The International Journal of Romanian Society of Endocrinology / Registered in 1938

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  • Case Report

    Yetkin DO, Melek K, Mehtap T

    Hypocalcemia and Hypomagnesemia Due to Long Term Omeprazole Treatment

    Acta Endo (Buc) 2014 10(4): 699-704 doi: 10.4183/aeb.2014.699

    Context. This is the first case of proton pump induced hypomagnesemia and hypocalcemia, accompanied with increased parathormone levels. Objective. The proton pump inhibitors are widely used medications. They are considered safe, however, they have some side effects. One of these side effects is hypomagnesemia. Here we report a case with severe hypocalcemia and hypomagnesemia due to long term proton pump inhibitor. Case. A 73 years old woman, admitted to emergency room due to generalized tonic-clonic seizures. She had a previous history of muscle cramps and paresthesia for 4 months. She had a medical history of peptic ulcer and she was taking omeprazole for 7 years. Her laboratory evaluation showed marked hypomagnesemia [0.5 mg/dL (normal: 1.7-2.55 mg/dL)] and hypocalcemia [6.2 mg/dL (8.8-10.2 mg/ dL)] with extremely low urinary calcium (Ca) and magnesium (Mg) excretion [0.01 gr/24 h (normal:0.05-0.3 gr/24 h), <1.22 mg/24 h (normal: 9.7-12.20) respectively]. Her vitamin D level was normal [35 ng/ mL (normal:30-80 ng/mL)] and PTH was increased [129 pg/mL (normal: 15-65 pg/ mL)] in accordance with the secondary hyperparathyroidism. Symptoms resolved with the intravenous supplementation of calcium gluconate and magnesium sulphate. However, despite high levels of oral replacement, Mg levels remained low. With omission of omeprazole two months after the admission, her ion levels returned to normal without any replacement. Conclusion. Especially elderly patients with long term proton pump inhibitor therapy, should be monitored for the symptoms of hypocalcemia and hypomagnesemia.
  • Images in Endocrinology

    Tausanovic KM, Zivaljevic V, Paunovic IR

    Vertebral Metastasis as First Sign of Thyroid Papillary Microcarcinoma

    Acta Endo (Buc) 2014 10(4): 705-706 doi: 10.4183/aeb.2014.705

  • Notes & Comments

    Ursu HI

    Consensus on Current Guidelines for the Management of Thyroid Cancer

    Acta Endo (Buc) 2014 10(4): 707-712 doi: 10.4183/aeb.2014.707

    British Thyroid Association Guidelines for the management of thyroid cancer (third edition) was published recently (July 2014). The most common presentation of thyroid cancer is a newly discovered thyroid nodule or increase in size of a preexisting nodule. The long-term outcome of patients treated effectively for differentiated thyroid carcinoma is usually favorable. Nine per cent of patients with a diagnosis of thyroid cancer die of their disease. All patients with thyroid cancer should be seen within a multidisciplinary team (MDT) framework. Supra-physiological doses of levothyroxine are used to reduce the risk of thyroid cancer recurrence. The surgeon should have training and expertise in the management of thyroid cancer and be a core member of the MDT. Tumor recurrence or progression can be diagnosed earlier by detecting a raised serum thyroglobulin (Tg) after TSH stimulation (sTg) than by measurement of Tg on suppressive levothyroxine therapy.
  • Actualities in medicine

    Galoiu S

    Clinical Trials for Reducing Cardiovascular Mortality

    Acta Endo (Buc) 2014 10(4): 713-716 doi: 10.4183/aeb.2014.713

  • Book Review

    Vintila M

    Pediatric Endocrinology - 4th Edition

    Acta Endo (Buc) 2014 10(4): 717-718 doi: 10.4183/aeb.2014.717