Endocrine Abstracts

Background: Hypoparathyroidism is a rare endocrine disorder characterised by low serum calcium with inappropriately low parathyroid hormone (PTH) levels. Calcium and vitamin D analogues have traditionally been the mainstay of treatment. However, these treatments may cause complications and may not fully address the well-being of this patient group. This study evaluates the current management of hypoparathyroidism in a large UK teaching hospital compared against current Europea...

Background: Symptoms consistent with hypercalcaemia are an indication for surgery in patients with primary hyperparathyroidism (PHPT). However, symptoms can be subtle and may not be documented systematically. We analysed the documentation of symptoms in a large series of patients with PHPT, and the subsequent impact of introducing a symptom scoring questionnaire.Methods: A standardised proforma was used to retrospectively analyse symptom documentation by...

Introduction: Osteogenesis imperfecta (OI) is a genetic, heterogeneous, connective tissue disorder most commonly caused by mutations in type I collagen genes. A hallmark of disease is frequent fractures that are precipitated by minimal trauma. There are limited data on the impact of OI on non-skeletal outcomes across the lifecourse. We present cross-sectional data of one of the largest single centre patient cohorts of OI in adulthood (n=186).The aim of this study was ...

Introduction: Vitamin D deficiency has been implicated in adverse health outcomes related to immunity, metabolism and physical function. Comprehensive assessments are required to characterise vitamin D status and relationships with physical function and frailty markers in the acutely unwell.Aims: To assess vitamin D and related parameters for patients admitted acutely to hospital who have been tested and to assess the relationship with muscle function an...

Background: Conventional treatment for chronic hypoparathyroidism (CHP) is Vitamin-D analogues and calcium supplementation, not replacement of lacking hormone, as done in other hormone-deficiency states.Objectives: Retrospective evaluation of CHP management in line with European Society of Endocrinology Guideline was undertaken, to assess adequacy of calcium-homeostasis and morbidity.Methodology: Retrospective case-note and electro...

Introduction: The role of Vitamin D in bone formation and cardiovascular health could not be overemphasized. Sunlight is one of the principal sources of this vitamin/hormone. However, it’s deficiency has been observed in sunlight affluent areas. The objective of the study was to determine the prevalence and risk factors of low vitamin D among adults in the tropics (Kano).Methods: The study was a community-based cross-sectional descriptive study. The...

Primary hyperparathyroidism (PHPT) is one of the common endocrine conditions and is frequently associated with hypertension and increased cardiovascular mortality but this association is not well recognised. The purpose of this study was to evaluate the effect of parathyroidectomy on blood pressure. The data of 112 patients who attended our out patients clinic over the period of 12 months, with the confirmed diagnosis of primary hyperparathyroidism was evaluated. Average age w...

Background: Primary hyperparathyroidism is an endocrine disorder characterized by autonomous production of parathyroid hormone (PTH) results in the derangement of calcium metabolism. Imaging modalities used to localize includes technetium-99m sestamibi, sestamibi-single photon emission computed tomography (SPECT), SPECT-CT fusion, ultrasound Neck and Four dimensional computed tomography (4D-CT). Sestamibi scintigraphy combined with sestamibi single photon emission computed tom...

Aim: Cinacalcet is a useful treatment option in primary hyperparathyroidism (PHPT) who are managed conservatively; however there are licensing issues and challenges for prescribing in primary care. The aim of our study was to assess the efficacy of cinacalcet treatment in PHPT and benefit of admission avoidance.Methods: Data on patients treated with cinacalcet for PHPT were analysed. PTH, adjusted calcium and vitamin D at initiation, calcium at 6 and 12 ...

Background: Transient hypocalcaemia post parathyroid or thyroidectomy is common. Locally, post operative follow up was Ad-hoc with weekly visits where one of the Endocrine team would reduce Adcal D3© or 1α-Hydroxycholecalciferol doses to maintain eucalcaemia. This was frustrating for staff and patients who spent weeks and sometimes months having weekly blood tests. In an effort to improve the experience we piloted a pathway based on fixed dose replacement and day 1 p...

Introduction: This audit was undertaken to determine whether Primary Hyperparathyroidism (PHPT) management in the clinical setting is compliant with the nine standards set of the existing PHPT pathway in the City Hospital Sunderland Foundation Trust (CHSFT). PHPT pathway was developed in (CHSFT) to allow effective management and surgical referral for this common condition in line with available national and international guidelines.Methods: Data was retr...

Background: Bone stress injuries are typically overuse injuries associated with repetitive loading of bone and inadequate recovery. A continuum of bone stress injury from periosteal reaction to cortical fracture exists. Intrinsic and extrinsic recognised risk factors have been encapsulated within broader working consensus statements e.g. Relative Energy Deficiency in Sport (RED-S). There is uncertainty as to the appropriate metabolic work-up for such patients.<p class="abs...

Aim: Chromolaena odorata and Tithonia diversifolia have been combined as folkloric treatment for pediatric anemia. However, the underlying molecular mechanism of this pharmacology has not been established. This study sought to establish the effects of these plants on erythropoietin (kidney), and erythropoietin receptor (bone marrow) expression and to monitor cyclin-dependent kinase inhibitors, and FasL/FAS signaling mechanism therefrom....

Bartter’s syndrome (BS) and Gitelman’s syndrome (GS) are renal tubular disorders affecting reabsorption of sodium, potassium and chloride. Common clinical features include muscle cramps and weakness, hypokalaemia, hypochloraemic metabolic alkalosis and elevated plasma aldosterone concentrations. Urinary calcium excretion and plasma magnesium concentrations may be differentiating features, such that hypomagnesaemia and hypocalciuria are typical of GS, and hypercalciur...

Pseudohypoparathyroidism (PHP) is due to parathyroid hormone (PTH) resistance that results in hypocalcaemia, hyperphosphataemia and elevated plasma PTH concentrations. Some PHP patients also have Albright’s hereditary dystrophy (AHO), which is characterised by short stature, round faces, dental hypoplasia, brachydactyly, subcutaneous ossifications and reduced mental acuity. The 3 major types of PHP referred to as PHP type 1a (PHP1a), PHP1b and pseudopseudohypoparathyroidi...

Women with Turners Syndrome (TS) have been shown to have reduced bone mineral density (BMD) but there is uncertainty about how this relates to fracture risk. The little data that does exist is conflicting, with one case series finding no difference compared to controls and one survey suggesting an increased risk of fracture particularly of the forearm. Proposed mechanisms for reduced BMD include short stature, oestrogen deficiency and bone dysplasia. In addition, fracture risk...

Background: Hypocalcaemia post parathyroidectomy and thyroidectomy is common and usually transient. A variety of drugs including tyrosine kinase inhibitors can cause hypocalcaemia. We present a case where a patient with primary hyperparathyroidism on imatinib with pre-op calcium 2.86 mmol/l, post-operatively developed resistant hypocalcaemia necessitating prolong hospitalisation and multiple calcium infusions which was not solely attributable to hungry bone syndrome.<p cla...