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Tertiary hyperparathyroidism

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https://www.readbyqxmd.com/read/28025445/hypertension-is-a-characteristic-complication-of-x-linked-hypophosphatemia
#1
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...
December 27, 2016: 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
#2
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
#3
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
#4
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
#5
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
#6
REVIEW
Carsote M, Paduraru Dn, Nica Ae, Valea A
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
September 8, 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
#15
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
https://www.readbyqxmd.com/read/27545973/persistently-elevated-parathyroid-hormone-after-successful-parathyroid-surgery
#16
William S Duke, Anna Song Kim, Jennifer L Waller, David J Terris
OBJECTIVES/HYPOTHESIS: Explore potential causes of persistently elevated parathyroid hormone levels after curative parathyroidectomy in patients with primary hyperparathyroidism due to single gland disease. STUDY DESIGN: Case series with planned data collection. METHODS: An analysis was undertaken of 314 patients with primary hyperparathyroidism undergoing parathyroid surgery in a tertiary academic practice between January 2009 and April 2013...
August 22, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27496461/does-the-parathyroidectomy-endanger-the-transplanted-kidney
#17
W Chudzinski, M Wyrzykowska, S Nazarewski, M Durlik, Z Galazka
BACKGROUND: Some investigators maintain that a parathyroidectomy (PTX) performed for tertiary hyperparathyroidism may potentially cause graft malfunction or even loss of the transplanted kidney after the operation. The goal of this study was to determine if parathyroidectomy affects transplanted kidney function. METHODS: The study group consisted of 48 renal graft recipients who underwent operation due to tertiary hyperparathyroidism. Thirty-nine subtotal parathyroidectomies and 9 more selective, less than subtotal parathyroidectomies were performed...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27459979/impact-of-the-introduction-of-calcimimetics-on-timing-of-parathyroidectomy-in-secondary-and-tertiary-hyperparathyroidism
#18
Willemijn Y van der Plas, Anton F Engelsman, Akin Özyilmaz, Anouk N van der Horst-Schrivers, Kornelis Meijer, Gooitzen M van Dam, Robert A Pol, Martin H de Borst, Schelto Kruijff
BACKGROUND: Hyperparathyroidism (HPT), both secondary and tertiary, is common in patients with end-stage renal disease, and is associated with severe bone disorders, cardiovascular complications, and increased mortality. Since the introduction of calcimimetics in 2004, treatment of HPT has shifted from surgery to predominantly medical therapy. OBJECTIVE: The aim of this study was to evaluate the impact of this change of management on the HPT patient population before undergoing (sub-)total parathyroidectomy (PTx)...
January 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27434479/occult-central-venous-stenosis-leading-to-airway-obstruction-after-subtotal-parathyroidectomy
#19
Duncan A Meiklejohn, Dylan K Chan, M Lauren Lalakea
Subtotal parathyroidectomy may be indicated in patients with chronic renal failure and tertiary hyperparathyroidism, a population at increased risk for central venous stenosis (CVS) due to repeated vascular access. Here we report a case of complete upper airway obstruction precipitated by subtotal parathyroidectomy with ligation of anterior jugular vein collaterals in a patient with occult CVS. This case demonstrates a previously unreported risk of anterior neck surgery in patients with chronic renal failure...
July 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27402205/unilateral-clearance-for-primary-hyperparathyroidism-in-selected-patients-with-multiple-endocrine-neoplasia-type-1
#20
Wouter P Kluijfhout, Toni Beninato, Frederick Thurston Drake, Menno R Vriens, Jessica Gosnell, Wen T Shen, Insoo Suh, Chienying Liu, Quan-Yang Duh
BACKGROUND: Primary hyperparathyroidism is the most common manifestation of multiple endocrine neoplasia type 1 (MEN1). Guidelines advocate subtotal parathyroidectomy (STP) or total parathyroidectomy with autotransplantation due to high prevalence of multiglandular disease; however, both are associated with a significant risk of permanent hypoparathyroidism. More accurate imaging and use of intraoperative PTH levels may allow a less extensive initial parathyroidectomy (unilateral clearance, removing both parathyroids with cervical thymectomy) in selected MEN1 patients with primary hyperparathyroidism...
December 2016: World Journal of Surgery
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