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Hyperparathyroidism

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https://www.readbyqxmd.com/read/28432842/low-grade-inflammation-and-tryptophan-kynurenine-pathway-activation-are-associated-with-adverse-cardiac-remodeling-in-primary-hyperparathyroidism-the-epath-trial
#1
Nicolas Verheyen, Andreas Meinitzer, Martin Robert Grübler, Klemens Ablasser, Ewald Kolesnik, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Christian Trummer, Verena Schwetz, Elisabeth Pieske-Kraigher, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo Alberto Sechi, Helmut Brussee, Dirk von Lewinski, Winfried März, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz
BACKGROUND: Primary hyperparathyroidism (pHPT) is associated with low-grade inflammation, left ventricular hypertrophy and increased cardiovascular mortality, but the association between inflammatory markers and parameters of adverse cardiac remodeling is unknown. We investigated the relationship between C-reactive protein (CRP), the essential amino acid tryptophan and its pro-inflammatory derivatives kynurenine and quinolinic acid (QUIN) with echocardiographic parameters. METHODS: Cross-sectional baseline data from the "Eplerenone in Primary Hyperparathyroidism" trial were analyzed...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28429905/maintenance-vitamin-d3-dosage-requirements-in-chinese-women-with-post-menopausal-osteoporosis-living-in-the-tropics
#2
Yogeswari Venugopal, Sharifah F Wan Muhamad Hatta, Nurbazlin Musa, Siti Abdul Rahman, Jeyakantha Ratnasingam, Sharmila Sunita Paramasivam, Lee Ling Lim, Luqman Ibrahim, Karen Choong, Alexander Tb Tan, Karuthan Chinna, Siew Pheng Chan, Shireene R Vethakkan
BACKGROUND AND OBJECTIVES: Vitamin D3 (cholecalciferol) dose required to maintain sufficiency in non- Caucasian women with postmenopausal osteoporosis (PMO) inthe tropics has not been well studied. Some guidelines mandate 800-1000 IU vitamin D/day but the Endocrine Society (US) advocates 1500-2000 IU/day to maintain 25-hydroxyvitamin-D (25(OH)D) concentration at >75 nmol/L. We aimed to establish oral cholecalciferol dose required to maintain 25(OH)D concentration at >75 nmol/L in PMO Chinese Malaysian women, postulating lower dose requirements amongst light-skinned subjects in the tropics...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28429839/pursuing-the-second-ipsilateral-gland-during-minimally-invasive-video-assisted-parathyroidectomy
#3
Cino Bendinelli, Andrew Gray, Hassan Suradi, Dieter G Weber, Shamasunder Acharya, Anna Price, Shaun McGrath
BACKGROUND: In patients with primary hyperparathyroidism (PHPT) and preoperative imaging suggesting a solitary parathyroid adenoma (SPA), focused parathyroidectomy is most often curative. Even so, large studies show up to 3% of patients experience persistent or recurrent PHPT. Unilateral neck exploration (UNE) aiming to identify the SPA and the other ipsilateral parathyroid may reduce this failure rate. We hypothesized that: (i) minimally invasive video-assisted (MIVA) approach would facilitate UNE and (ii) this would be a clinically relevant strategy...
April 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#4
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#5
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429545/do-the-benefits-of-using-calcitriol-and-other-vitamin-d-receptor-activators-in-patients-with-chronic-kidney-disease-outweigh-the-harms
#6
Nigel D Toussaint, Matthew J Damasiewicz
The primary indication for administration of calcitriol or other vitamin D receptor activators (VDRA) in chronic kidney disease (CKD) is secondary hyperparathyroidism (SHPT). Prevention and treatment of SHPT appears important, as imbalances in mineral metabolism are associated with renal osteodystrophy, and higher parathyroid hormone (PTH) levels are associated with increased rates of mortality and morbidity in CKD patients. There is, however, a lack of controlled trial data that show lowering PTH with calcitriol/VDRA equates to improved clinical outcomes...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28427988/obesity-bariatric-surgery-and-vitamin-d
#7
REVIEW
Joao Lindolfo C Borges, Isabella Santiago de M Miranda, Marta M S Sarquis, Victoria Borba, Sergio Setsuo Maeda, Marise Lazaretti-Castro, Neil Blinkey
The high prevalence of obesity is a worldwide problem associated with multiple comorbidities, including cardiovascular diseases. Vitamin D deficiency with secondary hyperparathyroidism is common in obese individuals and can be aggravated after bariatric surgery. Moreover, there is no consensus on the optimal supplementation dose of vitamin D in postbariatric surgical patients. We present new data on the variability of 25(OH)D response to supplementation in postmenopausal obese women. It is important to recognize and treat vitamin D deficiency before bariatric surgery to avoid postoperative complications, such as metabolic bone disease with associated high fracture risk...
April 17, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28421466/parathyroid-diseases-and-t-cells
#8
REVIEW
M Neale Weitzmann, Roberto Pacifici
PURPOSE OF REVIEW: This review summarizes studies into the permissive role of T cells in the bone catabolic effects of hyperparathyroidism and parathyroid hormone (PTH). RECENT FINDINGS: Work in animals combined with recent translational studies in humans now highlight the potent amplificatory action of T cells on PTH-induced bone resorption. Mechanistic animal studies reveal a complex pathway by which PTH exploits natural self-renewal functions of CD4(+) T cells, to drive TNFα production that promotes formation of IL-17A secreting Th17 T cells...
April 18, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28421299/compared-effects-of-calcium-and-sodium-polystyrene-sulfonate-on-mineral-and-bone-metabolism-and-volume-overload-in-pre-dialysis-patients-with-hyperkalemia
#9
Yosuke Nakayama, Kaoru Ueda, Sho-Ichi Yamagishi, Miki Sugiyama, Chika Yoshida, Yuka Kurokawa, Nao Nakamura, Tomofumi Moriyama, Goh Kodama, Tomohisa Minezaki, Sakuya Ito, Akiko Nagata, Kensei Taguchi, Junko Yano, Yusuke Kaida, Kazutaka Shibatomi, Kei Fukami
BACKGROUND: Hyperkalemia is prevalent in end-stage renal disease patients, being involved in life-threatening arrhythmias. Although polystyrene sulfonate (PS) is commonly used for the treatment of hyperkalemia, direct comparison of effects between calcium and sodium PS (CPS and SPS) on mineral and bone metabolism has not yet been studied. METHODS: In a randomized and crossover design, 20 pre-dialysis patients with hyperkalemia (>5 mmol/l) received either oral CPS or SPS therapy for 4 weeks...
April 18, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28421193/molecular-abnormalities-underlying-bone-fragility-in-chronic-kidney-disease
#10
REVIEW
Yoshiko Iwasaki, Junichiro James Kazama, Masafumi Fukagawa
Prevention of bone fractures is one goal of therapy for patients with chronic kidney disease-mineral and bone disorder (CKD-MBD), as indicated by the Kidney Disease: Improving Global Outcomes guidelines. CKD patients, including those on hemodialysis, are at higher risk for fractures and fracture-related death compared to people with normal kidney function. However, few clinicians focus on this issue as it is very difficult to estimate bone fragility. Additionally, uremia-related bone fragility has a more complicated pathological process compared to osteoporosis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28420920/the-many-guises-of-primary-hyperparathyroidism-an-unchanged-scenario
#11
Tasnim Ahsan, Uzma Erum, Khawaja Mohammad Inam Pal, Rukhshanda Jabeen, Saima Ghaus Qureeshi, Urooj Lal Rehman, Zeenat Banu
OBJECTIVE: To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism. METHODS: This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .SPSS 17 was used for data analysis. RESULTS: Of the 25 patients,1(4%)was male and 24(96%) were female. The overall mean age was 41...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28419560/fibroblast-growth-factor-23-concentration-in-dogs-with-chronic-kidney-disease
#12
L M Harjes, V J Parker, K Dembek, G S Young, L H Giovaninni, M M Kogika, D J Chew, R E Toribio
BACKGROUND: Chronic kidney disease (CKD) is associated with hyperphosphatemia, decreased vitamin D metabolite concentrations, and hyperparathyroidism. This syndrome is known as CKD-mineral bone disorder (CKD-MBD). Recently, it has been shown that an increase in fibroblast growth factor-23 (FGF-23) concentration is an early biomarker of CKD in people. It is an independent risk factor for both progression of renal disease and survival time in humans and cats with CKD. Information about FGF-23 in healthy dogs and those with CKD is lacking...
April 17, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28413385/calciphylaxis-presenting-with-various-symptoms-a-case-report
#13
Shinpei Miura, Kazuhiro Takahashi, Toshihide Akasaka
Calciphylaxis causes ischemia in multiple organs and skin ulcers owing to progressive calcification in small and medial arteries. It has a poor prognosis and often occurs in patients with hyperparathyroidism associated with end-stage renal failure and those undergoing hemodialysis. Here, we present a case of calciphylaxis associated with a wide range of symptoms, including lower thigh skin ulcers, a rectovaginal fistula, and femoral neck fracture. The patient underwent multiple treatments. However, she eventually died of cardiac failure...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28412706/endocrine-comorbidities-in-patients-with-psoriatic-arthritis-a-population-based-case-controlled-study
#14
Amir Haddad, Ron Ilan Ashkenazi, Haim Bitterman, Ilan Feldhamer, Sari Greenberg-Dotan, Idit Lavi, Erez Batat, Irina Bergman, Arnon Dov Cohen, Devy Zisman
OBJECTIVE: To investigate endocrine comorbidities in patients with psoriatic arthritis (PsA). METHODS: A retrospective, cross-sectional study was performed with the database of Clalit Health Services, the largest healthcare provider in Israel, between 2002 and 2014. Patients with PsA were identified and matched by age and sex to healthy controls. The following morbidities were analyzed: hypo/hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis...
April 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28412266/hyperparathyroidism-diagnosed-due-to-brown-tumors-of-the-jaw-a-case-report-and-literature-review
#15
Philip Brabyn, Ana Capote, Marko Belloti, Ian Zylberberg
This report describes the case of a 42-year-old woman who consulted with a maxillofacial specialist for pain and an exophytic lesion in the maxilla. Biopsy examination disclosed a bone cyst with abundant giant cells, and head and neck computed tomography was performed. A diagnosis of brown tumor in the maxilla and mandible was made, and primary hyperparathyroidism (parathyroid adenoma) was determined as the origin of the bone lesions. The patient underwent a left superior parathyroidectomy, which resolved the hormonal disorder (as determined by normal calcium and parathyroid hormone levels) and the brown tumors, which appeared to have mineralized at 1-year follow-up computed tomography...
March 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28409372/primary-hyperparathyroidism-treated-by-transoral-endoscopic-parathyroidectomy-vestibular-approach-toepva
#16
Thanyawat Sasanakietkul, Tobias Carling
BACKGROUND: Bilateral open cervical exploration with identifying all parathyroid glands and removing one or more enlarged parathyroid tumor(s) was the standard of care in primary hyperparathyroidism (pHPT). With the introduction of preoperative imaging and intraoperative parathyroid hormone (IOPTH) measurements [1, 2], various minimally invasive parathyroidectomy approaches have been developed, both open and endoscopic [3-8]. The most commonly used approach currently in the USA is the minimally invasive open parathyroidectomy (MIP), which can be performed in the ambulatory setting with excellent cure and minimal complication rates [9-12]...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28406904/relationship-between-bone-turnover-and-left-ventricular-function-in-primary-hyperparathyroidism-the-epath-trial
#17
Nicolas Verheyen, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Martin R Gruebler, Hans Peter Dimai, Karin Amrein, Klemens Ablasser, Johann Martensen, Cristiana Catena, Elisabeth Pieske-Kraigher, Caterina Colantonio, Jakob Voelkl, Florian Lang, Ioana Alesutan, Andreas Meinitzer, Winfried März, Helmut Brussee, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz
Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the "Eplerenone in Primary Hyperparathyroidism" (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e', diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed...
2017: PloS One
https://www.readbyqxmd.com/read/28405928/adynamic-bone-disease-is-a-predominant-bone-pattern-in-early-stages-of-chronic-kidney-disease
#18
REVIEW
Ziad Massy, Tilman Drueke
Chronic kidney disease (CKD) is complicated by disturbances of mineral and bone metabolism which start early in the course of the disease. It has long been assumed that high turnover bone lesions induced by secondary hyperparathyroidism are the predominant type of renal osteodystrophy from the start. However, there is increasing evidence in favor of the view that in early CKD stages low bone turnover is prevailing, with adynamic bone disease being the predominant form. Since serum parathyroid hormone levels increase progressively early on, and the most probable explanation is resistance to the skeletal action of this hormone...
April 12, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28402557/effect-of-parathyroidectomy-and-cinacalcet-on-quality-of-life-in-patients-with-end-stage-renal-disease-related-hyperparathyroidism-a-systematic-review
#19
Willemijn Y van der Plas, Roderick R Dulfer, Anton F Engelsman, Liffert Vogt, Martin H de Borst, Tessa M van Ginhoven, Schelto Kruijff
Background.: Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to ESRD-related hyperparathyroidism (HPT). Both cinacalcet and parathyroidectomy (PTx) are treatments for advanced HPT, but their effects on QoL are unclear. We performed a systematic review to evaluate the impact of cinacalcet and PTx on QoL. Methods.: A systematic literature search was performed using PubMed and EMBASE databases to identify relevant articles...
April 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28399538/risk-factors-for-intraoperative-hypertension-during-the-surgery-of-primary-hyperparathyroidism
#20
Vera D Sabljak, Vladan R Zivaljevic, Biljana R Milicic, Ivan R Paunovic, Anka R Toskovic, Ksenija S Stevanovic, Katarina M Tausanovic, Dejan Z Markovic, Marina M Stojanovic, Mirko V Lakicevic, Milan D Jovanovic, Aleksandar D Diklic, Nevena K Kalezic
OBJECTIVE: To investigate the incidence and to identify risk factors for the occurrence of intraoperative hypertension (IOH) during the surgery of primary hyperparathyroidism (pHPT). SUBJECTS AND METHODS: The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. The IOH was defined as an increase in systolic blood pressure ≥ 20% compared to baseline values which lasted for 15 minutes. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on American Society of Anesthesiologists - ASA classification), comorbidities, type and duration of surgery and duration of anesthesia on IOH occurrence...
April 10, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
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