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Tertiary hyperparathyroidism

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https://www.readbyqxmd.com/read/28793141/factors-associated-with-discordance-between-preoperative-parathyroid-4-dimensional-computed-tomographic-scans-and-intraoperative-findings-during-parathyroidectomy
#1
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
#2
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
#3
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...
June 21, 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
#4
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...
July 3, 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
#5
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
https://www.readbyqxmd.com/read/28616750/systematic-review-of-oral-manifestations-related-to-hyperparathyroidism
#6
REVIEW
Benjamin Palla, Egon Burian, Riham Fliefel, Sven Otto
OBJECTIVES: We sought to identify oral symptoms found in hyperparathyroidism and compare their rate of occurrence, as well as potential variations in sequelae between primary, secondary, and tertiary hyperparathyroidism. MATERIALS AND METHODS: Database searches were performed through EMBASE and PubMed, with a continual handsearch for relevant articles. PRISMA guidelines were followed. RESULTS: Two hundred five articles including 245 patients were analyzed with data extraction...
June 14, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28614027/parathyroid-surgery-from-inception-to-the-modern-day
#7
Neeraj Sethi, R James A England
Parathyroid surgery has undergone great changes since its inception less than a century ago. It is still the only definitive option available to cure primary or tertiary hyperparathyroidism. This review details the development of parathyroid surgery, our understanding of hyperparathyroidism and the treatment options available. It also discusses the technological advances that have enabled parathyroid localization and prediction of surgical success.
June 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28551925/-clinical-characteristics-of-male-patients-with-osteoporosis-referred-to-the-endocrine-clinic-of-a-tertiary-hospital
#8
Gloria Tsvetov, Ilana Shraga-Slutzky, Dania Hirsch, Hiba Masri, Tzippy Shohat, Alexander Gorshtein, Ilan Shimon
INTRODUCTION: Osteoporosis in men is underdiagnosed and undertreated. The prevalence of male osteoporosis increases with age and it becomes a significant public health burden. Currently, there are a few clinical studies on male osteoporosis with limited knowledge of effective therapeutic options. AIMS: Our study aimed to characterize men with osteoporosis in a referral metabolic clinic in Rabin Medical Center at the Beilinson Campus. METHODS: In this study we retrospectively analyzed the medical records of 270 consecutive male patients with osteoporosis diagnosed and treated in our clinic during 2013...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28533644/atypical-parathyroid-adenoma-with-multiple-brown-tumors-as-initial-presentation-a-rare-entity
#9
V S Krishna Mohan, Manishi L Narayan, Arun Mukka, Bharath Bachimanchi, Amit Kumar Chowhan, B Vijayalakshmi Devi, Suresh Vaikkakara, Alok Sachan
Brown tumors seen in hyperparathyroidism are rare, non-neoplastic lesions because of abnormal bone metabolism, and they can mimic benign bone tumors or malignancy. Although biopsy is considered as the gold standard for diagnosis, it can be inconclusive. As the diagnosis of brown tumors is often challenging, a high index of suspicion is essential for diagnosis. We present a case of 21-year-old woman who presented with multiple painful bony lesions, which were initially misdiagnosed as fibrous dysplasia. Due to persistent bone pain and deterioration in her physical mobility, she was referred to tertiary care centre...
April 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28527123/clinical-profile-of-juvenile-primary-hyperparathyroidism-a-prospective-study
#10
Federica Saponaro, Claudio Marcocci, Federica Cacciatore, Mario Miccoli, Elena Pardi, Simona Borsari, Gabriele Materazzi, Paolo Miccoli, Filomena Cetani
INTRODUCTION: Juvenile primary hyperparathyroidism is uncommon and more symptomatic than the adult counterpart. The aim of this prospective monocentric study, conducted in a tertiary referral center, was to evaluate the clinical, biochemical, and densitometric data, and the outcome of a series of patients with juvenile primary hyperparathyroidism. MATERIAL AND METHODS: The study group included 154 patients with sporadic and familial juvenile primary hyperparathyroidism, aged ≤40 years...
May 20, 2017: Endocrine
https://www.readbyqxmd.com/read/28518414/systematic-review-of-surgical-and-medical-treatment-for-tertiary-hyperparathyroidism
#11
REVIEW
R R Dulfer, G J H Franssen, D A Hesselink, E J Hoorn, C H J van Eijck, T M van Ginhoven
BACKGROUND: A significant proportion of patients with chronic kidney disease and secondary hyperparathyroidism (HPT) remain hyperparathyroid after kidney transplantation, a state known as tertiary HPT. Without treatment, tertiary HPT can lead to diminished kidney allograft and patient survival. Parathyroidectomy was commonly performed to treat tertiary HPT until the introduction of the calcimimetic drug, cinacalcet. It is not known whether surgery or medical treatment is superior for tertiary HPT...
June 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28513073/early-neurocognitive-improvements-following-parathyroidectomy-for-primary-hyperparathyroidism
#12
Shivani Shah-Becker, Jonathan Derr, Benjamin S Oberman, Aaron Baker, Brian Saunders, Michele M Carr, David Goldenberg
OBJECTIVES: To establish a time frame for postoperative improvements in neurocognitive function in patients who undergo parathyroidectomy for primary hyperparathyroidism by utilizing repeat neuropsychological assessment at multiple time points before and after surgery. STUDY DESIGN: Prospective cohort study. METHODS: A prospective study was conducted at a tertiary academic medical center between August 2014 and December 2015, including 50 patients with primary hyperparathyroidism who underwent parathyroidectomy...
May 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28493416/parathyroidectomy-for-the-treatment-of-hyperparathyroidism-thirty-day-morbidity-and-mortality
#13
Jessica A Tang, Anna M Salapatas, Lauren B Bonzelaar, Michael Friedman
OBJECTIVES/HYPOTHESIS: Evaluate morbidity and mortality rates for patients with different levels of hyperparathyroidism (HPT) undergoing parathyroidectomy (PTX), specifically comparing primary hyperparathyroidism to secondary and tertiary hyperparathyroidism. Assess predictive factors of increased morbidity and mortality. STUDY DESIGN: Retrospective national database review. METHODS: Patients undergoing PTX, defined by Current Procedural Terminology codes 60500, 60502, 60505, for the treatment of HPT, were identified in the American College of Surgeons National Surgical Quality Improvement Program database between 2006 and 2014...
May 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28439424/comparison-of-scintigraphy-and-ultrasound-imaging-in-patients-with-primary-secondary-and-tertiary-hyperparathyroidism-own-experience
#14
Małgorzata Kobylecka, Maria Teresa Płazińska, Witold Chudziński, Katarzyna Fronczewska-Wieniawska, Joanna Mączewska, Adam Bajera, Maria Karlińska, Leszek Królicki
BACKGROUND: The imaging techniques most commonly used in the diagnosis of hyperparathyroidisms are ultrasound and scintigraphy. The diagnostic algorithms vary, depending mainly on the population, and experience of physicians. AIM: Aim of the present research was to determine the usefulness of parathyroid scintigraphy and ultrasonography in patients diagnosed for hyperparathyroidism in own material. MATERIAL AND METHOD: In the present research, 96 operated patients with documented primary, secondary and tertiary hyperparathyroidism were retrospectively analyzed...
March 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28388724/thiazide-treatment-in-primary-hyperparathyroidism-a-new-indication-for-an-old-medication
#15
Gloria Tsvetov, Dania Hirsch, Ilan Shimon, Carlos Benbassat, Hiba Masri-Iraqi, Alexander Gorshtein, Dana Herzberg, Tzippy Shochat, Ilana Shraga-Slutzky, Talia Diker-Cohen
Context: There is no therapy for control of hypercalciuria in nonoperable patients with primary hyperparathyroidism (PHPT). Thiazides are used for idiopathic hypercalciuria but are avoided in PHPT to prevent exacerbating hypercalcemia. Nevertheless, several reports suggested that thiazides may be safe in patients with PHPT. Objective: To test the safety and efficacy of thiazides in PHPT. Design: Retrospective analysis of medical records. Setting: Endocrine clinic at a tertiary hospital...
April 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28383630/the-medical-and-surgical-treatment-in-secondary-and-tertiary-hyperparathyroidism-review
#16
REVIEW
G Cocchiara, S Fazzotta, V D Palumbo, G Damiano, M Cajozzo, C Maione, S Buscemi, G Spinelli, S Ficarella, A Maffongelli, F Caternicchia, A Ignazio Lo Monte, G Buscemi
INTRODUCTION: Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism). AIMS: There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28364324/primary-hyperparathyroidism-insights-from-the-indian-phpt-registry
#17
Sanjay Kumar Bhadada, Ashutosh Kumar Arya, Satinath Mukhopadhyay, Rajesh Khadgawat, Suja Sukumar, Sailesh Lodha, Deependra N Singh, Anjali Sathya, Priyanka Singh, Anil Bhansali
The presentation of primary hyperparathyroidism (PHPT) is variable throughout the world. The present study explored retrospective data submitted to the Indian PHPT registry ( http://www.indianphptregistry.com ) between July 2005 and June 2015 from 5 centres covering four different geographical regions. The clinical, biochemical, radiological and histopathological characteristics of PHPT patients across India were analysed for similarity and variability across the centres. A total of 464 subjects (137 men and 327 women) with histopathologically proven PHPT were analysed...
March 31, 2017: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/28346348/vitamin-d-in-chronic-kidney-disease-and-dialysis-patients
#18
REVIEW
Guillaume Jean, Jean Claude Souberbielle, Charles Chazot
Vitamin D deficiency (<20 ng/mL) and insufficiency (20-29 ng/mL) are common among patients with chronic kidney disease (CKD) or undergoing dialysis. In addition to nutritional and sunlight exposure deficits, factors that affect vitamin D deficiency include race, sex, age, obesity and impaired vitamin D synthesis and metabolism. Serum 1,25(OH)₂D levels also decrease progressively because of 25(OH)D deficiency, together with impaired availability of 25(OH)D by renal proximal tubular cells, high fibroblast growth factor (FGF)-23 and decreased functional renal tissue...
March 25, 2017: Nutrients
https://www.readbyqxmd.com/read/28104949/enlarged-parathyroid-glands-with-variable-sonomorphology-in-a-case-of-tertiary-hyperparathyroidism-sonographic-histopathologic-correlation
#19
Yashant Aswani, Varsha Dhume, Ravi Varma, Shenaz Saifi
The typical sonomorphology of homogeneously hypoechoic texture of an enlarged parathyroid gland (PG) is a reflection of uniform arrangement of the parathormone-producing chief cells. A variable cellular arrangement, hemorrhage, fibrosis, and adipocytes cause heterogeneous appearance. We describe a case of a 32-year-old male, a case of tertiary hyperparathyroidism, with increased serum parathormone levels, hypercalcemia, and enlargement of all four PGs, albeit with differing morphology. The left lower gland had two nodules, namely, superior and inferior...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28025445/hypertension-is-a-characteristic-complication-of-x-linked-hypophosphatemia
#20
Yoshie Nakamura, Masaki Takagi, Ryojun Takeda, Kentaro Miyai, Yukihiro Hasegawa
X-linked hypophosphatemia (XLH) is a group of rare disorders caused by defective proximal tubular reabsorption of phosphate. Mutations in the PHEX gene are responsible for the majority of cases. There are very few reports of long-term complications of XLH other than skeletal and dental diseases. The aim of this study was to identify the phenotypic presentation of XLH during adulthood including complications other than skeletal and dental diseases. The clinical and biochemical phenotype of 22 adult patients with a PHEX gene mutation were examined retrospectively from their medical records...
March 31, 2017: Endocrine Journal
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