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Tertiary hyperparathyroidism

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https://www.readbyqxmd.com/read/28388724/thiazide-treatment-in-primary-hyperparathyroidism-a-new-indication-for-an-old-medication
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27982325/the-deceptive-concept-of-hypoparathyroidism-and-recurrence-after-parathyroidectomy-in-dialysis-patients-are-we-offering-a-procrustean-bed-to-some-patients
#7
Fabio Luiz DE Menezes Montenegro, Marilia D'Elboux Guimaraes Brescia, Climério Pereira Nascimento, Ledo Mazzei Massoni, Sérgio Samir Arap, Stênio Roberto Castro Lima Santos, Patrícia Taschner Goldenstein, Rodrigo Oliveira Bueno, Melani Ribeiro Custodio, Vanda Jorgetti, Rosa Maria Affonso Moyses
Objective: to analyze the frequency of hypoparathyroidism and of its recurrence after parathyroidectomy in dialysis patients according to different existing classifications. Methods: we conducted a retrospective study of 107 consecutive dialysis patients undergoing total parathyroidectomy with immediate autograft in a tertiary hospital from 2006 to 2010. We studied the changes in PTH levels in the postoperative period over time. Were grouped patients according to different PTH levels targets recommended according to the dosage method and by the American and Japanese Nephrology Societies, and by an International Experts Consortium...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27979480/location-of-abnormal-parathyroid-glands-lessons-from-810-parathyroidectomies
#8
Melissa LoPinto, Gustavo A Rubio, Zahra F Khan, Tanaz M Vaghaiwalla, Josefina C Farra, John I Lew
BACKGROUND: Primary hyperparathyroidism (pHPT) is commonly treated with targeted parathyroidectomy (PTX) guided by preoperative imaging and intraoperative parathormone monitoring. Despite advanced imaging techniques, failure of parathyroid localization still occurs. This study determines the anatomical distribution of single abnormal parathyroid glands, which may help direct the surgeon in PTX when preoperative localization is unsuccessful. METHODS: A retrospective review of prospectively collected data of 810 patients with pHPT who underwent initial PTX at a tertiary medical center was performed...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27967299/thiazide-treatment-in-primary-hyperparathyroidism-a-new-indication-for-an-old-medication
#9
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 available targeted therapy for control of hypercalciuria in nonoperable patients with primary hyperparathyroidism (PHPT). Thiazide diuretics are used for idiopathic hypercalciuria but 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...
December 14, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27931570/natural-history-of-serum-calcium-and-parathyroid-hormone-following-renal-transplantation
#10
Z Al-Moasseb, E Aitken
BACKGROUND: Hyperparathyroidism is common in end-stage renal disease. It often persists following renal transplantation (RTx) and remains elusive to manage due to the lack of evidence base. We therefore present observational data describing the natural history and management of hypercalcemia and hyperparathyroidism following RTx. METHODS: Single-center experience of 216 adult patients undergoing kidney transplantation between January 1, 2011, and December 31, 2012...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27928436/parathyroidectomy-is-vitamin-d-a-player-for-a-good-outcome
#11
REVIEW
M Carsote, D N Paduraru, A E Nica, A Valea
Background: The field of parathyroidectomy (PTx) is complex and brings together many specialists. Even if the surgical approaches changed from classical to minimally invasive PTx, a good outcome is correlated with an adequate localization before and during PTx, while blood assays, such as parathormone (PTH) or 25-hydroxyvitamin D, become useful additional markers. Aim. Specific aspects related to parathyroidectomy and vitamins D (VD) were introduced. Material and Method. The article represents a PubMed-based narrative review...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27816765/micrornas-in-parathyroid-physiopathology
#12
V Vaira, C Verdelli, I Forno, S Corbetta
Parathyroid glands regulate calcium homeostasis through synthesis and secretion of parathormone (PTH). They sense the extracellular calcium concentration through the G-protein coupled calcium sensing receptor (CASR) and release PTH in order to preserve calcium concentration in the physiological range. Tumors of the parathyroid glands are common endocrine neoplasia associated with primary or secondary/tertiary hyperparathyroidisms. Small non-coding RNAs are regulators of gene expression able to modulate hormone synthesis, hormone release and endocrine cell proliferation...
November 2, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27696726/parathyroid-adenoma-a-comprehensive-biochemical-and-histological-correlative-study
#13
S Stern, A Mizrachi, Y Strenov, A Knaanie, C Benbassat, T Shpitzer, G Bachar
OBJECTIVE: To investigate the controversial relationship between preoperative calcium and parathyroid hormone levels and the dimensions and histological features of parathyroid adenoma in patients with primary hyperparathyroidism. STUDY DESIGN: Historical cohort. SETTING: Tertiary medical centre. SUBJECTS AND METHODS: Clinical and tumour-related data were collected from the medical files of all patients who underwent parathyroidectomy for primary hyperparathyroidism in 1996-2012...
October 3, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27683096/sudden-onset-of-parathyroid-hormone-independent-severe-hypercalcemia-from-reversal-of-tumoral-calcinosis-in-a-dialysis-patient
#14
Fareed B Kamar, Bikaramjit Mann, Gregory Kline
BACKGROUND: Tumoral calcinosis is a rare manifestation of extraskeletal calcification, featuring large calcified cystic masses in the periarticular regions of large joints. In chronic kidney disease (CKD), this disorder is thought to evolve through a chronically elevated calcium-phosphorus solubility product leading to calcium precipitation in soft tissue. Treating tumoral calcinosis in these patients involves interventions to lower the calcium-phosphorus product such as reduction in vitamin D therapy and intensive hemodialysis regimens...
September 29, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27664600/parathyroid-carcinoma-in-tertiary-hyperparathyroidism
#15
Byung Seup Kim, Han Suk Ryu, Kyung Ho Kang, Sung Jun Park
Parathyroid carcinoma is a rare disease of unknown etiology. This study presents a case of parathyroid carcinoma in a patient with tertiary hyperparathyroidism. Despite a successful kidney transplantation, the intact parathyroid hormone (iPTH) level of the patient was elevated consistently and could not be controlled by medical therapy. Due to the development of tertiary hyperparathyroidism with bone pain and osteoporosis, subtotal parathyroidectomy was performed 4 months after the kidney transplantation. Histological evaluation revealed that one of four parathyroid lesions was a parathyroid carcinoma, while the others were diffuse hyperplasia...
October 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27643800/selective-venous-blood-sampling-for-hyperparathyroidism-with-unclear-localization-of-the-parathyroid%C3%A2-gland
#16
C Hader, M Uder, R W R Loose, U Linnemann, T Bertsch, R Adamus
Purpose: Evaluation of the benefit of selective venous blood sampling (SVS) for the preoperative identification of parathyroid adenomas with unclear localization in non-invasive diagnostics. Materials and Methods: In a retrospective study, all patients (n = 23) with primary (n = 21) or tertiary (n = 2) hyperparathyroidism were evaluated from 2005 to 2016 at the Hospital Nuremberg-North. These patients all received one (n = 20) or more (n = 3) SVS. 15 patients had one or more previous unsuccessful surgeries (group A), 8 patients received the SVS primarily before the first surgery (group B)...
December 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27626242/standard-vs-distal-roux-en-y-gastric-bypass-in-patients-with-body-mass-index-50-to-60-a-double-blind-randomized-clinical-trial
#17
Hilde Risstad, Marius Svanevik, Jon A Kristinsson, Jøran Hjelmesæth, Erlend T Aasheim, Dag Hofsø, Torgeir T Søvik, Tor-Ivar Karlsen, Morten W Fagerland, Rune Sandbu, Tom Mala
Importance: Up to one-third of patients undergoing bariatric surgery have a body mass index (BMI) of more than 50. Following standard gastric bypass, many of these patients still have a BMI greater than 40 after peak weight loss. Objective: To assess the efficacy and safety of standard gastric bypass vs distal gastric bypass in patients with a BMI of 50 to 60. Design, Setting, and Participants: Double-blind, randomized clinical parallel-group trial at 2 tertiary care centers in Norway (Oslo University Hospital and Vestfold Hospital Trust) between May 2011 and April 2013...
December 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27622522/calciphylaxis-and-martorell-hypertensive-ischemic-leg-ulcer-same-pattern-one-pathophysiology
#18
Jürg Hafner
This review presents a closer look at four diseases which are probably closely related to one another pathophysiologically: (a) calciphylaxis (distal pattern); (b) calciphylaxis (proximal pattern); (c) Martorell hypertensive ischemic leg ulcer; (d) calciphylaxis with normal renal and parathyroid function (synonym: eutrophication). The four diseases have largely the same risk factors: (1) arterial hypertension, (2) diabetes mellitus (types 1 and 2), (3) secondary or tertiary hyperparathyroidism (in end-stage kidney disease) and (4) oral anticoagulation with vitamin K antagonists...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
https://www.readbyqxmd.com/read/27612033/fluorine-18-fluorocholine-pet-ct-localizes-hyperparathyroidism-in-patients-with-inconclusive-conventional-imaging-a-multicenter-study-from-the-netherlands
#19
MULTICENTER STUDY
Wouter P Kluijfhout, Wessel M C M Vorselaars, Sandra A M van den Berk, Menno R Vriens, Inne H M Borel Rinkes, Gerlof D Valk, Thijs van Dalen, John M H de Klerk, Bart de Keizer
BACKGROUND: Several reports have shown good performance of fluorine-18 fluorocholine (F-FCH) PET-computed tomography (CT) for parathyroid localization, although overall evidence remains scarce. We collected data from three institutions in the Netherlands and investigated the performance of F-FCH PET-CT as a second-line imaging modality. MATERIALS AND METHODS: We performed a retrospective review of all patients at least 18 years who underwent F-FCH PET-CT for biochemically proven hyperparathyroidism (HPT) and inconclusive ultrasound and sestamibi scintigraphy...
December 2016: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27563621/a-rare-case-of-regression-of-brown-tumors-of-tertiary-hyperparathyroidism-after-parathyroidectomy-and-renal-transplant-a-5-year-follow-up
#20
José Wilson Noleto, Ivana Alencar Svenson Ramos, Julierme Ferreira Rocha, Idelmo Rangel Garcia, Berthiene M Salvador Roberto
Tertiary hyperparathyroidism (HPT) is a rare condition that affects patients with secondary HPT, which develop hyperplasia of the parathyroid glands, thus causing an increase in parathyroid hormone levels. Bone alterations are the main consequences of this condition including the development of osteolytic lesions called brown tumor. This article reports an unusual case of brown tumors located in the maxilla and mandible in a 19-year-old man with chronic renal failure with hyperplasia of the parathyroid glands...
January 2016: Annals of Maxillofacial Surgery
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