Endocrine Abstracts

Context: Vitamin D deficiency following malabsorptive bariatric surgery can lead to osteomalacia. We report a patient with severe vitamin D deficiency following malabsorptive bariatric surgery successfully treated with calcifediol but not cholecalciferol.Case description: A 40-year-old woman, submitted to biliopancreatic diversion 20 years before and chronically treated with 50 000 IU cholecalciferol weekly, was admitted to our Endocrine Unit because of ...

Context: Teriparatide may represent a possible treatment for hypoparathyroidism when oral supplementation with calcium and calcitriol fail to maintain adequate serum calcium level (SCL). The switch from teriparitide to oral calcium and calcitriol could be challenging and there is no consensus for clinical management.Case presentation: A 50-year-old man was admitted at our Department for teriparatide discontinuation. Three years before admission, the pati...

Patients with chronic hypoparathyroidism (HypoPT) treated with oral calcium and active vitamin D metabolites are at risk of renal complications, because of the lack of action of PTH at the renal tubule. In the present study we evaluated 90 patients (68 females and 22 males; age: 51.8±14.1 yrs) with chronic postoperative Hypo (PO-HypoPT) diagnosed since at least 3 years. All patients were treated with calcitriol and 35 (39%) with oral calcium two patients were also treated...

Tumoral calcinosis is a rare autosomal recessive disease characterized by hyperphosphatemia due to increased renal phosphate reabsorption leading to soft tissue calcifications. The levels of fibroblast growth factor 23 (FGF23), a hormone required for normal renal phosphate reabsorption, are typically low in the classic form of the disease due to homozygous missense mutations in FGF23 or in the UDP-Nacetyl-alpha-D galactosamine:polypeptide N-acetylgalactos...

Hypercalcemia is a frequent metabolic disorder in metastatic breast cancer (BC). Aim of this study was to evaluate the incidence of hypercalcemia due to PHPT in BC patients. The study group included 271 consecutive BC, mean age±S.D. 57.7±11.96 yrs. 100/271(36.9%) evaluated at different times after mastectomy (A) and 171(63.1%) before surgery (B), with no distant metastases. Age matched control group included 108 healthy women (Co) and 70 women with thy...

Aim of this 2-year, prospective, randomized study is to compare the effect of parathyroidectomy (PTX) vs no treatment in patients with asymptomatic primary hyperparathyroidism (PHPT), who didn’t meet the 1991 NIH criteria for surgery. The study was approved by our local Ethical Committee. The primary endpoint was the change in lumbar spine bone mineral density (BMD); secondary endpoints were BMD changes at femur and distal radius, markers of bone turnover, quality ...

Medullary thyroid carcinoma (MTC) is a malignant tumour deriving from parafollicular C cells, with a highly chemoresistant phenotype. Failure of medical therapy has been ascribed, at least in part, to multi drug resistance (MDR1) gene over-expression. MDR1 encodes for a transmembrane glycoprotein, P-gp, which hampers intracellular accumulation of cytotoxic drugs. It has been demonstrated that P-gp expression and function depend on cyclo-oxygenase 2 (COX-2) expression, which is...

Background: The incidence of gestational diabetes mellitus (GDM) is increasing worldwide, with considerable impact on the health of both mother and newborn. There is no doubt that screening for GDM between 24 and 28 gestational weeks (GWks) is important to reduce the risk of adverse outcomes; however, there is no clear consensus about the diagnosis and treatment of GDM in early pregnancy.Aims: To evaluate the effect of time of GDM diagnosis (early onset ...

Primary hyperparathyroidism (PHPT) is a common disorder in adults but is uncommon in young people and features of juvenile PHPT (J-PHPT) are debated in literature. The aim of the study was to evaluate the characteristics of PHPT in juvenile sporadic (S) and familial (F) patients. It’s a monocentric prospective study at a referral centre in 154 patients with ≤40 years. Patients were evaluated at diagnosis and at the last follow-up visit (median follow-up 2 years), co...

Primary hyperparathyroidism (PHPT) is defined by hypercalcemia and high PTH levels. In recent years a variant of PHPT has been described, namely normocalcemic PHPT (NPHPT), which is characterized by normal serum calcium and high PTH levels, in the absence of other causes of secondary hyperparathyroidism. The epidemiology of NPHPT is poorly understood. We performed a survey in the early fall in a small Southern Italian village, in which all adult residents (n=1811) wer...