Endocrine Abstracts

Introduction: Hypoparathyroidism Bone Score (TBS) has been associated with fragility fractures in post-menopausal women. Estrogen-receptor positive breast cancer is usually treated with aromatase inhibitors (AIs), with international guidelines recommending initial bone density (BMD) evaluation, since this therapy is associated with high rates of fragility fractures. Each Country has different thresholds of intervention to recommend pharmacologic treatment for fracture preventi...

Context: Normocalcemic hyperparathyroidism (NHPT) is considered as an earlier or milder phenotype compared to traditional primary hyperparathyroidism (PHPT). To make a correct diagnosis, secondary hyperparathyroidism due to low calcium intake must be excluded. Whether calcium intake might affect presentation of PHPT vs NHPT has never been addressed consistently.Objective: To describe patients with a diagnosis of NHPT or PHPT in relation to their calcium ...

Context: Patients with primary hyperparathyroidism (PHPT) may be treated with denosumab due to coexisting osteoporosis. Few studies have been conducted in this population.Case presentation: An 84-year-old woman was seen in the outpatient clinic in March 2018 due to calcium levels at the upper limit of reference range (10,2 mg/dl) associated with elevated levels of PTH (112 pg/ml) and sufficient 25(OH)Vit D (24 ng/ml) levels, findings consistent with mild...

Clinical vignetteA 65-year-old woman was hospitalized due to severe hypercalcemia (albumin-corrected calcium 16.9 mg/dl) associated with severe renal failure (creatinine 3.48 mg/ml), normal phosphate levels (3.9 mg/dl) and PTH < 5 pg/ml. Her past medical history included total thyroidectomy complicated by chronic hypoparathyroidism, for which she was followed by her primary care physician. One year before hospital admission, renal function was normal...

Introduction: Adjuvant therapy with aromatase-inhibitors (AIs) increases bone loss and fracture risk. Concomitant antiresorptive treatment is currently recommended. The aim of this study was to evaluate the effects of AIs on bone metabolism and mineral density at 12 and 24 months.Methods: Among 400 women on AIs who attended our Endocrinology Unit from 2014 to 2016, we retrospectively evaluated those who initially refused antiresorptive and took cholecalc...

Context: ß-CTX are considered useful markers of response to denosumab and other anti-resorbtive treatments for osteoporosis. We report an unusual case of a completely absent effect of both denosumab and bisphosphonates on bone resorption markers.Case description: In 2017 a 74-year-old woman sought medical attention at the Endocrinology Unit of Policlinico di Sant’Orsola for the evaluation of an adrenal adenoma associated with osteoporosis. Meno...

Cushing disease and hypophosphatasia are rare conditions that may be both responsible of an important impairment of bone metabolism with increased fracture risk. We reported for the first time a case of a 43-year-old woman that came at our attention for recent onset of alopecia and amenorrhea. At the anamnesis, she denied any past relevant events and no drug assumption. At the physical examination, she presented rubeosis and facies lunaris and central adipose distribution (wai...

Introduction: Hypoparathyroidism (HP) is characterized by low serum calcium and increased phosphate levels associated with inappropriately low serum PTH levels. Clinical manifestations of HP are tingling, muscle cramps, seizures, nephrocalcinosis, kidney stone, kidney failure, depression and anxiety.Objective: Quantify the chronic symptoms and complications of HP in our monocentric cohort.Material and methods: We conducted a retros...

Background: The diagnosis of PHPT and chronic HypoPT is still challenging, mainly due to the wide spectrum of clinical and biochemical presentation and the lack of validated diagnostic index in literature. The serum Ca/P ratio has been proposed as an accurate tool to diagnose PHPT in a small sample of patients, while no data is available about its possible application for HypoPT.Aim: To validate the serum Ca/P ratio as a diagnostic index for PHPT and to ...

Introduction: Several risk factors are involved in post-liver transplantation osteoporosis. Immunosuppressive agents, glucocorticoids, decreased renal function associated with secondary hyperparathyroidism and immobilization are the main determinants of fragility fractures in this population. Denosumab is highly effective in increasing bone mineral density (BMD) and preventing fragility fractures. However, the efficacy of denosumab in liver transplantation osteoporosis has nev...