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    Evaluation of the efficacy of radiofrequency ablation therapy in cases with parathyroid adenoma
    (Tubitak Scientific & Technological Research Council Turkey, 2025) Evren, Bahri; Bozbay, Abdulkadir; Yildirim, Ismail Okan; Topaloglu, Omercan; Sahin, Ibrahim
    Background/aim: Radiofrequency ablation of solitary parathyroid adenoma has been used to treat primary hyperparathyroidism (pHPT) in high-risk patients for parathyroidectomy. This study aimed to evaluate the clinical efficacy of radiofrequency ablation for treating pHPT in patients with parathyroid adenomas. Materials and methods: The sample for this retrospective study comprised all consecutive patients with solitary parathyroid adenoma treated with radiofrequency ablation between 2013 and 2021. Patients' baseline serum calcium and parathyroid hormone (PTH) values were obtained. The patients were followed up with serial biochemical measurements after the intervention, then at the first-week, first-month, third-month, sixth-month, and twelfth-month follow-ups. The study's primary outcome was a biochemical cure, defined as the reestablishment of normal serum calcium and PTH levels, persisting for at least 6 months after the ablation. Results: The changes in the serum calcium and PTH levels were significant (p < 0.05). The biochemical cure rate was 30.2% at 1 year. At the end of 1 year, the rate of patients with normal serum calcium levels was 86.6%, whereas the rate of patients with normal serum calcium and higher PTH levels was 55.8%. Conclusion: Radiofrequency ablation of a solitary parathyroid adenoma may be considered an alternative treatment for pHPT, given that more than half of the cases investigated in this study had normocalcemic hyperparathyroidism at 1 year.
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    An unusual cause of hypoglycemia; the case of a male patient with Munchausen's Syndrome
    (2021) Genc, Selin; Evren, Bahri; Slocum, Ayshe; Bozbay, Abdulkadir; Sener Aydin, Emine; Sahi?n, Ibrahim
    Munchausen's Syndrome is a psychiatric illness in which patients create potentially life-threatening symptoms for the purpose of admission to a hospital or other primary gains. A 23-year-old male patient was admitted to the Inonu University, Turgut Ozal Medical Center Endocrinology Inpatient Unit with hypoglycemic attacks. The patient had hypoglycemia that required intensive dextrose infusion. Studies conducted after his hospitalization revealed that the patient intentionally injected himself with high doses of insulin in order to be hospitalized. A diagnosis of factitious hypoglycemia and Munchausen Syndrome (MS) was made. The patient was followed up with recommendations from the psychiatry department. Factitious hypoglycemia, resulting from deliberate usage of blood glucose-lowering medications in the absence of hyperglycemia, is characterized by frequent episodes of hypoglycemia and recurrent hospitalizations and causes a variety of severe symptoms. Typical signs include low blood glucose levels, suppressed c-peptide and pro-insulin levels, and inappropriately high insulin levels. The purpose behind the current case report is to emphasize the significance of considering MS in the differential diagnosis of patients presenting with hypoglycemia and, although it is more prevalent among females, to demonstrate