Endocrine Abstracts

A 29 year-old nursing student, was incidentally detected to have high serum calcium 3.43 mmol/l (2.2-2.6) whilst being treated for community acquired pneumonia. She had no symptoms of hypercalcaemia. Her uncle had been operated for primary hyperparathyroidism (PHPT) although only limited details were available. PTH of 28 pmol/l (1.6-7.2) confirmed the diagnosis of PHPT. She had vitamin D deficiency, normal liver and renal function. She was offered parathyroidectomy and preoper...

Introduction: Immobilization hypercalcemia is uncommon condition associated with limited movements following brain and spinal cord lesions. Immobilization results in stimulation of osteoclastic bone resorption hypercalciuria and hypercalcemia.Case report: 57 year female, Background of Breast Cancer (Treated with Skin sparing mastectomy and adjuvant radiotherapy) admitted following large subdural hematoma leading to craniotomy and evacuation of hematoma. ...

Background, case-history: Hypercalcaemia secondary to parathyroid hormone (PTH) independent mechanisms is well known, with differentials including Sarcoidosis. We describe a case of Sarcoid Myositis presenting with symptomatic hypercalcaemia (adjusted serum calcium levels of 3.12 mmol/l) but no muscle weakness in a 39-year-old lady with a background of Type 1 Diabetes Mellitus, Hyperthyroidism, and Rheumatoid Arthritis.Investigations: Laboratory investig...

Introduction: Primary parathyroid carcinoma accounts for less than 1% of the parathyroid gland tumours and almost always presents as primary hyperparathyroidism. Very few Turner syndrome patients have been reported so far to present with primary hyperparathyroidism secondary to parathyroid adenoma. We report a case of parathyroid carcinoma in a 59 years old lady with Turner syndrome who is presenting with recurrent mild hypercalcemia.Case presentation: A...

Background: Autoimmune polyglandular syndrome type 1 (APS-1) is an autoimmune inherited disorder, a potentially underdiagnosed clinical entity, caused by mutations in the autoimmune regulatory gene that can present with varying symptomatology as it affects various organs, posing both a diagnostic and management hurdle. We report a case to highlight this complexity.Case report: Case details involves a female who first presented in childhood with rash, eye...

A 25 year old Afghan male presented with a 4 day history of worsening left-sided loin pain. He had a past history of deafness since birth, speech problems and development delay. Bilateral renal calculi and widespread multiple well defined lytic lesions (likely brown tumours) were seen on CT-KUB. The corrected calcium was 3.21 mmols/l, PTH 80 pmol/l, Vitamin D 25 nmol/l, phosphate 0.49 mmols/l, ALP 960 IU/l and fractional calcium excretion was 0.16. His skull X Ray/OPG, done du...

Primary hyperparathyroidism (PHP) is the most common aetiology for hypercalcaemia. Its prevalence in pregnancy is reported to be between 0.15% and 1.4%[i][ii]. It presents a threat to the health of both mother (hyperemesis, nephrolithiasis) and foetus (foetal death, congenital malformations, neonatal severe hypocalcaemia induced tetany)[iii][iv]. However, there is a lack of clear guidance on management of primary hyperparathyroidism in pregnancy. We describe the ...

Spontaneous resolution of primary hyperparathyroidism following infarction for parathyroid adenomas is rare with infarction on treatment with cinacalcet being even rarer. A 53 year old female who presented to primary care with malaise was found to have biochemical evidence of primary hyperparathyroidism with adjusted calcium 3.31 mmol/l and parathyroid hormone 28.8 pmol/l. Previous medical history was unremarkable. Following discussion with endocrinology, treatment with cinaca...

Introduction: Vitamin D toxicity (VDT) is quite an uncommon condition which results from misperception between dosage regimens of vitamin D supplementation. VDT is diagnosed when Serum 25-hydroxyvitamin D levels are higher than 375 nmol/l (150 ng/ml). Vitamin D supplementation is easily accessible as over-counter medication and online. This report describes a patient who presented with severe hypercalcemia and acute kidney injury (AKI). Further assessment revealed that patient...

Introduction: Primary hyperparathyroidism is associated with numerous cardiovascular complications including hypertension, left ventricular hypertrophy and calcification of cardiac valves. However NICE have not included cardiovascular complications as an indication of parathyroidectomy. This literature review will be focused on benefits of parathyroidectomy on cardiovascular complications of primary hyperparathyroidism.Methodology: Literature search done...