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Tertiary hyperparathyroidism

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https://www.readbyqxmd.com/read/29644069/clinical-course-after-parathyroidectomy-in-adults-with-end-stage-renal-disease-on-maintenance-dialysis
#1
Christopher Thiam Seong Lim, Thevandra Kalaiselvam, Normayah Kitan, Bak Leong Goh
Background: Parathyroidectomy (PTX) is done in cases of secondary hyperparathyroidism from chronic kidney disease to improve renal osteodystrophy. Despite this widespread practice, clinical outcomes regarding the benefits of this procedure are still lacking. Most studies in the literature have opted to report the laboratory outcome instead. Our study aimed to evaluate the postoperative clinical course for patients who had undergone total PTX without autoimplantation. Methods and results: All patients who underwent PTX between January 2010 and February 2014 in a tertiary referral center were included in this study and followed up for 12 months...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29603323/brown-tumor-of-the-jaws-as-a-manifestation-of-tertiary-hyperparathyroidism-a-literature-review-and-case-report
#2
Bethina Dos Santos, Valesca Sander Koth, Maria Antonia Figueiredo, Fernanda Gonçalves Salum, Karen Cherubini
Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant-cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand-wrist, pelvis, and femur...
March 30, 2018: Special Care in Dentistry
https://www.readbyqxmd.com/read/29590494/endocrinopathies-and-renal-outcomes-in-lithium-therapy-impact-of-lithium-toxicity
#3
R Dineen, D Bogdanet, D Thompson, C J Thompson, L A Behan, A P McKay, G Boran, C Wall, J Gibney, V O'Keane, M Sherlock
Background: Lithium is the mainstay of treatment for bipolar disorder, mania and an augmentation therapy in patients with treatment resistant depression. It has a narrow therapeutic index, with recognized adverse multi-system and endocrine side effects. Aim: To assess the impact of lithium therapy, in particular lithium toxicity, on the development of endocrine and renal disorders in a cohort of patients in a single tertiary referral centre in Ireland. Study design: A retrospective analysis was performed of the prevalence of lithium toxicity and renal, thyroid and parathyroid dysfunction in our study population...
December 1, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29581916/hip-fracture-in-a-patient-with-primary-hyperparathyroidism-medical-and-surgical-lessons
#4
M N Baig, Cathal Mac Dhaibheid, Fintan J Shannon
Hyperparathyroidism is a condition which can be primary, secondary or tertiary and is characterized by increased calcium levels, low phosphate levels, and elevated parathyroid hormone (PTH) levels. Primary hyperthyroidism can cause severe bone resorption leading to bone pains and pathological fracture. We present the case of a patient with severe primary hyperparathyroidism with an atraumatic fracture at the neck of the femur and multiple medical comorbidities presenting a surgical challenge. While primary hyperparathyroidism is rare, it should be considered during differential diagnoses...
January 23, 2018: Curēus
https://www.readbyqxmd.com/read/29549509/changing-profile-of-primary-hyperparathyroidism-over-two-and-half-decades-a-study-in-tertiary-referral-center-of-north-india
#5
Sanjay Kumar Yadav, Saroj Kanta Mishra, Anjali Mishra, Sabaretnam Mayilvagnan, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Ashok Kumar Verma
BACKGROUND: Most of the cases of PHPT in developing countries present in symptomatic stage, some even in very advanced stage but in recent years the trend seems to be changing. This has been corroborated from few recently published literature from developing countries. The scope of this study is to further carry out an in-depth analysis of various clinical and biochemical parameters of PHPT patients at a tertiary care center of northern India. METHODS: In this retrospective analysis, a total of 333 patients with PHPT from the year 1990 to 2016 were studied...
March 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29531614/brown-tumour-in-the-mandible-and-skull-osteosclerosis-associated-with-primary-hyperparathyroidism-a-case-report
#6
Danica Popovik-Monevska, Suzana Bozovik-Dvojakovska, Vladimir Popovski, Alberto Benedetti, Aleksandar Grchev, Filip Koneski
BACKGROUND: The hyperparathyroidism (HPT) is a condition in which the parathyroid hormone (PTH) levels in the blood are increased. HPT is categorised into primary, secondary and tertiary. A rare entity that occurs in the lower jaw in association with HPT is the so-called brown tumour, which an osteolytic lesion is predominantly occurring in the lower jaw. It is usually a manifestation of the late stage of the disease. Osteosclerotic changes in other bones are almost always associated with renal osteodystrophy in secondary HPT and are extremely rare in primary HPT...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29484563/4d-ct-is-superior-to-ultrasound-and-sestamibi-for-localizing-recurrent-parathyroid-disease
#7
Moska Hamidi, Michael Sullivan, George Hunter, Leena Hamberg, Nancy L Cho, Atul A Gawande, Gerard M Doherty, Francis D Moore, Matthew A Nehs
BACKGROUND: Recurrent primary hyperparathyroidism (PHPT) presents a diagnostic challenge in localizing a hyperfunctioning gland. Although several imaging modalities are available for preoperative localization, 4D-CT is increasingly utilized for its ability to locate both smaller and previously unlocalized lesions. Currently, there is a paucity of data evaluating the utility of 4D-CT in the reoperative setting compared with ultrasound (US) and sestamibi. We aimed to determine the sensitivity of 4D-CT in localizing parathyroid adenomas in recurrent or persistent PHPT...
February 26, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29458876/bone-densitometry-status-and-its-associated-factors-in-peri-and-post-menopausal-females-a-cross-sectional-study-from-a-tertiary-care-centre-in-india
#8
Jaya Chawla, Neena Sharma, Devendra Arora, Manisha Arora, Lovely Shukla
OBJECTIVE: Osteoporosis is a skeletal disorder characterized by diminished bone strength that increases the risk of fracture at instances of trivial trauma. Asians have a lower bone mass than the west. The present study was designed to add data from India on women above the age of 40 years with respect to low bone mineral density (BMD) and its associated high risk factors. MATERIALS AND METHODS: After a written informed consent, a detailed history was taken. Basal metabolic index was recorded, and biochemical and endocrine tests were done, followed by dual X ray absorptiometry scan...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29419958/-total-parathyroidectomy-autoimplant-and-cryopreservation-for-the-treatment-of-hyperparathyroidism-of-renal-origin-in-children-and-young-adults
#9
T Ferraris, L Toselli, J Udaquiola, R Vagni, P Coccia, G Alonso, P Lobos, J Moldes, D Liberto
OBJECTIVES: To describe our initial experience in the treatment of hyperparathyroidism (HPP) of renal cause using total or subtotal parathyroidectomy, autoimplant and cryopreservation in pediatric patients. Secondary HPP is the increased function of the parathyroid hormone (PTH) due to an abnormal phosphocalcic metabolism in patients with chronic renal failure (CRF). This situation produces increased bone resorption resulting in osteodystrophy and endovascular calcifications. Surgical treatment is aimed to diminish the level of PTH in CRF patients, to avoid HPP complications...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29408534/probability-of-positive-genetic-testing-results-in-patients-with-family-history-of-primary-hyperparathyroidism
#10
Mustapha El Lakis, Pavel Nockel, Apostolos Gaitanidis, Bin Guan, Sunita Agarwal, James Welch, William F Simonds, Lee Weinstein, Stephen Marx, Naris Nilubol, Dhaval Patel, Roxanne Merkel, Amit Tirosh, Electron Kebebew
BACKGROUND: Approximately 10% of patients with primary hyperparathyroidism (PHPT) have hereditary disease. Hereditary PHPT may be syndromic (multiple endocrine neoplasia (MEN1, 2, 4), hyperparathyroidism-jaw tumor syndrome) or non-syndromic (familial isolated primary hyperparathyroidism). There are limited data on the probability of testing positive for genetic mutation based on clinical presentation. The aim of this study was to determine potential associations between clinical and biochemical features and mutation in susceptibility genes for PHPT in patients with a family history of PHPT...
February 2, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29357735/niche-point-of-care-endocrine-testing-reviews-of-intraoperative-parathyroid-hormone-and-cortisol-monitoring
#11
Li-Sheng Chen, Ravinder J Singh
Point-of-care (POC) testing, which provides quick test results in near-patient settings with easy-to-use devices, has grown continually in recent decades. Among near-patient and on-site tests, rapid intraoperative and intra-procedural assays are used to quickly deliver critical information and thereby improve patient outcomes. Rapid intraoperative parathyroid hormone (ioPTH) monitoring measures postoperative reduction of parathyroid hormone (PTH) to predict surgical outcome in patients with primary hyperparathyroidism, and therefore contributes to the change of parathyroidectomy to a minimally invasive procedure...
March 2018: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29322299/serum-parathyroid-hormone-and-25-hydroxyvitamin-d-concentrations-before-and-after-biliopancreatic-diversion
#12
Vanessa Tardio, Jean-Philippe Blais, Anne-Sophie Julien, Pierre Douville, Stefane Lebel, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Claudia Gagnon
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) decreases vitamin D and calcium absorption, which may result in secondary hyperparathyroidism. This study aimed at evaluating the prevalence of vitamin D deficiency and secondary hyperparathyroidism before and after BPD-DS. METHODS: A retrospective analysis of patients who had undergone BPD-DS at a tertiary bariatric center between 2003 and 2010 and for whom simultaneous measurements of serum 25-hydroxyvitamin D and parathyroid hormone were available within 5 years post-op was performed...
January 10, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29302479/near-total-parathyroidectomy-for-the-treatment-of-renal-hyperparathyroidism
#13
Marco Puccini, Cristina Ceccarelli, Ophelia Meniconi, Claudia Zullo, Valerio Prosperi, Mario Miccoli, Lucio Urbani, Piero Buccianti
Background: Different surgical strategies are used to treat medical refractory renal hyperparathyroidism. Our preferred choice in patients with moderate secondary hyperparathyroidism (SHPT) and in patients with low compliance with medical treatment is to leave a very small parathyroid remnant in situ: we name this operation "near total parathyroidectomy" (ntPTX). We report here our results with this technique. Methods: Retrospective study [2001-2015] of all patients submitted to ntPTX in a single centre...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29154082/are-preoperative-sestamibi-scans-useful-for-identifying-ectopic-parathyroid-glands-in-patients-with-expected-multigland-parathyroid-disease
#14
Farah Karipineni, Zeyad Sahli, Helina Somervell, Aarti Mathur, Jason D Prescott, Ralph P Tufano, Martha A Zeiger
BACKGROUND: The role of preoperative localization studies in patients with hyperparathyroidism and expected multigland disease remains poorly defined. Our study investigates the usefulness of obtaining preoperative sestamibi scans and ultrasonography of the neck in identifying ectopic glands in this group of patients. METHODS: Under Institutional Review Board approval, we performed a retrospective review of patients who underwent operation for secondary hyperparathyroidism, tertiary hyperparathyroidism, lithium-induced hyperparathyroidism, and multiple endocrine neoplasia syndrome at a tertiary institution between 2004 and 2015...
January 2018: Surgery
https://www.readbyqxmd.com/read/29143130/two-threshold-levels-of-vitamin-d-and-the-prevalence-of-comorbidities-in-outpatients-of-a-tertiary-hospital
#15
I N Furuie, M J J Mauro, S Petruzziello, S C Riechi, R R Petterle, C L Boguszewski, V Z C Borba
This study evaluated the number of comorbidities between two normal values of 25OHD in outpatients during 1 year of 25OHD measurements. Five hundred twenty-nine outpatients were included, patients with 25OHD ≥ 20 and < 30 ng/mL had the higher number of comorbidities, suggesting that for this specific population, 25OHD ≥ 30 ng/mL would be more appropriate. INTRODUCTION : This study evaluated the comorbidities between two values of 25OHD in outpatients of a tertiary hospital. METHODS: This is a cross-sectional study with measures of 25OHD in 1-year period, excluding 25OHD < 20 and > 50 ng/mL, clinical research participants, and liver disease and chronic renal failure patients...
November 15, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29131092/value-of-intraoperative-parathyroid-hormone-assay-during-parathyroidectomy-in-dialysis-and-renal-transplant-patients-with-secondary-and-tertiary-hyperparathyroidism
#16
Amr El-Husseini, Kevin Wang, Annick Edon, David Saxon, Florence Lima, David Sloan, B Peter Sawaya
BACKGROUND: In dialysis and renal transplant patients with secondary and tertiary hyperparathyroidism (HPT), the value of intraoperative parathyroid hormone (ioPTH) during parathyroidectomy (PTX) and its association with long-term PTH levels are unknown. The present study aims at evaluating the relationship of ioPTH with long-term PTH levels post-PTX in dialysis and renal transplant patients in a single-center study. METHODS: The ioPTH was measured in 57 dialysis patients (33 females and 24 males) and 18 renal transplant recipients (12 males and 6 females) who underwent PTX from 2005 to 2015 for refractory HPT...
November 9, 2017: Nephron
https://www.readbyqxmd.com/read/29076678/vitamin-d-toxicity-and-other-non-malignant-causes-of-hypercalcemia-a-retrospective-study-at-a-tertiary-care-hospital-in-pakistan
#17
Muhammad Naeem Khan, Muhammad Qamar Masood, Mohammad Arsalan Siddiqui, Sabahat Naz, Najmul Islam
BACKGROUND: Hypercalcemia is a common clinical problem; primary hyperparathyroidism and malignancy is commonest causes of hypercalcemia. Aetiology of hypercalcemia are changing, causes that were diseases of the past like Vitamin-D toxicity and milk alkali syndrome are observed more often. Vitamin-D deficiency is an important problem and overzealous replacement of Vitamin-D has been observed, suspected to cause toxicity. METHODS: This was a retrospective review of patients admitted at the Aga Khan University Hospital from January 2008 to December 2013 with hypercalcemia...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29054174/long-term-nutritional-impact-of-sleeve-gastrectomy
#18
M Caron, F S Hould, O Lescelleur, S Marceau, S Lebel, F Julien, S Simard, Laurent Biertho
BACKGROUND: Sleeve gastrectomy (SG) has become a predominant bariatric procedure throughout the world. However, the long-term nutritional impact of this procedure is unknown. OBJECTIVES: To describe the nutritional deficiencies before and after SG and to analyze the influence of baseline weight on nutritional status. SETTING: University-affiliated tertiary care center. METHODS: All patients who underwent SG as a standalone procedure between 2008 and 2012 were included in this study...
October 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29040582/cdc73-related-disorders-clinical-manifestations-and-case-detection-in-primary-hyperparathyroidism
#19
Karin van der Tuin, Carli M J Tops, Muriel A Adank, Jan-Maarten Cobben, Neveen A T Hamdy, Marjolijn C Jongmans, Fred H Menko, Bernadette P M van Nesselrooij, Romana T Netea-Maier, Jan C Oosterwijk, Gerlof D Valk, Bruce H R Wolffenbuttel, Frederik J Hes, Hans Morreau
Context: Heterozygous pathogenic germline variants in CDC73 predispose to the development of primary hyperparathyroidism (pHPT) and, less frequently, ossifying fibroma of the jaw and renal and uterine tumors. Clinical information on CDC73-related disorders has so far been limited to small case series. Objective: To assess the clinical manifestations and penetrance in CDC73-related disorders and to improve case detection in pHPT. Design: Nationwide retrospective Dutch cohort study...
December 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29021995/tumor-induced-osteomalacia
#20
Pablo Florenzano, Rachel I Gafni, Michael T Collins
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome clinically characterized by bone pain, fractures and muscle weakness. It is caused by tumoral overproduction of fibroblast growth factor 23 (FGF23) that acts primarily at the proximal renal tubule, decreasing phosphate reabsorption and 1α-hydroxylation of 25 hydroxyvitamin D, thus producing hypophosphatemia and osteomalacia. Lesions are typically small, benign mesenchymal tumors that may be found in bone or soft tissue, anywhere in the body...
December 2017: Bone Reports
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