Endocrine Abstracts

Despite i.v. bisphosphonates, including pamidronate and zoledronate, representing the established agents used to reduce calcium levels, a proportion of patients with hypercalcemia either fail to respond to such treatments or relapse following their use.We present a case of hypercalcaemia refractory to conventional treatments that was treated with the use of the human MAB denosumab.A 70-year-old male presented to the emergency depar...

Postural orthostatic tachycardia syndrome (PoTS) reflects a disturbance of autonomic function leading to a myriad of clinical features. Subcutaneous octreotide injections and intramuscular long acting preparations of octreotide have been used in the treatment of PoTS. However, inconvenience of frequent injections, side effects and theoretical overexposure, as well as cost of the intramuscular preparation, makes them far from ideal.We present a case of un...

Mr DP was referred by palliative care to ophthalmology with anisocoria, diplopia and nystagmus. He was known to have a poorly differentiated carcinoma of the prostate with skeletal metastasis (Gleason score 4+5=9). He was on hormonal therapy and had received radiotherapy to the cervical spine. PSA was normal, at 5.31 μg/l.An MRI scan revealed a 12 mm mass in the left side of the pituitary gland, displacing the stalk to the right and lying close to t...

Introduction: The role of hormones and their underlying mechanisms in the development of osteoporosis are complex and not completely understood. Serum SHBG concentration is increased in older men and may be correlated with reduced bone mineral density and increased fracture risk. However, there is little data on exact relation of BMD with 24-h mean concentration and circadian rhythm of SHBG.Methods: We measured 24-h mean SHBG concentration in 3 groups of...

A 64 year old man presented with confusion and agitation following diarrhoea for 48 hours. He had a background history of hypertension, type 2 diabetes, depression and had a normal sodium concentration of 135 mmol/L a year prior to admission. His medications included bendroflumethiazide and sertraline in addition to metformin, diclofenac sodium, aspirin, simvastatin, nifedipine and enalapril. On examination he was conscious but confused. He was afebrile with a blood pressure o...

Background: Adult growth hormone deficient (AGHD) is associated with reduced bone turnover and reduced bone mineral density (BMD): factors improved by growth hormone replacement (GHR). Obesity is associated with reduced bone turnover but increased BMD. We investigated the impact of body mass index on parathyroid hormone (PTH), phospho-calcium metabolism and bone turnover in AGHD patients before and after GHR.Study design: Of 31 AGHD patients (15 obese pa...

Introduction: Adult growth hormone deficiency (AGHD) is associated with target organ insensitivity to parathyroid hormone (PTH) and abnormal PTH circadian rhythm. In aging women with established osteoporosis, GH and insulin like growth factor -1 (IGF-1) concentrations are low and administration of GH has been shown to increase bone turnover and bone mineral density (BMD), but the mechanisms remain unclear. Consequently we investigated the effects of declining GH and IGF-1 conc...