Endocrine Abstracts

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...

Context: Although Trabecular Bone Score (TBS) has been widely and independently associated with fragility fractures, its diagnostic power in certain populations remains to be established. Women initiating aromatase inhibitors for breast cancer should be screened for bone health to prevent cancer treatment-induced bone loss as much as possible. TBS is regarded as an adjunctive tool to evaluate these patients, but thresholds of pharmacologic interventions are still a gray zone, ...

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...

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...

Context: Numerous studies propose a potential role of PTH in uric acid (UA) metabolism, particularly through its impact on the ABCG2 transporter, which is responsible for UA excretion in the intestines and kidneys. Another suggested mechanism involves increased tubular reabsorption of UA due to hypercalcemia-induced extracellular volume contraction. Elevated UA levels constitute a well-established risk factor for cardiovascular disease, nephrolithiasis, and chronic kidney dise...

Context: Several studies have shown that Trabecular Bone Score (TBS) predicts fractures independently of Bone Mineral Density (BMD) measured with Dual Energy X-ray Absorptiometry (DXA), even in patients with Primary Hyperparathyroidism (PHPT), known to have deteriorated bone microarchitecture. Low TBS values alone are still not considered as a single criterium to recommend parathyroid surgery. Measuring bone quality in patients with PHPT may be helpful to identify a proportion...

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...

Background: Primary hyperparathyroidism (PHPT) is characterized by an excessive secretion of the parathyroid hormone (PTH) with normal or high calcium levels. The gold standard therapy involves minimally invasive parathyroidectomy with intraoperative PTH (ioPTH) monitoring. Different criteria have been identified when predicting cure rates using ioPTH values.Objective: To evaluate the percent ioPTH drop (ΔioPTH), the post-excision ioPTH, the first p...