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https://www.readbyqxmd.com/read/29049872/optimal-dosing-and-delivery-of-pth-and-its-analogues-for-osteoporosis-and-hypoparathyroidism-translating-the-pharmacology
#1
REVIEW
D Tay, S Cremers, J P Bilezikian
In primary hyperparathyroidism (PHPT), bone loss results from the resorptive effects of excess parathyroid hormone (PTH). Under physiological conditions, PTH has actions that are more targeted to homeostasis and to bone accrual. The predominant action of PTH, either catabolic, anabolic, or homeostatic, can be understood in molecular and pharmacokinetic terms. When administered intermittently, PTH increases bone mass, but when present continuously and in excess (e.g., PHPT), bone loss ensues. This dual effect of PTH depends not only on the dosing regimen, continuous or intermittent, but also on how the PTH molecule interacts with various states of its receptor (PTH/PTHrP receptor) influencing downstream signaling pathways differentially...
October 19, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29047366/the-use-of-cinacalcet-hinders-the-diagnosis-of-parathyroid-carcinoma-in-a-chronic-dialysis-patient-a-case-report
#2
Daisuke Takada, Tatsuo Tsukamoto, Miho Fuse, Shinpei Kada, Motoko Yanagita
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving chronic dialysis therapy. Although cinacalcet can control parathyroid function and bone turnover, preventing ectopic calcification remains challenging. Cinacalcet can also suppress PTH secretion due to parathyroid carcinoma in the same way as it does for parathyroid hyperplasia in the uremic condition. We present a case of parathyroid carcinoma partially controlled by cinacalcet, in which tumorous calcinosis was successfully resolved by total parathyroidectomy...
October 18, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29044732/fresh-tissue-parathyroid-allotransplantation-with-short-term-immunosuppression-1-year-follow-up
#3
Emrah Yucesan, Beyza Goncu, Harun Basoglu, Nur Ozten Kandas, Yeliz Emine Ersoy, Fahri Akbas, Erhan Aysan
BACKGROUND: Permanent hypoparathyroidism is a serious problem and requires medications indefinitely. Parathyroid allotransplantation (PA) with short-term immunosuppression is definitive choice but long-term results are not clear. METHOD: We performed PA from two donors to two recipients. Both recipients were 39-year-old females. Donors were a 32-year-old female and a 36-year-old male, who both have chronic kidney disease. Routine tests, viral markers, and cross-matches were analyzed individually...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29040300/risk-factors-for-nodular-hyperplasia-of-parathyroid-glands-in-shpt-patients
#4
Mark D Jäger, Michaela Serttas, Jan Beneke, Jörg A Müller, Harald Schrem, Alexander Kaltenborn, Wolf Ramackers, Bastian P Ringe, Jill Gwiasda, Wolfgang Tränkenschuh, Jürgen Klempnauer, Georg F W Scheumann
INTRODUCTION: Nodular hyperplasia of parathyroid glands (PG) is the most probable cause of medical treatment failure in secondary hyperparathyroidism (sHPT). This prospective cohort study is located at the interface of medical and surgical consideration of sHPT treatment options and identifies risk-factors for nodular hyperplasia of PG. MATERIAL AND METHODS: One-hundred-eight resected PG of 27 patients with a broad spectrum of sHPT severity were classified according to the degree of hyperplasia by histopathology...
2017: PloS One
https://www.readbyqxmd.com/read/29036000/unilateral-submandibular-gland-atrophy-and-sialolithiasis-diagnosed-on-99mtc-mibi-spect-ct-in-a-patient-with-primary-hyperparathyroidism
#5
Puskar Pattanayak, Prasanna Santhanam, Mehrbod Som Javadi, Lilja B Solnes, Steven P Rowe
A variety of sequelae of elevated calcium levels are encountered in patients with underlying primary hyperparathyroidism, including stone formation such as calculi in the urinary tract and sialoliths in the salivary glands and ducts. We present a case of a 54-year-old woman with fatigue, myalgia, and poor concentration who was found to have hypercalcemia (corrected calcium, 11.2 mg/dL) and elevated parathyroid hormone level (112 pg/mL), laboratory values consistent with primary hyperparathyroidism. She underwent evaluation with a Tc-MIBI parathyroid SPECT scan that included x-ray CT acquisitions for anatomical localization and attenuation correction...
October 13, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29030756/a-herald-of-plasma-cell-myeloma-a-report-of-malignant-plasma-cells-identified-in-parathyroid-adenoma-and-a-review-of-non-parathyroid-malignancies-in-parathyroid-glands
#6
Vincent Cracolici, Raymon H Grogan, Madina Sukhanova, Jason X Cheng, Sandeep Gurbuxani, Nicole A Cipriani
Involvement of the parathyroid glands by non-parathyroid neoplasia is an infrequent event. Rare cases of metastases to the parathyroid gland have been reported in parathyroidectomies and autopsies of patients with known solid or hematopoietic malignancies. Here, we present a case of atypical clonal plasma cells incidentally identified within a parathyroid adenoma resected for hyperparathyroidism and hypercalcemia, which served as the sentinel event for a subsequent diagnosis of plasma cell myeloma. To our knowledge, this is the only reported case of a hematopoietic malignancy involving a parathyroid adenoma and the only reported case of malignant hematopoietic cells initially detected in parathyroidectomy...
October 13, 2017: Head and Neck Pathology
https://www.readbyqxmd.com/read/29022783/current-predictive-models-do-not-accurately-differentiate-between-single-and-multi-gland-disease-in-primary-hyperparathyroidism-a-retrospective-cohort-study-of-two-endocrine-surgery-units
#7
O Edafe, E E Collins, C S Ubhi, S P Balasubramanian
Background Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism is dependent upon accurate prediction of single-gland disease on the basis of preoperative imaging and biochemistry. The aims of this study were to validate currently available predictive models of single-gland disease in two UK cohorts and to determine if these models can facilitate MIP. Methods This is a retrospectively cohort study of 624 patients who underwent parathyroidectomy for primary hyperparathyroidism in two centres between July 2008 and December 2013...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022781/near-infrared-autofluorescence-imaging-to-detect-parathyroid-glands-in-thyroid-surgery
#8
R Ladurner, N Al Arabi, U Guendogar, Kkj Hallfeldt, H Stepp, Jks Gallwas
Objective To identify and save parathyroid glands during thyroidectomy by displaying their autofluorescence. Methods Autofluorescence imaging was carried out during thyroidectomy with and without central lymph node dissection. After visual recognition by the surgeon, the parathyroid glands and the surrounding tissue were exposed to near-infrared light with a wavelength of 690-770 nm using a modified Karl Storz near infrared/indocyanine green endoscopic system. Parathyroid tissue was expected to show near infrared autofluorescence at 820 nm, captured in the blue channel of the camera...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28993832/-diagnostics-and-treatment-of-primary-hyperparathyroidism
#9
C Nies
Primary hyperparathyroidism is a disease that occurs more frequently than generally thought and is often overlooked. Classical symptoms are bone pain and osteoporosis, renal calculi and peptic ulcers. Many patients are asymptomatic or have unspecific complaints. It is easy to establish the biochemical diagnosis based on calcium and parathormone (PTH) levels and 24-h urine calcium excretion. The most sensitive localization procedures for parathyroid adenomas are sonography and Tc-99(m)-MIBI scintigraphy. The indication for surgery is undisputed in symptomatic patients; however, there is controversy concerning patients without classical symptoms...
October 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28985747/thyroid-hemiagenesis-and-hashimoto-s-thyroditis-diagnostic-and-treatment-pitfalls
#10
Minghao Wang, Lingmi Hou, Maoshan Chen, Lin Ren, Peng Tang, Yi Zhang, Jun Jiang
BACKGROUND: Thyroid hemiagenesis (TH) is a rare congenital disease with absence of a thyroid lobe; most patients have no clinical symptoms. The etiology of TH remains unclear. In this paper, we describe a rare case of TH and congenital absence of the ipsilateral parathyroid gland, found during the operation, combined with the autoimmune disease Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis. CASE PRESENTATION: A 31-year-old woman was admitted to our hospital because of a mass in the right neck...
October 6, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28984340/water-clear-cell-adenoma-of-the-mediastinal-parathyroid-gland
#11
Deniz Arik, Emine Dündar, Evrim Yilmaz, Cumhur Sivrikoz
Water-clear cell adenoma of the parathyroid gland is a rare neoplasm that consists of cells with abundant clear-pink cytoplasm. There have only been 19 cases reported in the English literature. Here we report a case of water-clear cell adenoma of the mediastinal parathyroid gland. A 70-year-old male patient presented to the hospital with back pain and a mediastinal mass 6 cm in size was detected. After excision and microscopic evaluation, uniform, large clear cells with fine cytoplasmic vacuolization, without nuclear atypia, and arranged in solid and acinar patterns were revealed...
October 6, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28980761/parathyroid-nodular-hyperplasia-and-responsiveness-to-drug-therapy-in-renal-secondary-hyperparathyroidism-an-open-question
#12
REVIEW
Carlo Vulpio, Maurizio Bossola
The goal of the pharmacological therapy in secondary hyperparathyroidism (SHPT) is to reduce serum levels of parathyroid hormone and phosphorus, to correct those of calcium and vitamin D, to arrest or reverse the parathyroid hyperplasia. However, when nodular hyperplasia or an autonomous adenoma develops, surgery may be indicated. We reviewed the literature with the aim of defining if the echographic criteria predictive of unresponsiveness of SHPT to calcitriol therapy are valid also in the cinacalcet era and if drug therapy may reverse nodular hyperplasia of parathyroid gland (PTG)...
October 5, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28979642/nonfunctional-double-parathyroid-carcinoma-with-incidental-thyroid-micropapillary-carcinoma-a-rare-case
#13
Kursat Dikmen, Hasan Bostanci, Huseyin Gobut, Alp Yildiz, Onur Ertunc, Ali Celik, Murat Akin, Ferit Taneri
Parathyroid carcinomas are rare endocrine tumors which comprise 0.3-5.6% of all causes of hyperparathyroidism. 90% of them are hormonally active, while 10% of them may be non-functional. They mostly occur in a single parathyroid gland. Concurrent involvement of both parathyroid glands is quite rare. A 57-year-old male patient was admitted to emergency department with the complaint of dyspnea. Thorax tomography revealed a retrosternal mass. The mass was thoracoscopically excised by thoracic surgeons. Histopathological examination result of the mass was reported as parathyroid carcinoma...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28976876/parathyroidectomy-in-hyperparathyroidism-associated-calciphylaxis-in-end-stage-renal-disease-should-be-prompt-and-radical-a-case-report-with-two-original-therapeutic-modifications-and-successful-outcome
#14
Sylvie Dusilová Sulková, Jiří Horáček, Eva Vykoukalová, Roman Šafránek, Alena Malá, Vladimír Palička
We present a case of severe calciphylaxis in both thighs and calves in a patient with end-stage renal disease and advanced secondary hyperparathyroidism with successful outcome after modified therapeutic approach. The cause of calciphylaxis is multifactorial. In our case, not only severe hyperparathyroidism and mediocalcinosis, but also medication (warfarin, calcium and active vitamin D) was involved. Because the initial conservative therapy was not successful, we indicated parathyroidectomy. However, we were not able to localize parathyroid glands and we contraindicated bilateral neck exploration due to the patient's critical status...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28964572/transcription-factor-mafb-may-play-an-important-role-in-secondary-hyperparathyroidism
#15
Naoki Morito, Keigyou Yoh, Toshiaki Usui, Hisashi Oishi, Masami Ojima, Akiko Fujita, Ryusuke Koshida, Hossam H Shawki, Michito Hamada, Masafumi Muratani, Kunihiro Yamagata, Satoru Takahashi
The transcription factor MafB is essential for development of the parathyroid glands, the expression of which persists after morphogenesis and in adult parathyroid glands. However, the function of MafB in adult parathyroid tissue is unclear. To investigate this, we induced chronic kidney disease (CKD) in wild-type and MafB heterozygote (MafB+/-) mice by feeding them an adenine-supplemented diet, leading to secondary hyperparathyroidism. The elevated serum creatinine and blood urea nitrogen levels in heterozygous and wild-type mice fed the adenine-supplemented diet were similar...
September 27, 2017: Kidney International
https://www.readbyqxmd.com/read/28963593/retropharyngeal-parathyroid-glands-important-differences
#16
James W Gallagher, Meghan L Kelley, Linwah Yip, Sally E Carty, Kelly L McCoy
INTRODUCTION: In primary hyperparathyroidism (PHPT), parathyroid ectopia is seen in up to 22% leading to more difficult surgery. We aimed to determine the rate and characteristics of retropharyngeal (RP) parathyroid glands. METHODS: A prospective database was queried for patients with sporadic PHPT who had surgery from 1997 to 2016. The data of RP patients were compared to those who had surgery for sporadic PHPT over the same time period with hyperfunctioning parathyroids in anatomically normal positions (N)...
September 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28955671/is-decline-rate-of-intact-parathyroid-hormone-level-a-reliable-criterion-for-early-discharge-of-patients-after-total-thyroidectomy
#17
Mohsen Kolahdouzan, Shahab Shahabi Shahmiri, Seyed Mozafar Hashemi, Behrouz Keleidari, Masoud Nazem, Rastin Mohammadi Mofrad
INTRODUCTION: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. The current study aimed at evaluating the comparative predictive role of serum calcium and intact parathyroid hormone (iPTH) for post-thyroidectomy hypocalcemia. MATERIALS AND METHODS: This prospective study was performed in 83 consecutive patients undergoing total thyroidectomy...
September 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28953673/evaluation-of-clinical-significance-and-risk-factors-of-incidental-parathyroidectomy-due-to-thyroidectomy-a-single-center-retrospective-clinical-study
#18
Jianwei Zheng, Huimin Song, Shuyan Cai, Yunlei Wang, Xiaofeng Han, Haoliang Wu, Zhigang Gao, Fanrong Qiu
We assessed the clinical significance and risk factors of incidental parathyroidectomy during total thyroidectomy with or without central neck dissection or subtotal thyroidectomy.Retrospective analysis of clinical and pathological features of 548 consecutive thyroidectomy cases was compared by grouping into inadvertent resection (IR, n = 86) with IR of parathyroid glands, non-IR (n = 462) without, and then into postoperative hypoparathyroidism (PH, n = 140) with PH and non-PH (n = 408) without...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953664/risk-factors-of-hypoparathyroidism-following-total-thyroidectomy-with-central-lymph-node-dissection
#19
Anping Su, Bin Wang, Yanping Gong, Rixiang Gong, Zhihui Li, Jingqiang Zhu
The risk factors of hypoparathyroidism after total thyroidectomy (TT) with central lymph node dissection (CND) have not been completely defined. The aim of the study was to evaluate the risk factors of hypoparathyroidism after the surgery.We retrospectively reviewed our patients who underwent TT and CND (including lateral lymph node dissection) for thyroid carcinoma between January 2013 and June 2016. According to the postoperative serum levels of parathyroid hormone within 6 months, the patients were divided into normal, transient hypoparathyroidism, and permanent hypoparathyroidism groups...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28949123/endocrine-and-neuroendocrine-cytopathology
#20
Massimo Bongiovanni, Stefano LA Rosa, Gerasimos P Sykiotis
Cytology is an easily accessible, cost-effective and safe procedure for the initial evaluation of most endocrine/neuroendocrine lesions. Both fine-needle aspiration cytology and exfoliative cytology have shown good sensitivity and specificity in detecting endocrine/neuroendocrine benign proliferations and malignancies. Thanks to its utility for early diagnosis, cytology has contributed to the decline in mortality of endocrine/neuroendocrine neoplasms. The endocrine system comprises different endocrine organs, such as the thyroid, adrenal glands, paraganglia, parathyroid, pancreas, hypothalamus, pituitary gland, ovaries and testes, which can give rise to non-neoplastic, benign and malignant proliferations...
September 25, 2017: Minerva Endocrinologica
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