Biochemical Analysis of Mineral Metabolism and Central Bone Mineral Density in 157 Adult Women

Bechir, Edwin Sever; Cârșote, Mara; Ţuculină, Mihaela Jana; Bătăiosu, Marilena; Dascălu, Ionela Teodora; Raescu, Mihaela; Rîcă, Radu; Dăguci, Constantin; Dăguci, Luminiţa; Predescu, Anca Mihaela; Andrei, Oana Cella; Mercuţ, Răzvan; Cumpătă, Cristian Niky

doi:10.37358/rc.18.12.6793

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…As expected for a patient with metabolic complications, low levels of vitamin D were identified but associating a normal parathormone value (15,16). Also, the blood bone turnover markers were irrelevant even in glucocorticoid-induced bone loss a high resorption with low bone formation is presented, as well as blunted turnover in diabetes mellitus (17,18,19).…”

Section: Tumour-related Osteoporosismentioning

confidence: 67%

Striae rubrae: Cushing’s syndrome

Valea¹,

Şandru²,

Dumitrașcu³

et al. 2019

Ro J Med Pract.

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Striae rubrae or red striae are found in different circumstances like pregnancy, weight gain and Cushing's syndrome regardless of endogenous or exogenous type. This type of skin lesion is commonly found in general population and usually does not underline a severe condition. The histological aspect that involves the stretch marks is the destruction of the dermal fibbers and their local network. The fibbers have receptors for glucocorticoids. A secondary epidermal anomaly is also seen. In benign scenarios the prevention with topic applications is still a matter of debate while therapy lasers of different types might help. In cases with pathological glucocorticoids excess the removal of the source improves the skin lesions yet not completely, they become white. We aim to introduce two cases of Cushing's disease of different origins to whom impressive red striae were positive from the presentation. Red striae may be the hallmark of Cushing's syndrome in association with different cardio-metabolic and/or bone complications. Despite the remission of the glucocorticoid excess the skin lesions are not completely reversible.

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Section: Tumour-related Osteoporosismentioning

confidence: 67%

Striae rubrae: Cushing’s syndrome

Valea¹,

Şandru²,

Dumitrașcu³

et al. 2019

Ro J Med Pract.

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“…Yet in cases with renal failure and persistent hyper-parathyroidism the re-intervention decision is delicate and a close selection needs to be done (17). In this particular situation the values of PTH are extremely high as seen here in addition to increased bone turnover profile reaching levels that are completely different to usual cases of primary hyperparathyroidism or primary osteoporosis (18,19). Moreover, even the patient had extremely high PTH serum calcium levels were controlled through haemodialysis (20).…”

Section: Discussionmentioning

confidence: 88%

Tertiary hyperparathyroidism – location dilemma

Cârșote¹,

Albu²,

Şandru³

et al. 2019

Ro Med J.

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Renal failure is associated with numerous complications including cardiovascular, dermatological, neurological, surgical and endocrine. Hypovitaminosis D induces secondary hyperparathyroidism and long term effects are represented by autonomous stimulation of the parathyroid glands (tertiary hyperparathyroidism). Fail of PTH (parathyroid hormone) levels control through vitamin D replacement makes necessary a surgical intervention because of the risk of chronic complications in addition to the general morbidities caused by chronic kidney disease including osteoporosis. Our aim is to present a case of an adult woman with a very long history of renal failure complicated with tertiary hyperparathyroidism and osteoporosis. The clue of the case is the difficult localisation of PTH source after total parathyroidectomy was previously done in order to remove it and timing of re-intervention. There is a challenge to adequately locate the parathyroid remnants after a prior glands removal and a skilled surgeon is still the best "tool". However, the risk of surgery in a cases with multiple complications is very high so it is preferable a pre-operatory localisation. The neck ultrasound is the most accessible tool offering a good accuracy if there is no mediastinal localisation and also the combination with parathyroid scintigram increases the rate of detection. abbreviations BMD = bone mineral density DXA = Dual-Energy X-Ray Absorptiometry PTH = parathormone SD = standard deviation

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“…In Paget's disease or multiple myeloma the markers may reach to extremely high values (10,12). Under biphosphonates the markers get low opposite to teriparatide therapy as an osteoanabolic option (13,14,15). In this case we do not currently consider clinically relevant the value of CrossLaps.…”

Section: Discussionmentioning

confidence: 99%

“…In this case the bone turnover were within normal limits except for a small decrease of CrossLaps. Generally the bone turnover markers are considered with a high inter-and intra-individual variability (12,13). The derivates from collagen are most useful in daily practice (12,13,14).…”

Section: Discussionmentioning

confidence: 99%

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Forearm lump and osteoporosis

Cârșote¹,

Albu²,

Şandru³

et al. 2019

Ro J Med Pract.

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We introduce a case of a menopausal woman newly diagnosed with primary osteoporosis who has been detected with a forearm lump. A 57-year old female is confirmed with osteoporosis at DXA. The patient developed within 10 days a painful lump with local redness at dorso-medial part of left forearm. Apparently no local trauma was identified. Neither had she a general infection or any other condition in the mean time. The ultrasound identified a hypoechoic area of 4 by 1.3 by 4 cm, with positive Doppler signal. A local infection was considered and she was offered antibiotics for 10 days. However, since the patient also accused bone pain, she was re-referred for an endocrine assessment. The hormonal panel was consistent with the first assays. Also a mild inflammatory syndrome was detected based on erythrocytes sedimentation rate of 31 mm/1-hour (normal: < 25 mm/1-h) and C reactive protein of 1.4 mg/dl (normal: < 1 ng/ml). An X-Ray of the region was done and showed no anomaly. The bone whole body scintigram was negative at forearm but a fracture rib at the level of 9th left rib was identified and considered osteoporotic. A computed tomography showed the subcutaneous localisation of the lump with small calcifications and no bone involvement. Paget's disease of the bone was excluded based on normal bone turnover markers and negative bone scintigram. The proximity with a bone disease diagnosis needs to differentiate a subcutaneous lesion from a potential bone deformity caused by a metabolic bone condition.

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Biochemical Analysis of Mineral Metabolism and Central Bone Mineral Density in 157 Adult Women

Cited by 3 publications

References 7 publications

Striae rubrae: Cushing’s syndrome

Striae rubrae: Cushing’s syndrome

Tertiary hyperparathyroidism – location dilemma

Forearm lump and osteoporosis

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