Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHPT) commonly goes unrecognized due to the physiological changes of pregnancy.PHPT is associated with significant maternal and fetal morbidity and mortality. Current evidence supports parathyroidectomy is the main treatment, performed preferably during the second trimester, when the serum calcium is above 11–mg/dl. We report the clinical course of a woman with newly diagnosed gestational PHPT who refused minimally invasive parat...

Objective: The aim of the study was to examine characteristics and treatment patterns of Polish acromegalic patients.Methods: A retrospective database analysis was conducted. Adult acromegalic patients treated medically for ≥1 year including at least three injections of lanreotide AUTOGEL 120 were recruited in 36 centres between 29/10/2010 and 31/03/2012. Descriptive analysis was performed to describe demographic and clinical characteristics, treat...

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Clinical suspicion is determined by the severity of hyperparathyroidism associated or not with palpable cervical tumor and local invasion when surgery.Case report: A 45-year-old woman without any previous history of kidney stones or fractures. Admitted to hospital because of high hypercalcemia (calcium 15.1 mg/dl), fatigue and generalized arthralgia. Physical examination revealed right...

The growing adoption of bariatric surgery (BS) as treatment for severe and complex obesity, is resulting in the emergence of both iatrogenic and nosohypokatastatic (disease substitution) diseases. Malabsorption (an integral part of gastric bypass surgery) may compound mineral, vitamin and trace element deficiencies that also result from poor nutrition that can be worsened by the restricted intake imposed by BS. Thiamine deficiency (especially in those who have frequent vomitin...

Introduction: I present here a challenging case of gastrinoma which posed challenges in diagnosis and treatment. Gastrinomas are tumours of pancreas or duodenum secreting excessive gastrin leading to acid over secretion in stomach leading to ulcer, perforations, and diarrhoea.Clinical case: A 77-year-old lady had been suffering from gradually worsening bouts of severe watery diarrhoea and vomiting for previous 10 years and six stones weight loss. Frequen...

A 34-year-old lady with previous renal stones, constipation and well controlled bipolar mood disorder, on lithium for 13 years, was referred with a high calcium of 2.75 mmol/l (normal range: 2.10–2.58 mmol/l) and raised parathyroid hormone of 9.1 pmol/l (normal range: 1.1–4.2 pmol/l). Urine calcium excretion and TFT were normal.The biochemistry was consistent with primary hyperparathyroidism. A workup for possible underlying MEN syndrome came b...

The calcium receptor (CASR) serves as one of the main regulators of the calcium homeostasis. CASR is expressed in among other tissues parathyroid chief cells and kidney tubule cells. It has been hypothesized that CASR gene variations are responsible for low circulating calcium levels together with hypercalciuria and thereby increased risk of kidney stones. The CASR gene polymorphism A986S has been shown associated to elevated serum calcium levels in vivo<...

Giant cell granuloma is a skeletal manifestation seen now rarely in hyperparathyroidism due to early recognition of the disease. Lesions usually occur in the areas of intense bone resorption. They can affect mandible, maxilla, clavicle, ribs and pelvic bones. Most of the patients who have primary hyperparathyroidism are asymptomatic and are discovered incidentally during laboratory examinations. Here, we represent a female patient who was referred to endocrinology clinics beca...

Introduction: We diagnosed multiple endocrine neoplasia type 1 (MEN1) based upon the occurrence of two primary MEN1 tumor types in patient without family history of MEN1. Hyperparathyroidism was diagnosed in patient five years after gastrinoma surgery. With hormone tests and morphologic investigation we excluded pituitary adenoma.Case report: Forty-nine year old patient was admitted with abdominal pain and vomiting. Laboratory testing revealed elevated v...

Introduction: MEN1 is inherited as an autosomal dominant trait, with a prevalence of 2–20/100 000 in the general population. It is characterized by tumors envolving the parathyroid glands, the endocrine pancreas and the pituitary. Other tumors are more rarely associated: adrenal adenomas, carcinoid tumors, pheocromocytomas, angiofibromas, lipomas, collagenomas and meningiomas. The presence of two or more of MEN1 associated tumors is diagnostic of the syndrome.<p class...