PTH and neoplasm: Other clinical manifestations of GD not included in the GED-C scoring system should be considered in future algorithms developed for GD diagnosis, for example co-morbidities that may be associated with GD such as neoplasms, endocrinological disorders like insulin-like growth hormone deficiency, as well as abnormalities in parathyroid hormone levels, phospho-calcium metabolism, and vitamin D levels [22–25].