Endocrine Abstracts

Paget’s disease of bone is the second most common metabolic bone disease after osteoporosis. It is a condition characterised by abnormal bone cellular activity resulting in the formation of disorganised (and weaker) bone. Paget’s disease can affect single or multiple bones. In many cases it may be asymptomatic, however it can often be associated with pain affecting the pagetic bone or there may be ‘peri-pagetic’ pain related to altered biomechanics due to c...

A 30 year old woman presented with two year history of right lower leg pain. The pain was constant, worse in cold weather, not worsened by weight bearing and occasionally woke her from sleep. On examination she was tender on palpation of mid distal right tibia. X ray showed sclerotic portions of right tibia and fibula. MR lower right leg demonstrated extensive area of intramedullary bone marrow oedema in the distal half of the right tibia with associated cortical thickening an...

A 77 year old female was referred to endocrinology with an incidental finding of hypophosphataemia (0.26 mmol/l) on routine bloods. She described a slight unsteadiness on her feet, but denied bone pain or overt muscle weakness. Past medical history included Type 2 Diabetes Mellitus, a left humeral fragility fracture and the subsequent diagnosis of osteoporosis 2 years previously. At presentation the corrected calcium was slightly elevated (2.64 mmol/l), which normalised when r...

Introduction: Primary hyperparathyroidism (PHPT) affects 0.3% of the population. It is characterised by hypercalcaemia with an inappropriately high parathyroid hormone level. The majority of patients with primary hyperparathyroidism are asymptomatic and are diagnosed following an incidental finding of hypercalcaemia. Symptomatic disease is related to hypercalcaemia and can present with complications such as renal calculi and osteoporosis. Parathyroidectomy is the treatment of ...

Introduction: Denosumab is a human monoclonal antibody against the receptor activator of nuclear factor-kB ligand, to reduce bone resorption by limiting maturation of osteoclasts. It has been approved for use in Scotland in patients with a bone mineral density (BMD) T-score of between −4 to 2.5 who are unable to take bisphosphonates. We aimed to analyze the effects of denosumab on BMD and fracture rate in a cohort of patients who have completed a 3-year cycle of...

Introduction: BONJ is a recognised complication of bisphosphonate treatment (both oral and intravenous). Data are sparse with the reported incidence of BONJ in the oral treatment of osteoporosis between 0.01% to 0.067% or alternatively described as 1.04 to 69 per 100,000 patient-years. This study aimed to estimate the incidence of BONJ in patients taking oral bisphosphonates as a treatment for osteoporosis.Methods: Forth Valley Hea...

Introduction: Denosumab is a human monoclonal antibody against the receptor activator of nuclear factor-kB ligand, to reduce bone resorption by limiting maturation of osteoclasts. It has been approved for use in Scotland in patients with a bone mineral density (BMD) T-score of between −4 to 2.5 who are unable to take bisphosphonates. We aimed to analyze the effects of denosumab on BMD and fracture rate in a cohort of patients who have completed a 3-year cycle of...

Introduction: BONJ is a recognised complication of bisphosphonate treatment (both oral and intravenous). Data are sparse with the reported incidence of BONJ in the oral treatment of osteoporosis between 0.01% to 0.067% or alternatively described as 1.04 to 69 per 100,000 patient-years. This study aimed to estimate the incidence of BONJ in patients taking oral bisphosphonates as a treatment for osteoporosis.Methods: Forth Valley Hea...

Introduction: Hypophosphatasia (HPP) is a very rare systemic musculoskeletal disease characterised by low tissue non-specific alkaline phosphatase (ALP). The prevalence of HPP and its associated morbidity in an adult setting is unclear.Methods: A search for serum ALP results less than 36 IU/l within NHS Greater Glasgow and Clyde between 2017 and 2018 revealed 16 280 results. A further search for patients with two ALP <36 separated by 30 days or more ...

Objective: Denosumab is a highly specific MAB, which binds to RANK Ligand thus inhibiting osteoclast formation, function and survival1.It’s efficacy in the treatment of osteoporosis was demonstrated in the FREEDOM trial which was an international, randomised, placebo controlled trial involving 7686 post menopausal women. The trial demonstrated a reduction in risk for vertebral fractures (68%), non vertebral fractures (20%), and hip fractu...