Endocrine Abstracts

Clinical interactions with patients are fulfilling and rewarding. We can make a difference to patients’ health and lives by tuning care and attention to their individual needs on a 1:1 basis. Frustrations sometimes emerge from clinicians due to perceived restrictions and limitations in the healthcare system that appear to perversely impact patient care. Those frustrations are often exacerba...

The European PARAT group have recently explored a number of practical management issues in parathyroid diseases. Herein, we present expert opinion on areas of controversy in the diagnosis and management of primary hyperparathyroidism (PHPT). Although PHPT is common, its differential diagnosis from familial hypocalciuric hypercalcaemia (FHH) poses practical problems. Proposed approaches to addressing this will be discussed. The definition and clinical course of normocalcemic PH...

Success following initial parathyroid surgery is high at approximately 95%. Developments in preoperative imaging techniques and subtle variations in parathyroid surgical approach have marginally improved already high success rates. However, failed initial neck exploration or true later recurrence of primary hyperparathyroidism (PHPT) can be difficult to manage. The initial consideration is always to ensure that the diagnosis of PHPT is secure and it is prudent to re-evaluate t...

Hypercalcaemia is common and can represent a broad spectrum of underlying diseases that range from common to extremely rare. Furthermore, causes of hypercalcaemia can be mild and indolent or may be rapidly progressive and represent serious underlying diseases such as cancers. It is thus important to have a clear understanding of hypercalcaemia, particularly its early assessment and management that will lead to a diagnosis of the underlying cause. Hypercalcaemia can present as ...

The natural history of osteogenesis imperfecta (OI) during childhood is changing due to the availability and effectiveness of bisphosphonates in ameliorating fracture risk and promoting significant gains in bone mineral density in most children with OI. Not all children with OI require treatment with bisphosphonates, however. Fracture rates in patients with OI typically fall in the latter teenage years as the longitudinal growth of the skeleton ceases. Most adults with OI enjo...

Patients receiving parenteral forms of treatment for osteoporosis (e.g. denosumab (DMAB) and zoledronic acid (ZOL)) should be vitamin D replete prior to administration, to minimise the risk of hypocalcaemia. Most patients receiving DMAB or ZOL take supplemental (calcium and) vitamin D but it is widely accepted that adherence to calcium and vitamin D is poor. Frequency of testing 25-hydoxyvitamin D (25OHD), calcium and renal function varies widely between centres in the UK. In ...

We report a case of a rare genetic condition of disordered bone turnover requiring complex multidisciplinary management.A 42-year-old lady presents with a 2-year history of worsening pain in both her legs and feet. She has a long standing history of structural equinus deformities worse on the right ankle and permanently walking on her toes. She also has fixed flexion deformities at both her knees. She normally is not able to weight bear and uses crutches...

Aim: To evaluate the prevalence of kidney stones and osteoporosis in a cohort of patients with a confirmed diagnosis of primary hyperparathyroidism (PHPT).Study Design: This retrospective study reviewed the clinical records of patients with a confirmed diagnosis of PHPT in a single tertiary referral centre for metabolic bone disease over a period of 6 years (January 2010 – December 2015).Patients: There ...

Aim: To evaluate the prevalence of kidney stones and osteoporosis in a cohort of patients with a confirmed diagnosis of primary hyperparathyroidism (PHPT).Study Design: This retrospective study reviewed the clinical records of patients with a confirmed diagnosis of PHPT in a single tertiary referral centre for metabolic bone disease over a period of 6 years (January 2010 – December 2015).Patients: There ...

Objective: To describe a 32-year-old patient presenting to endocrine clinic as painful gynecomastia.Method: We present clinical and radiological course of a rare case of gynecomastia secondary to HCG producing lung tumour.Result: A 32-year-old patient presented to endocrine clinic with symptoms of painful lumpiness of nipples for the last 6 months. There is no history of any milk or blood discharge from the nipples and he has not n...