Endocrine Abstracts

Introduction: Acromegaly – a serious debilitating disease resulting in decreased quality and length of life. Due to the late nature of the diagnosis, the lack of prospects for a surgical or non-radical adenomectomy leads to a somatostatin analogues (SA) treatment as primary or secondary therapy, which is a long-term, sometimes lifelong. Therefore, the question of tolerability and prevention of life-threatening complications for these patients is very important. Since the ...

PRIMARA is the first observational study to describe the demographic and clinical profiles of adults with primary hyperparathyroidism (pHPT) receiving cinacalcet in daily clinics across European countries.Patients with pHPT aged ≥18 years without prior cinacalcet treatment were eligible. Initial cinacalcet dosage and subsequent dose changes were at the investigator’s discretion. Information on dosing, biochemistry and adverse drug reactions (A...

Urine free cortisol (UFC) is analysed in 24 h urine collections in suspected Cushing’s syndrome, and provides an integrated measure of cortisol secretion over the whole day. The aim of this audit was to review how clinically useful UFC results were, and whether this analytical service was still justified. The current automated immunoassay with manual sample preparation was time-consuming, expensive (disproportionate quality control / external quality assessment (EQA) samp...

Normocalcemic primary hyperparathyroidism (NC-PHPT) is a condition characterized by normal albumin-adjusted total serum calcium or ionized calcium and persistently elevated serum PTH. Therefore, to recognize this entity it is necessary to measure PTH in normocalcemic individuals. The question arises why would someone measure PTH in a normocalcemic subject? A pro-active approach to women evaluated in their early postmenopausal years for parameters of skeletal health as well as ...

A 60-year-old woman with a previous history of twice transsphenoidal pituitary surgery due to acromegaly,had a surgery with a presumed diagnosis of bladder stone. She was reevaluated after the surgery when her hematuria persisted. Percutaneous nephrolitotomy was planned. when multiple stones were identified in the left ureter, but the operation had to be postponed till the achievement of glycemic control. At the meantime endocrinological evaluation revealed a 30×15 mm mac...

Clinical caseIntroduction: Insulinoma is a rare disorder with an estimated incidence of 1 case per 250 000 people per year.Case report: 37 years old female, with a history of irritable bowel syndrome, dyslipidemia and kidney stones. In December 2010, she developed a headache, dizziness and visual disturbances, predominantly in the evening and amnesia for some of the episodes. Initially interpreted as peripheral vertiginous syndrome, because of recurrence...

Aim: We performed a retrospective analysis to evaluate the surgical treatment of primary hyperparathyroidism in a tertiary referral centre.Methods: We reviewed the case notes of 80 patients who underwent parathyroid surgery (2003 to 2011). Patients were identified from the national BAETS audit.Results: Median age was 56 years (range 25–86). 72.5% of the patients were females and 30% were asymptomatic. Mean adjusted calcium con...

The diagnosis of normocalcemic primary hyperparathyroidism (PHPT) can be made in subjects whose total and ionized serum calcium are completely normal but in whom the PTH level is persistently elevated. In order to make the diagnosis of normocalcemic PHPT, secondary causes for an elevated PTH level should be ruled out, such as vitamin D insufficiency, or renal insufficiency. Replacing the former patients with vitamin D to reach levels now considered to be normal (i.e. >30 n...

The prevalence of primary hyperparathyroidism (PHPT) is increasing and the majority (over 85%) are now asymptomatic and remain untreated. In order to know whether or not they can be left safely without surgery, issues on disease progression need to be addressed. We aimed to update the natural history of PHPT, with a focus of serum calcium progression in mild untreated patients, selected from a large pre-defined cohort of PHPT in Tayside, Scotland. Possible predictors of progre...

Background: The geographical difference in presentation of primary hyperparathyroidism (PHPT) is well known however, there is spare literature on influence of age and gender on presentation of PHPT.Objective: To study the effect of age and gender on clinical and biochemical presentation of PHPT.Method: This is a retrospective analysis of 184 histopathologically proven PHPT patients between March 1990 and March 2010 from a single ce...