Endocrine Abstracts

Background: Since pelvic gender-affirming surgery (GAS) is no longer required for legal gender change, we expect a growing number of transgender men and gender nonbinary people who refrain from pelvic surgery. Little is known about the effects of long-term testosterone use on the reproductive organs. Polycystic ovaries and endometrial changes have been described in previous histology-based studies. Furthermore, cervical cancer screening (CCS) is still recommen...

Background: Hypercalciuria is a relevant complication in patients with treated hypoparathyroidism. Hypercalciuria is usually estimated by 24 h urinary calcium excretion (24 hUCa). In contrast, in pediatric endocrinology the calcium-creatinine-ratio (CaCrR) is more often used due to feasibility. This study aims to compare these two approaches in adult patients with hypoparathyroidism.Methods: In 181 systematically evaluated patients with primary hypoparat...

Introduction: Insulinoma is a rare, generally benign neuroendocrine tumor, primarily manifesting as hypoglycemia in non-diabetic patients. Although surgery is the gold standard treatment for insulinoma, managing hypoglycemia becomes challenging in cases where surgery is not feasible. This challenge arises due to significant side effects that often limit the use of most drugs and therapeutic alternatives.Case report: A 90-year-old non-diabetic man was adm...

Introduction: Reduction of quality of life in patients with chronic hypoparathyroidism (HPT) has been reported by several studies. Additionally, self-report data point to a higher prevalence of anxiety disorders in HPT compared to patients after thyroidectomy.Objectives: To characterize psychiatric diseases in a systematically reviewed cohort of patients with chronic HPT.Methods: We systematically assessed psychiatric comorbidities...

Background and Aim: We previously demonstrated that low-dose estradiol (E2) administered sublingually alone for 6 months in treatment-naïve trans women (TW), suppressed testosterone to the same degree, but generated higher serum E2 levels as the same oral dose combined with cyproterone acetate. We now sought to assess the possible differential impact of these approaches on anthropometric and body composition measurements, sex-dependent indicators with proven metabolic pro...

Background: Sublingual estradiol (E) for gender-affirming hormone therapy (GAHT) of transgender women (TW) might obviate the need for an anti-androgen, and mitigate pro-coagulant changes. We recently showed that 2 mg E, divided into 4 daily SL doses (SLE), offers no clinical advantage over the same dose given orally in combination with cyproterone acetate (CPA). Furthermore, we showed that after each sublingual administration, serum E2 (sE2) peaked to levels, the likes of whic...

Background: The clinical manifestations of thyrotoxicosis do not always correlate with the extent of thyroid biochemical abnormalities. Here, we report the case of a COVID-19 positive patient who presented with congestive heart failure as a first-time presentation of thyrotoxicosis. Case report: A 40-year-old female presented to Emergency Department with two days history of lower limb oedema and abdominal distension. She denied dyspnoea, chest pain, palp...

Autosomal dominant hypocalcemia type 1 (ADH1), caused by gain-of-function calcium-sensing receptor gene (CASR) variants, is characterized by low parathyroid hormone (PTH) levels, hypocalcemia, hypercalciuria, hyperphosphatemia and hypomagnesemia. Conventional therapy (calcium and active vitamin D) worsens hypercalciuria, which may result in renal complications. Calcilytics, such as encaleret, are negative allosteric modulators of the calcium-sensing receptor (CaSR). T...

Background: The standard approach for Gender-Affirming Hormone Therapy (GAHT) of transgender women (TW) in Israel is oral estradiol (OE) combined with the potent anti-androgen cyproterone acetate (CA). Recently, many of our non-binary patients have requested sublingual estradiol (SLE) without CA, under the unproven belief it preserves erectile function, and does not induce depression. Preliminary data in a few subjects, who self-practiced this approach, suggested it also maint...

Background: Myxoedema coma although uncommon can be life-threatening in patients who are poorly compliant with levothyroxine replacement. Some of the precipitating factors include intercurrent respiratory infection, use of sedatives, and electrolyte imbalance such as hyponatremia(Wiersinga 2018). A 73-year-old man presented to the Hospital with face and tongue swelling, shortness of breath, and type 2 respiratory failure. His past medical history includes hypothyroidism, Obstr...