Endocrine Abstracts

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...

Familial Benign Hypocalciuric Hypercalcaemia (FBHH) is a benign autosomal dominant condition characterised by elevated serum calcium and parathyroid hormone (PTH) and low urine calcium. It is a genetically heterogeneous disorder but the majority of cases (type 1 FBHH) can be shown to be due inactivating mutations in the Calcium Sensing Receptor (CASR). This is a guanine nucleotide-binding-protein (G-protein) coupled receptor that signals through the G-protein subunit α11 ...

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 ...

A 29-year-old man of South Asian descent presented with pancreatitis. Adjusted calcium was 3.10 mmol/l and PTH 9.8 μmol/l. Of note was that his parents were first cousins, and a cousin had undergone parathyroidectomy for hypercalcaemia.Pituitary, adrenal and thyroid function, calcitonin, prolactin, phosphate, magnesium, alkaline phosphatase and urinary catecholamines were all normal. 25-Hydroxyvitamin D was 20 nmol/l (15–100) The patient was th...

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...

A 54-year old female presented with fluctuating consciousness and seizures 4-weeks after gastric sleeve surgery. On admission blood glucose was 1.1 mmol/l, GCS was 10 and she was tachycardic. Examination was otherwise unremarkable. Her GCS improved after Glucagon and Glucogel. She described episodes of disorientation, slurred speech, fatigue and dysthesia since her surgery. These occurred particularly in the morning and her symptoms impro...

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...

A 54-year old female presented with fluctuating consciousness and seizures 4-weeks after gastric sleeve surgery. On admission blood glucose was 1.1 mmol/l, GCS was 10 and she was tachycardic. Examination was otherwise unremarkable. Her GCS improved after Glucagon and Glucogel. She described episodes of disorientation, slurred speech, fatigue and dysthesia since her surgery. These occurred particularly in the morning and her symptoms impro...