siampanopoulou Vasiliki , Angelousi Anna , Karampela Athina , Papalexis Petros , Lafioniatis Alexandros , Mytareli Chrysoula , Ziogas Dimitrios , Gogas Helen , Kassi Evanthia

Background: Immune checkpoint inhibitors (ICIs) constitutes a novel treatment for patients with melanoma. Endocrine-related adverse effects are now a distinctive clinical entity of ICIs, with hypophysitis and thyroiditis being the most common. Recent consensus doesn’t suggest routinely screening of bone mass indexes in patients on ICIs since data in the literature are scarce.Methods: Data regarding bone disease were retrospectively analysed in 118 p...

ea0090ep174 | Calcium and Bone | ECE2023

Predictive factors of Hungry Bone Syndrome after surgical management of Primary Hyperparathyroidism

El Amel Rania , Zarraa Lamiae , Berrabeh Soumiya , Laalaoua Yousra , Rouf Siham , Latrech Hanane

Introduction: Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Hungry bone syndrome (HBS) is one of the complications that can occur after parathyroidectomy, and that can cause severe and prolonged hypocalcemia. The aim of this study was to determine the risk factors for HBS in patients who underwent parathyroidectomy for PHP.Patients and Methods: This is a retrospective descriptive and analyti...

ea0090ep175 | Calcium and Bone | ECE2023

Electronic health record with decision support as a tool to improve quality of care for women with postmenopausal osteoporosis

Derevyanko Olga , Rumyantseva Tatiana , Balashov Alexandr , Fomin Dmitry

Background and Aims: Awareness and knowledge about any disease is the first step to prevent and treat it. Osteoporosis is a worldwide health problem. Osteoporosis is characterized by decreased normal bone density. More than 8.9 million fractures worldwide annually are caused by osteoporosis; these fractures are a significant cause of morbidity and mortality. Evidence suggests that the modification of several lifestyle habits, diagnostics, prevention and treatment could assist ...

ea0090ep176 | Calcium and Bone | ECE2023

Hypophosphatasia: recurrent fractures and a suppressed alkaline phosphatase level - can we make the connection?

Shah Najeeb , Thow Jonathan

Case: A 66-year-old female was referred to the Endocrinology clinic for suspected osteoporosis after a right femoral shaft fracture. As the site was atypical and the injury was low energy, a pathological fracture was suspected. There was a history of recurrent fractures sustained after the age of 30 years and were either spontaneous or from low-energy impacts (Table 1). Growing up, she was told that “there was something wrong with her bones” and required regular phys...

ea0090ep177 | Calcium and Bone | ECE2023

Maxillary brown tumor revealing primary hyperparathyroidism: A case report

Besrour Chayma , Ben Nacef Ibtissem , Mekni Sabrine , Essayeh Sawsen , Mchirgui Nadia , Rojbi Imen , Khiari Karima

Introduction: Primary hyperparathyroidism is an asymptomatic endocrine disorder in 80% of the cases. The bone manifestation represents the late stage of the disease and the brown tumor represents an exceptional and rare lesion.Observation: We report the case of a 73-year-old patient, with a medical history of type 2 diabetes, followed in the oto-rhino-laryngology department for a gingival tumor. A biopsy was performed and the anatomopathological examinat...

ea0090ep178 | Calcium and Bone | ECE2023

Development of parathyroid adenoma suggesting tertiary hyperparathyroidism in a patient with a renal transplant history

Stofas Anastasios , Patereli Amalia

Introduction: Tertiary hyperparathyroidism (THPT) is not uncommon in patients with secondary hyperparathyroidism after successful renal transplantation. It occurs up to 25% of these patients one year after transplantation despite renal function improvement. It can be developed due to the autonomous function of at least one parathyroid gland and leads to overproduction of parathyroid hormone (PTH). Tertiary hyperparathyroidism mostly reveals diffuse or nodular pattern of chief ...

ea0090ep179 | Calcium and Bone | ECE2023

Primary hyperparathyroidism by an ectopic mediastinal subpericardial parathyroid adenoma

Amel Rahal

Introduction: Primary hyperparathyroidism is frequent; it can be ectopic in 11 to 25% of cases, the mediastinal position is the most frequent ectopic position, but the intrapericardial position is exceptional.Clinical Case: A 58 year old woman with primary hyperparathyroidism complicated by severe osteoporosis. The CT scan and parathyroid scintigraphy reveals a 17 mm parathyroid adenoma in the mediastinal aortopulmonary position. After a first thoracic s...

ea0090ep180 | Calcium and Bone | ECE2023

Vitamin D in Primary Hyperparathyroidism: status and its effects on Primary Hyperparathyroidism

El Amel Rania , Laalaoua Yousra , Berrabeh Soumiya , Zarraa Lamiae , Rachedi Hanae , Rouf Siham , Latrech Hanane

Introduction: Low levels of vitamin D are commonly seen in patients with primary hyperparathyroidism (PHP). The aim of this study was to determine the vitamin D status and to evaluate its relation with primary hyperparathyroidism severity.Patients and Methods: This is a retrospective descriptive study including 48 patients with primary hyperparathyroidism followed-up in the Endocrinology-Diabetology and Nutrition Department of the University Hospital Cen...

ea0090ep181 | Calcium and Bone | ECE2023

Late-onset hypoparathyroidism following total thyroidectomy

Mashadi Ayesha , Soong Elaine , Myint Khin Swe

Background: Post-operative hypoparathyroidism is a known complication of total thyroidectomy. It can either be transient or long-term requiring lifelong treatment. Delayed presentation of hypoparathyroidism occurring after several years of surgery is rare, with only a few cases reported in literature but can be life-threatening.Presentation: We report a case of a 70-year-old female presenting with features of hypocalcaemia (tinnitus and tingling in her f...

ea0090ep182 | Calcium and Bone | ECE2023

Brown tumors in patients with secondary and tertiary hyperparathyroidism

Masmoudi Mohamed , Zitouni Chaima , Thabet Wadii , Chebil Ezer , Hasnaoui Mehdi , Mighri Khelifa

Introduction: Brown tumors result from the destruction of bone occurring especially in regions where bone resorption is rapid with hemorrhage and repa-rative granulation tissue replacing the normal tissue. This bone lesion can affect any part of the skeleton. It results from uncontrolled hyperparathyroidism in patients with chronic renal failure.Objective: The aim of this report is to describe the management and the evolution after treatment of brown tum...

ea0090ep183 | Calcium and Bone | ECE2023

Severe hypocalcemia during respiratory alkalosis reveals a case of Pseudohipoparathyroidism type 1B

Roque Catarina , Fonseca Ricardo , Osorio Ana Sofia , Oliveira Sofia , Machado Catarina

We present a case of Inactivating PTH/PTHrP signalling disorder (IPPSD) revealed in aduthood in the context of respiratory alkalosis caused by covid-19 infection that led to worsening of the preexisting hypocalcemia and intensification of the usual hypocalcemic symptoms. A 39 year old female with history of subclinical hypothyroidism and bilateral cataracts was admited due to hypoxemia in the context of severe covid-19 infection with bilateral pulmonary infiltrates. She was vi...

ea0090ep184 | Calcium and Bone | ECE2023

A case of a giant parathyroid adenoma associated with a secondary hyperparathyroidism in a hemodialysis patient

Jihene Houas , Heyfa BelHadj Miled , Monia Ghammam , Jawaher Kechiche , Malika El Omri , Mouna Bellakhdher , Yosra Hasni El Abed , Abir Meherzi , Wassim Kermani , Mohamed Abdelkefi

Introduction: Secondary and tertiary hyperparathyroidism (HPT) usually result from parathyroid gland hyperplasia that produces excess parathyroid hormone (PTH). Collectively, secondary and tertiary HPT comprise a minority of the patients diagnosed with HPT. Due to the relative rarity of these conditions and common underlying disease pathology, they are frequently discussed and researched together. While the disease processes are related, secondary and tertiary HPT are two dist...

ea0090ep185 | Calcium and Bone | ECE2023

Comparison of biochemical values in asymptomatic and symptomatic urolithiasis

Ince Nurcan , Turan Kubra , Baser Husniye , Seyrek Neslihan Cuhacı , Ozdemir Didem , Topaloglu Oya , Ersoy Reyhan , Cakir Bekir

Background: Primary Hyperparathyroidism (PHPT) is a common endocrine disorder that is characterized by hypercalcaemia and elevated or inappropriately normal serum levels of parathyroid hormone. Most often, the presentation of PHPT is asymptomatic. PHPT can manifest with osteoporosis and hypercalciuria as well as with vertebral fractures and nephrolithiasis, both of which can be asymptomatic. Our aim in this study; to determine the frequency of kidney stones in patients operate...

ea0090ep186 | Calcium and Bone | ECE2023

A rare etiology of primary hyperparathyroidism

Jihene Houas , Emna Bergaoui , Monia Ghammam , Maroua Naouar , Malika El Omri , Mouna Bellakhdher , Yosra Hasni El Abed , Abir Meherzi , Wassim Kermani , Mohamed Abdelkefi

Introduction: Parathyroid cysts are a rare clinical and histological entity, with less than 300 cases reported in the literature. They constitute 0.5% of all parathyroid pathologies and 1% of all cystic lesions in the cervical region. Parathyroid cysts can give rise to a varied symptomatology by the local or hormonal repercussions.Case: We report the case of a 65-year-old patient with no pathological history who presented for bone pain with functional im...

ea0090ep187 | Calcium and Bone | ECE2023

Hyperparathyroidism Jaw Tumour Syndrome in Pregnancy: A rare coexistence

Lopes Sofia , Monsanto Alice , Ferreira Mafalda , Ventura Mara , Ruas Luisa , Oliveira Patricia , Paiva Isabel

Introduction: Only <1% of cases of primary hyperparathyroidism (PHPT) occur during pregnancy. PHPT increases risk of complications such as miscarriage, premature birth and life-threatening maternal hypercalcemic crises. Hyperparathyroidism Jaw Tumor Syndrome (HPT-JT) is a rare inherited cause of PHPT, resulting from CDC73 gene mutations. There are a few reports described about HPT-JT in pregnancy. Although parathyroidectomy is the definite treatment for PHPT, given the sca...

ea0090ep188 | Calcium and Bone | ECE2023

22q11.2 deletion syndrome diagnosed in the context of a seizure in adulthood

de Brito Marques Francisca , Simoes de Carvalho Francisco , Ferreira Joana Lima

Introduction: The 22q11.2 deletion syndrome or DiGeorge syndrome (DGS) is rare and the diagnosis in adults is uncommon. The phenotype is highly heterogeneous and of variable severity, including hypoparathyroidism and epilepsy.Case Report: A 26-year-old man was admitted in the emergency room for inaugural tonic-clonic seizure. He had history of cognitive impairment and learning difficulties. Neurologic examination, brain CT and basic analysis were irrelev...

ea0090ep189 | Calcium and Bone | ECE2023

Multiple brown tumors mistaken for bone metastases: Bone scintigraphy and 99m-Tc sestamibi imaging findings

Nasr Maali Ben , El Ajmi Wassim , Sellem Ali , Hammami Hatem

Introduction: Brown tumors or osteitis fibrosa cystica are benign bone tumors complicating uncontrolled primary or secondary hyperparathyroidism. They may behave aggressively and can be destructive. Their osteolytic aspect may be misinterpreted as skeletal metastases.Methods: A 37-year-old female patient with chronic renal failure on dialysis, presented with pain and swelling of her left knee for 10 days, with no associated trauma. She gave history of tu...

ea0090ep190 | Calcium and Bone | ECE2023

Denosumab in the treatment of fracturary osteoporosis: the double effect on bone and glycemic metabolism

Cosme Ines , Nobre Ema , Barbosa Ana Paula

Background: Denosumab (Dmab) is a human monoclonal antibody with an anti-reabsorptive bone effect, used in osteoporosis treatment. It is also suggested that Dmab may improve glucose tolerance through the reduction of hepatic insulin resistance. Some studies have suggested that insulin sensitivity and glycemia can influence bone metabolism.Aims: To evaluate the relationship between bone turnover markers (BTM) and insulin resistance and glycemia in fractur...

ea0090ep191 | Calcium and Bone | ECE2023

Severe calcific uremic arteriolopathy lessions and acute hypocalcemia after parathyroidectomy for secondary hyperparathyroidism in haemodialysis patients: Case series

Hristov Ioana , Elena Aciobanitei , Radu Danila

Introduction: Calcific Uremic Arteriolopathy (CUA) is a rare but severe complication of end-stage kidney disease with one year survival rates between 45-55%. Extensive skin ulcers and concomitant painful purpura are the clinical features and diagnosis criteria as defined by Hayashi. Parathyroidectomy treatment for hyperparatiroidism is reserved for patients with inadequate response to calcimimetics, persistent elevated PTH>800 pg/ml or calciphylaxis and it has been shown t...

ea0090ep192 | Calcium and Bone | ECE2023

Features of diagnosis and management of parathyroid cysts

Aleksandrov Yuriy , Dyakiv Artem , Patrunov Yury

The retrospective experience of diagnosis and treatment of 18 people with true parathyroid cysts was studied. Clinical features, ultrasound results, laboratory parameters, surgical aids and subsequent dynamics were studied. All patients were women aged 35 to 77 years. Parathyroid cysts had no clinical manifestations, hyperparathyroidism and compression syndrome were absent. All parathyroid cysts were discovered accidentally during an ultrasound examination of the neck. Often t...

ea0090ep193 | Calcium and Bone | ECE2023

Parathyroid carcinoma: A case report

Maram Ben Salem , Chiboub Marwa , Hilel Wafa Ben , Jemel Manel , Kammoun Ines

Introduction: Parathyroid carcinoma is an uncommon cause of primary hyperparathyroidism. It is responsible of 0.4% to 5% of all cases of primary hyperparathyroidism. Parathyroid carcinoma has a high probability of local recurrence, regional node and distant metastasis and the preoperative diagnosis is challenging.Case presentation: We report a case of a 66-year-old female patient with medical history of hypertension and chronic kidney failure. She was di...

ea0090ep194 | Calcium and Bone | ECE2023

Completely intra-thyroidal parathyroid adenoma: A rare entity

Baruah Manash , Roy Bubul C , Baruah Upasana M , Das Anup K , Bhuyan Ashok K , Patawari Pankaj

Introduction: Intra thyroidal parathyroid adenoma is an uncommon presentation of primary hyperparathyroidism (PHPT). Herein we report such a patient who had recurrent hypercalcemia after a classical parathyroid exploration.Case presentation: 45 year old female, home-maker had a long standing history of weakness, back and lower limb pain, loss of appetite. Preliminary evaluation at secondary care level revealed hypercalcemia (18.3 mg/dl) with high intact ...

ea0090ep195 | Calcium and Bone | ECE2023

Primary Hyperparathyroidism and colon cancer: Incidental association or causal link?

Echchad Lamya , Gorgi Khaoula , Rifai Kaoutar , Iraqi Hinde , Gharbi Mohamed El Hassan

Introduction: Hypercalcemia is often observed in patients with cancer, secondary to the production s of parathyroid hormone (PTH)-related peptides. However, the association of primary hyperparathyroidism (pHPT) and colon cancer is rarely reported.Case: We present the case of a 76 years old female patient, who was operated one year ago of for a low-grade colorectal adenocarcinoma. As part of her routine workup of her disease she underwent a phosphocalcic ...

ea0090ep196 | Calcium and Bone | ECE2023

Depot medroxyprogesterone acetate (DMPA)-associated early-onset osteoporotic fracture with ALPL gene mutation: Challenges and Limitations in the era of molecular diagnostics

Thewjitcharoen Yotsapon , Nakasatien Soontaree , Krittiyawong Sirinate , Veerasomboonsin Veekij , Himathongkam Thep

Background: Recent advances in next-generation sequencing technology have greatly increased the number of Variants of Uncertain Significance (VUS) encountered in clinical practice. Herein, we present difficulty in diagnostic path and challenges in a premenopausal woman with an unusual fracture history and osteoporosis.Clinical Case: A 37-year-old Thai woman with no known underlying disease was diagnosed with osteoporosis (a BMD Z-score of -2.6 a...

ea0090ep197 | Calcium and Bone | ECE2023

Body mass index as predictor of bone mineral density in postmenopausal women

Popovic Pejicic Snjezana , Pejicic Nina , Malesevic Gabrijela , Stankovic Valentina Soldat

Introduction: In order to detect the subjects at risk for osteoporotic fractures, one should actively search for them, primarily in a group of postmenopausal women, considering clinical risk factors. Body mass index (BMI) is a well-known, significant predictor of bone mineral density (BMD) of entire skeleton.Aim: The aim of this study was to examine relationship between BMI and BMD in a group of postmenopausal women.Methods: The st...

ea0090ep198 | Calcium and Bone | ECE2023

Porphyria presenting as osteoporosis

Hale Erbatur Nuriye , Koc Gonul , Kuskonmaz Serife Mehlika , Culha Cavit

Introduction: Secondary osteoporosis is defined as bone loss caused or exacerbated by other clinical disorders. Secondary osteoporosis can be due to a wide range of medical disorders, including endocrine disorders and genetic disorders. We are presenting a clinical case which the patient diagnosed as acute intermittent porphyria while being investigated for secondary osteoporosis.Clinical Case: 41-year-old female patient applied with bone and back pain, ...

ea0090ep199 | Calcium and Bone | ECE2023

Osteoporosis in a patient with Glycogen Storage Disease Type I

Iyidir Ozlem , Turer Tugce Ilayda , Atikcan Deniz

Glycogen storage disease type 1 is a rare autosomal recessive disorder. Osteoporosis is one of the long term complications. However factors associated with low bone mass has not fully understood. Metabolic derangements that occur with poor control may contribute to bone disease. Low bone mass could be caused by hypogonadtropic hypogonadism, a unique issue identified in GSD. Herein we report a patient with GSD type 1, osteoporosis and hypogonadotropic hypogonadism. A 20 years o...

ea0090ep200 | Calcium and Bone | ECE2023

Cortisone-induced osteoporosis: A dreaded complication of prolonged corticosteroid therapy

Soomauroo Siddiqa , Salah Raida Ben , Kacem Akid Faten Haj , Abid Mohamed , Bahloul Zouheir

Introduction: Cortisone-induced osteoporosis (CO) is the most frequent complication of corticosteroid therapy. It is the first cause of secondary osteoporosis. The aim of this study is to clarify the characteristics of CO.Patients and Methods: We report a retrospective study of 39 cases of CO among 128 cases of osteoporosis during a 15-year period. The diagnosis of CO was based on a bone densitometry (BMD) of more than -1.5 standard deviations.<p cla...

ea0090ep201 | Calcium and Bone | ECE2023

A Late Diagnosed Neurofibromatosis Case During Preoperative Evaluation For Scoliosis

Yazan Ceyda Dincer , Abbasgholizadeh Anna , Yavuz Dilek Gogas

Objective: Neurofibromatosis type 1 is an autosomal dominant inherited neurocutaneous condition characterized with multipl cafe-au-lait spots, neurofibromas, predisposition to malignancies, and the incidence of disease is 1:3000. Patients are diagnosed according to diagnostic criteria and 97% of the patents meet the criteria before 8 years of old. Diagnosis and follow-up of patients for manifestations of neurofibromatosis is important for early diagnosis and treatment of malig...

ea0090ep202 | Calcium and Bone | ECE2023

Gayet Wernicke’s encephalopathy: An exceptional complication of primary hyperparathyroidism

Elleuch Mouna , Soomauroo Siddiqa , Salah Dhouha Ben , Missaoui Abdel Mouhaymen , Maalej Souhir , Charfi Nadia , Hamza Fatma , Moalla Khadijah , Mnif Mouna , Mnif Fatma , Majdoub Nabila Rekik , Dammak Mariem , Guermazi Fadhel , Kacem Faten Hadj , Abid Mohamed

Introduction: Gayet Wernicke’s encephalopathy (GWE) is a severe encephalopathy secondary to acute thiamine (vitamin B1) deficiency which may lead to severe sequelae or death if the diagnosis is delayed. We report the first case in the literature of an association between GWE and primary hyperparathyroidism (PHP) in a man.Observation: He was a 57 years old man, with a personal history of hypertension and primary infertility, who presented with incoer...

ea0090ep203 | Calcium and Bone | ECE2023

Multiple Endocrine Neoplasia type 1: A case report

Besrour Chayma , Essayeh Sawsen , Mekni Sabrine , Rojbi Imen , Mchirgui Nadia , Ben Nacef Ibtissem , Khiari Karima

Introduction: Wermer syndrome or multiple endocrine neoplasia type 1 (MEN1) is a rare hereditary disease characterized by the presence of generally benign tumors of the endocrine glands.Observation: We report the case of a 68-year-old patient with a family history of a sister having a primary hyperaldosteronism and a personal history of primary hyperaldosteronism who was referred to our department for the exploration of asymptomatic hypercalcemia. The bi...

ea0090ep204 | Calcium and Bone | ECE2023

Atypical parathyroid adenomas, a challenging diagnosis and management - Case Report

Stan Raluca , Dumitrache Sabina , Zubaci Ana , Iliescu Marina , Tarna Mihaela , Grosu Iustina , Cima Luminita , Stefan Cristina , Giulea Cosmin , Fica Simona

Introduction: Primary hyperparathyroidism is typically caused by a parathyroid adenoma (80-85% of the cases). Very rare causes are represented by parathyroid carcinoma and atypical parathyroid adenoma (0.5-1.5% of the cases). Atypical parathyroid adenomas have atypical histological features, not sufficient to be considered a carcinoma, and have an uncertain malignant potential and risk of recurrence. We report the case of a 66-year-old man referred from another medical center ...

ea0090ep205 | Calcium and Bone | ECE2023

Hypercalcaemia as the first manifestation of lymph node tuberculosis

Amel Rahal

Introduction: Tuberculosis is a granulomatosis with systemic manifestations. Pulmonary involvement is usually in the foreground. Rarely, hypercalcaemia initiates the pathology. The incidence of hypercalcaemia in tuberculosis varies according to studies and regions between 2 and 25%, with the highest incidences in the most isolated countries and those with the highest calcium and vitamin D intakes.Clinical Case: This is the case of our patient known for b...

ea0090ep206 | Calcium and Bone | ECE2023

Severe PTH-dependent Hypercalcemia Secondary to Atypical Parathyroid Adenoma

Maia Ariana , Fonseca Liliana , Viveiros Ana Luisa , Neves Joao , Cardoso Helena

Introduction: Hypercalcemia is not uncommon in clinical practice and may present as a life-threatening emergency. Its main aetiologies are primary hyperparathyroidism (80% parathyroid adenomas; 20% multiglandular hyperplasia, <1% parathyroid carcinomas) and hypercalcemia of malignancy, with or without presence of bone metastases.Case Report: We present a case of a 77 years-old male, submitted to a subtotal gastrectomy at the age of 73 due to a perfor...

ea0090ep207 | Calcium and Bone | ECE2023

Primary hyperparathyroidism revealed by multiple brown tumors: A case report

Toulali Fatima , Farah Kamel , Gorgi Khaoula , Isselmo Diehah , Rifai Kaoutar , Hinde Iraqi , Gharbi Mohamedelhassan

Introduction: Primary hyperparathyroidism revealed by multiple brown tumors is rare. We report the case of a patient with primary hyperparathyroidism on parathyroid adenoma discovered in front of multiple brown tumors.Case Presentation: A 72-year-old female patient, who presented for 6 months a functional impotence of both lower limbs with paraparesis, associated with bone pain from where the realization of a phospho-calcium assessment returning in favor...

ea0090ep208 | Calcium and Bone | ECE2023

Post-surgical hypoparathyroidism with teriparatide treatment

Rodriguez Carla Rodriguez , Gonzalez Cristina Lorenzo , Mesa Elena Marquez

Post-surgical hypoparathyroidism occurs as inadvertent removal or irreversible damageparathyroid disease, irreversible or permanent causing decreased action of parathormone leading to hypocalcemia and hypophosphatemia.Clinical Case: A 52-year-old woman referred from our outpatient clinics due to severe hypocalcemia symptomatic; hand and foot cramps, and hyperphosphatemia: albumincorrected calcium. (5.52 mg/dl and phosphate of 6.6 mg/dl). She presents a h...

ea0090ep209 | Calcium and Bone | ECE2023

Hungry bone syndrome after Graves’ disease surgery in children

Amel Rahal

Although rare in children, Graves’ disease remains the major cause of hyperthyroidism. Positive diagnosis is easy, but management can be extremely problematic.Case Report: We report the case of a 13 year old female patient treated for Graves’ disease since 4 years; non compliant to treatment; after adjustment of therapy and achievement of euthyroidism; a surgical cure is programmed. 24 hours after surgery, severe hypocalcaemia appeared, requiri...

ea0090ep210 | Calcium and Bone | ECE2023

Primary hyperparathyroidism and papillary thyroid carcinoma: Incidental association or causal link?

Mohamed Ali Boutheina , Mohamed Moctar , Cheikh Mariem , Rifai Kaoutar , Hinde Iraqi , Gharbi Mohamedelhassan

Introduction: Primary hyperparathyroidism is a frequent pathology, its association with papillary thyroid carcinoma is rare.Case Report: A 53 year old patient was admitted for management of primary hyperparathyroidism. The biological work-up showed a blood calcium level of 120 mg/l, parathyroid hormone (PTH) 4 times the normal range and hypophosphatemia. Cervical ultrasound showed a right parathyroid nodule with thyroid nodules classified Tirads 4, MIBI ...

ea0090ep211 | Calcium and Bone | ECE2023

Parathyroid gland locations during surgery

Masmoudi Mohamed , Zitouni Chaima , Thabet Wadii , Chebil Ezer , Hasnaoui Mehdi , Mighri Khelifa

Introduction: Typically, there are 4 parathyroid glands in humans: 2 superior parathyroid glands usually located near the crico-thyroid joint, and 2 inferior parathyroid glands near the inferior pole of the thyroid gland. However they can be variable in number and location. Awareness of their potential location is crucial for the operating surgeon.Objective: The purpose of this study is to describe parathyroid gland locations found during surgery.<p ...

ea0090ep212 | Calcium and Bone | ECE2023

Severe proximal myopathy revealed a primary hyperparathyroidism: about a case and literature review

Katia Benabdelatif , Lachkhem Aicha , Yahi Abdelkader , Bouchenna Amira , Samia Ould Kablia

Introduction: Proximal myopathy presents as symmetrical weakness of proximal upper and/or lower limbs. There is a broad range of underlying causes including drugs, alcohol, endocrine and metabolic myopathies such as primary hyperparathyroidism.Observation: We describe a 48-year-old male, hospitalised in neurology departement for exploration of severe proximal myopathy. Cliniquely, he presented progressive debilitating muscle weakness, severe muscle wasti...

ea0090ep213 | Calcium and Bone | ECE2023

Autoimmune hypocalciuric hypercalcaemia: A diagnostic dilemma

Omer Tahir , Suareldahab Ibrahim , Hamed Rama

Introduction: Hypercalcaemia is a relatively common medical condition affecting around 1% of the general population. Around 90% of the cases are due to either primary hyperparathyroidism (PHPT) or malignancy. Familial hypocalciuric hypercalcaemia (fHH) is a rare autosomal dominant condition that can result in hypercalcaemia. It has an estimated prevalence of1 in 78 000. In most of the cases, fHH is due to a mutation in the calcium-sensing receptor gene (CaSR). Other rare cases...

ea0090ep214 | Calcium and Bone | ECE2023

The difficult diagnostic of cystic adenomas of the parathyroid gland

Cemerkaite Aiste , Lizdeniene Vita

Context: Cystic adenomas of the parathyroid gland are relatively rare, with an estimated incidence of 0.3-1.5% of all parathyroid tumors. These tumors are benign and typically present as a single cyst or multiple small cysts within a solid nodule. Due to their rarity and nonspecific imaging features it may be challenging to diagnose preoperatively. However, the diagnosis is confirmed by fine-needle aspiration (FNA) biopsy and pathological examination of the tissue obtained by ...

ea0090ep215 | Calcium and Bone | ECE2023

Short-term treatment with 2000IU of cholecalciferol in patients with secondary hyperparathyroidism due to vitamin d insufficiency

Angelopoulos Nikolaos , Boniakos Anastasios , Karras Spyridon , Paparodis Rodis , Livadas Sarantis

Introduction: Conventional treatment of secondary hyperparathyroidism (SHP) requires supplementation of vitamin d analogues combined with calcium however several studies have reported concerns regarding the safety of calcium supplements particularly in the long term. If vitamin d without concomitant calcium supplementation is sufficient to prompt a fall in the parathyroid hormone (PTH) is still not known with certainty. The purpose of our study was to investigate if vitamin d ...

ea0090ep216 | Calcium and Bone | ECE2023

Brown tumor revealing primary hyperparathyroidism

Alami Hassani Chaymaa , Lahousssaine Abainou , Idrissi Ayoub , Elhadri Sanae , Meftah Azzelarab , Baizri Hicham

Introduction: Hyperparathyroidism is a frequent endocrinopathy, often diagnosed in the stage of asymptomatic hypercalcemia. The revelation by a bone or renal complication has become increasingly rare dominated by osteoporosis and brown tumors giving a blown aspect of the cortices exposing to pathological fractures. We report 2 cases of primary hyperparathyroidism revealed by a brown tumor and pathological fracture.Observation 1: This is a 52 year old fem...

ea0090ep217 | Calcium and Bone | ECE2023

Hypocalcemia in a term neonate of a mother with gestational diabetes: A case report

Gorgi Khaoula , Tadlaoui Abderrahmane , Chakdoufi Sanae , Errahali Yassine , Guerboub Ahmed Anas

Introduction: Maternal diabetes is described as a risk factor for neonatal hypocalcemia along with maternal vitamin D deficiency or maternal hyperparathyroidism. The frequency of hypocalcemia in a diabetic mother is 20 and 60%, but low in gestational diabetes (GD).Observation: A 38 year old female patient, with a pregnancy estimated of 35 weeks of gestation, was referred to our department for the management of her gestational diabetes, her cycle was very...

ea0090ep218 | Calcium and Bone | ECE2023

Hypercalcemia and confusional syndrome: A case report

Gorgi Khaoula , Abdilahi Mohamed Hamid , Tadlaoui Abderrahman , Errahali Yassine , Guerboub Ahmed Anas

Introduction: Severe hypercalcemia is an uncommon but potentially life-threatening condition. Calcium plays a variety of roles and explains the impact of hypercalcemia on the functioning of different organs. We report the case of a patient with severe hypercalcemia revealed by a confusional syndrome.Observation: A 60 year old male patient, with a medical history of hypertension under treatment, presented a confusional syndrome of progressive onset which ...

ea0090ep219 | Calcium and Bone | ECE2023

Super bone scan: metabolic or secondary origin: Discussion around a clinical case

Boubagura Imane , Hassan Neima , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: – The "super bone scan" is a peculiar condition characterized by extremely high bone uptake compared to soft tissue, with no visualization of renal radioactivity.– Super bone scan has been described in relation to several conditions such as metastatic disease (prostate/breast cancer), metabolic bone disease (Paget’s disease/hyperparathyroidism) and myeloproliferative disorders.Clinical Case: – A 75 year old man, ...

ea0090ep220 | Calcium and Bone | ECE2023

A rare cause of hypocalcaemia: The clues were in the biochemistry

Chopra Tanya , Haddad Aiman , Hyams Elizabeth , Joshi Shivani , Mitchell Catherine , Rahman Mushtaqur

Introduction: Pseudohypoparathyroidism (PHP) is a rare cause of hypocalcaemia due to parathyroid hormone (PTH) resistance in the proximal renal tubules. In contrast to PHP type 1A, PHP type 1B is characterised by the absence of the characteristic skeletal abnormalities and is transmitted in an autosomal dominant manner, but in the maternal line. Patients may have resistance to the action of other G-protein signaling hormones, like thyroid stimulating hormone (TSH).<p class...

ea0090ep221 | Calcium and Bone | ECE2023

Our experience with the treatment of pseudohypoparathyroidism

Pavaiova Anna , Pavai Dušan , Vanuga Peter

Pseudohypoparathyroidism (PHP) is a group of rare hereditary diseases caused by tissue resistance to parathyroid hormone (PTH), there are two main types I and II. Type I is divided into subtypes. The authors present a case of PHP Ib, with hypocalcemia (level of total calcium 1.41 mmol/l), accidentally detected at childbirth. After the unsuccessful treatment of hypocalcemia, the etiology was considered, but the confirmation of the diagnosis were not adequately tightened. Due to...

ea0090ep222 | Calcium and Bone | ECE2023

Femoral fracture revealing primary hyperparathyroidism in a very young patient and multiple lytic bone lesions: A case report

El Hafiani Asmae , Gharbi Mohamedelhassan , Hinde Iraqi , Kaoutar Rifai , Fatima Toulali , Hamza Elqandili

Introduction: Primary hyperparathyroidism is the most common endocrinopathy after diabetes and thyroid diseases. Most often, the diagnosis is made at the asymptomatic stage due to the frequent phosphocalcic assessment objectifying hypercalcemia. Much more rarely, primary hyperparathyroidism is diagnosed at the stage of digestive, renal or bone complications. We report the case of a young patient with a femoral fracture that revealed primary hyperparathyroidism.<p class="ab...

ea0090ep223 | Calcium and Bone | ECE2023

Osteoporosis secondary to diabetes mellitus

Soomauroo Siddiqa , Salah Raida Ben , Akid Faten Haj Kacem , Abid Mohamed , Bahloul Zouheir

Introduction: Osteoporosis is a generalized skeletal disease that combines a decrease in bone density with changes in bone microarchitecture. The bone is abnormally fragile and therefore the risk of fracture is high. We report the case of osteoporosis in a young woman secondary to type 1 diabetes mellitus (T1DM).Case Report: Patient A.M, 26 years old, with a history of polyglandular autoimmune syndrome type 3 since the age of 12, associating T1DM and Has...