Endocrine Abstracts

The aim of this work is to present two patients with vitamin D deficiency and primary HPT.

A 51-year old woman (first refer, 2009-jul) was operated for pathohistologically confirmed parathyroid (PT) adenoma seen by ultrasound (US) and scintigraphy (Sc). Patient treated for previous years for hypertension and depression. Calcium (Ca; mmol/l): 3.1; Creatinine (Cre; μmol/l): 67. The results will be shown in following order: pre-/postoperatively, 3rd month, 27th m. (– / –, –, –). Symptoms of depression (yes/yes, yes, without). Ca (ionized; mmol/l): 1.53–1.81/1.0, 1.15, 1.11. Ca (Urine; mmol/d): 7.53/–, 0.81, –. Parathormone (PTH; pg/ml): 488/280, 372, 38.9. VitD3(25OH) (nmol/l): 24.5/–, 10, 51. US of the abdomen: bilateral nefrocalcinosis and nefrolithiasis, BMD (g/cm2) L1-4 T score: −3.7 / –, –, −2.8. Serum CrossLaps (CL; pg/ml): 2197/–, 521, –. Osteocalcin (OC; ng/ml): 171/–, 45.6, –. Therapy with 1α-OHvitD3 (μg/day): –/0.25, 1.0, 2.0. Second patient a 76-year old man (first presentation, 2011-may) with Sc accumulation in PT, US undetectable PT hipoehogenicity, aortocoronary bypass (2006), Cre 154 μmol/l (Adult Polycystic Kidney Disease), BMD (g/cm2) L1-4 T score: −0.5, CL(pg/ml): 243, OC(ng/ml): 22.6. The results: the first visit, after 4 m (–, –). Ca (ionized; mmol/l): 1.33, 0.94. PTH (pg/ml): 244.9, 74.4 (2009-Oct: 169.5). VitD3(25OH) (nmol/l): 13, 10 Therapy with 1α-OHvitD3 g/day: –, 2.0.

Discussion: The chronic vitD deficiency lead to adenoma growth or growth of preexisting adenoma. Adenoma size were not in relationship with 25(OH)D similar as we seen in Indian vs. American patients. Disease stability (Ca, Cre levels) will determine the length and dosage of conservative (nonsurgical) treatment in man with normocalcemic HPT and woman with ‘hungry bones’. Losing symptoms of weakness and anxiety only three months after the booster dose of vitD could be the direct effect on the brain tissue.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.