Endocrine Abstracts

Calcium and phosphorus represent the main building material for bone stiffness. The supplier of these bone minerals is the hormone calcitriol, which originates from vitamin D, itself made by sunshine in human skin. Requirement for bone mineral supply is highest during phases of rapid growth, such as in the foetus, infant and pubertal child, making them particularly vulnerable.Deprivation of calcium, whether through low dietary calcium intake and/or low v...

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Osteoporosis in children is not just BMD and bisphosphonates. Children are unique in their ability to grow and repair bone tissue. Diagnostics, management and the spectrum of osteoporotic conditions encountered in children are different from adults. Children can have primary osteoporosis which are rare diseases like osteogenesis imperfecta (OI), and secondary osteoporosis resulting from chronic conditions or their treatment. Disorders of the bone minerals calcium and phosphate...

Brown tumours are benign osteolytic lesions of bone caused by high levels of serum parathyroid hormone (PTH). They are now rarely seen as a feature of primary hyperparathyroidism. We report two cases of brown tumour in adolescent girls caused by secondary hyperparathyroidism due to severe vitamin D and dietary calcium deficiency.Case 1: 14.5-year-old South Asian girl referred with a 1 year history of right hip pain. She had presented to the orthopaedic t...

Introduction: Arthrogryposis multiplex congenita is a rare congenital disorder characterised by multiple joint contractures. The association with hypopituitarism has only been reported once before. We report two further children with multiple pituitary hormone deficiencies (MPHD) and arthrogryposis.Case reports: Case 1: this 12-year-old girl was born to consanguineous parents; a previously affected sibling had died. She was dysmorphic with multiple joint...

Introduction: ‘At risk’ groups for vitamin D deficiency have long been identified, including the chronically ill. According to guidelines published by the European Society of Endocrinology (ESPE, 2002), the American Academy of Paediatrics (AAP, 2008) and the Endocrine Society (ENDO, 2011), vitamin D levels should be measured in chronically ill or at risk patients. We aimed to test the current knowledge of these guidelines amongst consultants in a large tertiary hospi...

Background: The level of 25OH vitamin D (25OHD) which separates deficiency from sufficiency is heavily deabted. With decreasing 25OHD levels, typical biochemical derangements set in, such as increasing parathyroid hormone (PTH) and alkaline phosphatase (ALP) levels, and decreasing phosphate and calcium levels. In adults, serum concentrations of PTH reportedly start to rise when serum 25OHD levels drop below 30 μg/l. Such data are scarce in children....

Background and objectives: Children with Osteogenesis Imperfecta (OI) require frequent imaging for fractures and surveillance of bone mineral density. Radiation exposure in childhood carries the highest risk of cancer. Here, we estimate the cumulative effective radiation dose (E) and lifetime cancer risk (LAR) from imaging in children with OI. We also explore the hypothesis that the rate of fracture positive imaging for investigation of injuries is related to family history of...

Background: Conventional treatment of X-linked hypophosphataemic rickets (XLH) involves administration of oral phosphate and vitamin D analogues. Newer therapies such as Anti Fibroblast Growth Factor 23 antibodies (burosumab) have now become available. An important treatment goal is to heal rickets; assessed by normalisation of serum alkaline phosphatase (ALP) levels and resolution of radiological signs of rickets.Objectives: (1) Assess disease severity ...

Background: HbA1c is a marker for the risk of long-term complications of Diabetes. Our unit cares for 349 children and young people (CYP) from a population with a higher than average prevalence of low-income families, ethnic minority families, and high unemployment. Over the last 10 years there have been service improvements, increased resources and changes in practice.Aims: To review HbA1c outcomes achieved annually from 2003, compared with published na...