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Tertiary hyperparathyroidism

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https://www.readbyqxmd.com/read/29419958/-total-parathyroidectomy-autoimplant-and-cryopreservation-for-the-treatment-of-hyperparathyroidism-of-renal-origin-in-children-and-young-adults
#1
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
#2
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
#3
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...
January 22, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
October 12, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29021995/tumor-induced-osteomalacia
#12
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
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#13
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
November 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28876685/a-histopathological-audit-of-hyperparathyroidism-in-the-south-african-setting
#14
A Hoosain, T E Luvhengo, C Mitchell, M Schamm
BACKGROUND: Hyperparathyroidism is a common endocrine disorder. Parathyroidectomy is indicated for primary and tertiary hyperparathyroidism. Parathyroid adenoma is the cause in close to 85% of cases of primary hyperparathyroidism. METHOD: An audit based on histopathology records of patients who had parathyroidectomy from January 2011 to December 2015 in academic hospitals linked to Wits was conducted. Data collected included patients' demographics and histopathological findings...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28845158/2d-shear-wave-elastography-in-the-evaluation-of-parathyroid-lesions-in-patients-with-hyperparathyroidism
#15
Ioana Golu, Ioan Sporea, Lavinia Moleriu, Anca Tudor, Marioara Cornianu, Adrian Vlad, Romulus Timar, Melania Balas, Daniela Amzar, Mihaela Vlad
BACKGROUND AND AIMS: 2D-shear wave elastography (2D-SWE) is a relatively new elastographic technique. The aim of the present study is to determine the values of the elasticity indexes (EI) measured by 2D-SWE in parathyroid benign lesions (adenomas or hyperplasia) and to establish if this investigation is helpful for the preoperative identification of the parathyroid adenoma. MATERIAL AND METHODS: The study groups were represented by 22 patients with primary or tertiary hyperparathyroidism, diagnosed by specific tests, and 43 healthy controls, in whom the thyroid parenchyma was evaluated, in order to compare the EI of the thyroid tissue with those of the parathyroid lesions...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28793141/factors-associated-with-discordance-between-preoperative-parathyroid-4-dimensional-computed-tomographic-scans-and-intraoperative-findings-during-parathyroidectomy
#16
Shonan Sho, Alexander D Yuen, Michael W Yeh, Masha J Livhits, Ali R Sepahdari
Importance: Parathyroid 4-dimensional computed tomographic scans (4D-CTs) have emerged as an accurate and cost-effective initial localization study for patients with primary hyperparathyroidism. However, potential limitations and factors affecting the accuracy of preoperative 4D-CTs remain poorly defined. Objectives: To characterize factors associated with missed parathyroid lesions on preoperative 4D-CTs and to investigate patterns of commonly observed errors. Design, Setting, and Participants: A prospectively accrued patient database was analyzed from September 1, 2011, through October 31, 2016...
August 9, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28748891/study-of-chronic-kidney-disease-mineral-bone-disorders-in-newly-detected-advanced-renal-failure-patients-a-hospital-based-cross-sectional-study
#17
Praveen Kumar Etta, R K Sharma, Amit Gupta
We aim to evaluate the disturbances in mineral metabolism, abnormalities in bone mineral density (BMD), and extraskeletal calcification in newly detected, untreated predialysis stage 4 and 5 chronic kidney disease (CKD) patients at a tertiary care hospital in North India. This is cross-sectional observational study. A total of 95 (68 males, 27 females) newly detected patients underwent clinical evaluation, biochemical assessment [serum calcium, phosphorus, alkaline phosphatase (ALP), albumin, creatinine, intact parathyroid hormone (iPTH), 25- hydroxyvitamin D (25(OH)D)], BMD measurement (at spine, hip, and forearm) by dual-energy X-ray absorptiometry (DXA), lateral abdominal radiograph [for abdominal aortic calcification (AAC)], skeletal survey (to look for any abnormality including fractures), and echocardiography [for any cardiac valvular calcification (CVC)]...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28735762/parathyroidectomy-for-tertiary-hyperparathyroidism-a-systematic-review
#18
REVIEW
Jessica A Tang, Jacob Friedman, Michelle S Hwang, Anna M Salapatas, Lauren B Bonzelaar, Michael Friedman
OBJECTIVE: Analyze the efficacy and indications for parathyroidectomy as an intervention for tertiary hyperparathyroidism. DATA SOURCES: PubMed, MEDLINE, and Cochrane Library databases. REVIEW METHODS: A systematic literature search was performed using the. Original research articles in English were retrieved using the search terms ("tertiary hyperparathyroidism" OR "3HPT") AND "parathyroidectomy". Articles were analyzed in regards to their surgical indications, operative endpoints, comparison between different surgical interventions, characterization of disease recurrence rates, and evaluation of alternative medical management...
September 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28678063/failure-to-diagnose-hyperparathyroidism-in-10-432-patients-with-hypercalcemia-opportunities-for-system-level-intervention-to-increase-surgical-referrals-and-cure
#19
Courtney J Balentine, Rongbing Xie, James K Kirklin, Herbert Chen
OBJECTIVE: To determine whether a significant number of patients with hyperparathyroidism remain undiagnosed and untreated. BACKGROUND: Failure to diagnose primary hyperparathyroidism and refer patients to surgeons leads to impaired quality of life and increased costs. We hypothesized that many patients with hyperparathyroidism would be untreated due to not considering the diagnosis, inadequate evaluation of hypercalcemia, and under-referral to surgeons. METHODS: We reviewed administrative data on 682,704 patients from a tertiary referral center between 2011 and 2015, and identified hypercalcemia (>10...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28645310/pth-monitoring-after-total-parathyroidectomy-with-forearm-auto-transplantation-potential-for-spuriously-high-levels-from-grafted-forearm
#20
Diana Khalil, Paul D Kerr
BACKGROUND: We have identified a cause of falsely elevated parathyroid hormone (PTH) levels after total parathyroidectomy with forearm auto-transplantation (TPT-ATx). Our cases highlight the need to draw PTH samples remotely, away from forearm graft sites, to ensure accurate levels. CASE PRESENTATIONS: We report on four patients who were referred to our surgical team at an academic tertiary care center for what was perceived to be recurrent hyperparathyroidism 2-5 years following total parathyroidectomy with auto-transplantation...
June 23, 2017: Journal of Otolaryngology—Head & Neck Surgery
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