Clinical Case 5.6

A 26-year-old man had been under long-term follow up for hypopituitarism as a result of the treatment of a very large 3rd ventricular brain tumor presenting at the age of 15 years. He had been treated by the insertion of a ventricular—peritoneal shunt to reduce hydrocephalus and 5500 cGy of craniospinal irradiation. Over the course of his 26th year, it was noted that his standing height decreased by 6 cm. His serum biochemistry was normal. In particular, the serum calcium was 2.45 mmol/l (NR 2.2–2.6 mmol/l), the Pi 1.1 mmol/l (NR 0.8–1.4 mmol/l) and the albumin 38 g/l (NR 38–48 g/l) and his replacement endocrine medication of hydrocortisone, thyroxine and mixed testosterone esters was unchanged. X-rays of his spine reveal marked osteoporosis (Box 5.34) that was confirmed on bone biopsy. Bone mineral density by dual X-ray absorptiometry was markedly reduced.

From: Chapter 5, The parathyroid glands and vitamin D

Cover of Endocrinology
Endocrinology: An Integrated Approach.
Nussey S, Whitehead S.
Copyright © 2001, BIOS Scientific Publishers Limited.

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