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Patrick S Parfrey
Use of calcimimetics will be influenced not only by assessment of benefits and harms in individual patients but also by cost and by national guidelines. The Japanese Society for Dialysis Therapy has a lower PTH threshold for PTH control than other countries. The current RCT, despite its limitations, provides a rationale for use of evocalcet in the management of secondary hyperPTH.
October 2018: Kidney International
Jonathan Zagzag, Mimi I Hu, Sarah B Fisher, Nancy D Perrier
Incidentally detected hypercalcemia usually presents in an indolent manner and is most likely caused by primary hyperparathyroidism. In contrast, hypercalcemia in the patient with a history of cancer presents in a wide range of clinical settings and may be severe enough to warrant hospitalization. This form of hypercalcemia is usually secondary to hypercalcemia of malignancy and can be fatal. Hypercalcemia of malignancy is most commonly mediated by tumoral production of parathyroid hormone-related protein or by cytokines activating osteoclast degradation of bone...
September 21, 2018: CA: a Cancer Journal for Clinicians
Jianjun Xue, Yan Liu, Ting Ji, Aomei Zhao, Yiqian Liang, Huixing Deng, Qi Wang, Yuemin Zhang, Lulu Yang, Aimin Yang
OBJECTIVE: The aim of this study was to evaluate the value of technetium-99m methoxyisobutylisonitrile (Tc-MIBI) imaging and ultrasound in preoperative localization of parathyroid adenoma (PA) and parathyroid hyperplasia (PH). PARTICIPANTS AND METHODS: A retrospective study of Tc-MIBI double-phase scintigraphy (DPS) was performed in 187 hyperparathyroidism cases with pathologically diagnosed PA or PH. Of these patients, 167 cases underwent ultrasound, and 146 cases underwent Tc-MIBI single-photon emission computed tomography/computed tomography (SPECT/CT)...
September 19, 2018: Nuclear Medicine Communications
Kazuya Narushima, Hiroshi Maeda, Masanari Shiramoto, Yuichi Endo, Satoko Ohtsuka, Hiroaki Nakamura, Yoshinori Nagata, Tatsuo Uchimura, Ayako Kannami, Ryutaro Shimazaki, Masafumi Fukagawa, Tadao Akizawa
Evocalcet is a novel calcimimetic agent for the treatment of secondary hyperparathyroidism (SHPT). This study evaluated the effects of evocalcet on inhibition and induction of cytochrome P450 (CYP) isozymes. Although drug interactions arising from reversible inhibition of CYP isozymes by evocalcet were considered unlikely based on the results of in vitro studies and static model analyses, the potential for evocalcet to cause time-dependent inhibition of CYP3A or induction of several CYP isozymes could not be ruled out...
September 20, 2018: Clinical and Translational Science
Malachi J McKenna, Julie Martin-Grace, Rachel Crowley, Patrick J Twomey, Mark T Kilbane
Congenital hypophosphataemia (CH) is a collection of disorders that cause defective bone mineralisation manifesting with rickets in childhood and osteomalacia in adulthood. Bone turnover markers (BTMs) are surrogate measures of metabolic bone disease severity. We explored the utility of BTMs in 27 adults with CH: 23 had X-linked hypophosphataemia (XLH), of whom 2 were hypoparathyroid post-total parathyroidectomy (PTx); 2 had autosomal dominant hypophosphataemic rickets (ADHR), and 2 had none of the known mutations...
September 20, 2018: Journal of Bone and Mineral Metabolism
Satyendra Kumar Sonkar, Harendra Pratap Singh, Gyanendra Kumar Sonkar, Sant Pandey
Introduction: Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia...
July 2018: Journal of Family Medicine and Primary Care
H-X Dai, J-W Li, Y-Q Zhang, X-S Chen, X Huang, L-J Liu, Y-P Yang, E-Q Liu, J-X Wang, X-F Chen, S Zeng, T Liang, X-H Xu
OBJECTIVE: To understand the value of high frequency ultrasound in the clinical screening of parathyroid gland, and to summarize the intrinsic relationship between primary hyperparathyroidism and recurrent urinary calculi. PATIENTS AND METHODS: 98 cases of urinary calculi were randomly selected, and the patients were admitted to our hospital from March 2014 to August 2017. A total of 100 healthy subjects were selected as group B in the same period. High frequency color Doppler ultrasonography scan recorded the results...
September 2018: European Review for Medical and Pharmacological Sciences
Chen Huimin, Cui Ying, Xing Changying, Zha Xiaoming, Zhang Yan, Wang Qingting, Ma Haoyang, Zhang Lina, Zeng Ming, Yang Guang, Lv Xiaolin, Yogendranath Purrunsing, Wang Ningning
Currently, the second-generation intact parathyroid hormone (iPTH) assay is commonly used for measuring PTH levels. The iPTH assay detects both full-length (1-84)PTH and (7-84)PTH fragments, which have antagonistic effects on (1-84)PTH in bones and kidneys. The third-generation PTH assay is specific for (1-84)PTH. This study examined the features of different PTH fragments in stage 5 chronic kidney disease (CKD) and the effects of parathyroidectomy (PTX) on the above markers in severe secondary hyperparathyroidism (SHPT) patients...
September 17, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et M├ętabolisme
Carlo Alfieri, Anna Regalia, Francesca Zanoni, Simone Vettoretti, Mario Cozzolino, Piergiorgio Messa
Secondary hyperparathyroidism (SHPT) is a frequent condition in the presence of chronic kidney disease (CKD). In CKD patients, SHPT is reported to increase both morbidity and mortality, especially cardiovascular. The difficulty in the treatment of SHPT in clinical practice is frequently encountered from a not always adequate conduct of the clinicians and a common non-compliance to the therapy of CKD patients. In this review, the greatest difficulties from clinicians and CKD-patients' point of view in the treatment of SHPT will be addressed, with particular attention to those related to dialysis features, nutritional habits, and medical therapy...
September 17, 2018: Blood Purification
Arnoldo Piccardo, P Trimboli, M Rutigliani, M Puntoni, L Foppiani, L Bacigalupo, Anna Crescenzi, G Bottoni, G Treglia, F Paparo, P Del Monte, M Lanata, G Paone, G Ferrarazzo, U Catrambone, A Arlandini, L Ceriani, M Cabria, L Giovanella
PURPOSE: The localization of hyperfunctioning parathyroid gland(s) (HPTG) in patients with primary hyperparathyroidism (PHPT) with negative or inconclusive first-line imaging is a significant challenge. This study aimed to evaluate the role of integrated 18 F-choline PET/4D contrast-enhanced computed tomography (4DCeCT) in these patients, compare its detection rate and sensitivity with those of 18 F-choline PET/CT and (4DCeCT), and analyse the association between choline metabolism and morphological, biochemical and molecular parameters of HPTG...
September 15, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Heyjin Kim, Kihyun Kim, Sung Ran Cho, Hee Jin Kim, Sun Hee Kim
No abstract text is available yet for this article.
January 2019: Annals of Laboratory Medicine
Karl L Insogna
New England Journal of Medicine, Volume 379, Issue 11, Page 1050-1059, September 2018.
September 13, 2018: New England Journal of Medicine
Marcella D Walker, Haley M Zylberberg, Peter H R Green, Michael S Katz
PURPOSE: The purpose of this article is to review recent literature regarding endocrine disorders related to celiac disease (CD). METHODS: We describe a case report and review existing literature on the endocrine manifestations of CD. RESULTS: CD is an autoimmune disorder characterized by intestinal inflammation in response to gluten. CD can cause a wide range of extra-intestinal complications, including endocrine manifestations. Metabolic bone disease including osteoporosis and osteopenia, vitamin D deficiency, secondary hyperparathyroidism and less frequently osteomalacia can be seen...
September 10, 2018: Endocrine Research
Vincenzo Triggiani, Marco Castellana, Paolo Basile, Giuseppina Renzulli, Vito Angelo Giagulli
BACKGROUND: Neurofibromatosis type 1 is an autosomal dominant disorder characterized by an increased incidence of tumors, including endocrine ones. Primary hyperparathyroidism can be rarely caused by a parathyroid carcinoma; these patients are generally characterized by severe symptoms, large neck lesions and high levels of PTH and calcium. We report a case of hyperparathyroidism due to parathyroid carcinoma in a patient affected by neurofibromatosis type 1. A systematic review of literature was also conducted...
September 10, 2018: Endocrine, Metabolic & Immune Disorders Drug Targets
Lei Du, Xiwei Zhang, Liang Yan, Hao Zhang, Xuefeng Tang, Xiancheng Kong, Gang Liu, Jianping Huang
Objective Secondary hyperparathyroidism (sHPT) is one of the most serious complications in patients on long-term hemodialysis. These patients may suffer from metabolic bone diseases, severe atherosclerosis, and undesirable cardiovascular events. Endoscopic parathyroidectomy with autotransplantation is a treatment option for those who do not respond to clinical management. This study aimed to investigate practical use of a self-made device in parathyroid autotransplantation for patients with sHPT, and to compare this device with ordinary surgical scissors...
September 9, 2018: Journal of International Medical Research
Paul M Bunch, Hillary R Kelly
Importance: Successful minimally invasive parathyroidectomy requires confident and accurate preoperative localization. Several noninvasive imaging techniques are well established for preoperative localization, and others are emerging. Observations: Ultrasonography and sestamibi imaging are established preoperative localization techniques with good sensitivity and positive predictive value. Multiphase 4-dimensional computed tomography is a newer technique with arguably superior performance, particularly in the setting of negative or discordant ultrasonography and sestamibi imaging, residual or recurrent primary hyperparathyroidism following a previous surgical operation, and multiglandular disease...
September 6, 2018: JAMA Otolaryngology—Head & Neck Surgery
Andrew A Rosenthal, Rachele J Solomon, Thomas Capasso, Stephanie A Eyerly-Webb
No abstract text is available yet for this article.
August 1, 2018: American Surgeon
Jacob Q Lloyd, Jenny M Holcombe, Allyssa A Rackley, Richard M Tanner, W Heath Giles
99mTechnetium sestamibi scans (MIBI) can provide negative or inaccurate results in patients with biochemical primary hyperparathyroidism. Reliance on MIBI as a diagnostic modality rather than as a localization tool leads to misdiagnosis and inappropriate care. The aim of this study was to determine the impact of negative MIBI scans on referral patterns and surgical intervention. Adults with MIBI scans at our institution from January 1, 2011, to May 31, 2017, were retrospectively reviewed. Data collected include demographics, study date and results, ordering physician specialty, pre/postoperative laboratories, and operative and final pathology...
August 1, 2018: American Surgeon
Kiminori Yukata, Tsukasa Kanchiku, Hiroshi Egawa, Michihiro Nakamura, Norihiro Nishida, Takahiro Hashimoto, Hiroyoshi Ogasa, Toshihiko Taguchi, Natsuo Yasui
Hyperparathyroidism, which is increased parathyroid hormone (PTH) levels in the blood, could cause delayed or non-union of bone fractures. But, no study has yet demonstrated the effects of excess continuous PTH exposure, such as that seen in hyperparathyroidism, for fracture healing. Continuous human PTH1-34 (teriparatide) infusion using an osmotic pump was performed for stabilized tibial fractures in eight-week-old male mice to determine the relative bone healing process compared with saline treatment. Radiographs and micro-computed tomography showed delayed but increased calcified callus formation in the continuous PTH1-34 infusion group compared with the controls...
September 4, 2018: Scientific Reports
Banafsheh Motazedi, Maziar Rahmani, James M Welch, Abbas Motazedi
A 77-year-old woman was diagnosed with pheochromocytoma followed by adrenalectomy at age 57. Hyperparathyroidism without osteoprosis was diagnosed at age 58. At age 75, Dual Energy X-ray Absoptiometry (DEXA) revealed osteoporosis and sestamibi scan showed a left parathyroid adenoma. Criteria for parathyroidectomy were met, and she underwent parathyroidectomy. Furthermore, she presented with haematochezia at age 75. An abdominal CT demonstrated a mass in the second portion of the duodenum. Additionally, octreoscan revealed somatostatin receptor positive tissue in the duodenum and Gallium 68 dotatate scan also showed a well-differentiated duodenal neuroendocrine tumour (NET)...
September 4, 2018: BMJ Case Reports
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