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Hyperparathyroidism not tertiary

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
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
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...
September 14, 2016: JAMA Surgery
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
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
Stephanie M Toth-Manikowski, Jean M Francis, Amitabh Gautam, Craig E Gordon
Mineral and bone disorders that precede kidney transplantation are exacerbated in the post-transplant setting by tertiary hyperparathyroidism and immunosuppressive regimens. Bone mineral density (BMD) decreases following transplantation, leading to increased fracture risk. The effect of bisphosphonates on fracture is unknown. The aim of this study was to update estimates of change in BMD and fracture rates in bisphosphonate-treated kidney transplant recipients through meta-analysis. Studies comparing bisphosphonate therapy to standard of care were included if follow-up duration was more than 6 months...
September 2016: Clinical Transplantation
Giuseppe Viccica, Filomena Cetani, Edda Vignali, Mario Miccoli, Claudio Marcocci
The purpose of the study was to evaluate the relationship between serum 25(OH)D and the clinical phenotype in 215 consecutive Italian Caucasian women with sporadic primary hyperparathyroidism (PHPT) not taking vitamin D supplements. The study was performed at a single Italian tertiary center. PHPT-related manifestations, serum 25(OH)D, and other parameters of calcium metabolism and bone mineral density (BMD) by DXA were recorded. Serum 25(OH)D was negatively correlated with age (r = -0.18; P = 0.006), BMI (r = -0...
March 31, 2016: Endocrine
Pahnwat T Taweesedt, Sinee Disthabanchong
After successful kidney transplantation, accumulated waste products and electrolytes are excreted and regulatory hormones return to normal levels. Despite the improvement in mineral metabolites and mineral regulating hormones after kidney transplantation, abnormal bone and mineral metabolism continues to present in most patients. During the first 3 mo, fibroblast growth factor-23 (FGF-23) and parathyroid hormone levels decrease rapidly in association with an increase in 1,25-dihydroxyvitamin D production. Renal phosphate excretion resumes and serum calcium, if elevated before, returns toward normal levels...
December 24, 2015: World Journal of Transplantation
K P Sreelesh, G Nair Sreejith, K Prabhakaran Pranab
Here we report a 65-year-old woman with multiple brown tumors and renal stones secondary to primary hyperparathyroidism. This case highlights the need for early recognition of parathyroid hyperactivity.
January 2016: Proceedings of the Baylor University Medical Center
Gomathy Sethuraman, Raman K Marwaha, Apoorva Challa, Vamsi K Yenamandra, Lakshmy Ramakrishnan, Sanjay Thulkar, Vinod K Sharma
Severe vitamin D deficiency and rickets are highly prevalent among children with congenital ichthyosis. We report an incidental observation of a dramatic and excellent clinical response with regard to skin scaling and stiffness in children with congenital ichthyosis after short-term high-dose vitamin D supplementation that has not been previously described. Seven children with congenital ichthyosis (5 with autosomal recessive congenital ichthyosis; 2 with epidermolytic ichthyosis) and severe vitamin D deficiency (and/or rickets) were given 60,000 IU of oral cholecalciferol daily for 10 days under supervision...
January 2016: Pediatrics
M N Bratucu, N D Garofil, P A Radu, V Paic, V Goleanu, M Zurzu, F Popa, V Strambu, D N Straja
BACKGROUND: Surgery is the definitive treatment of secondary hyperparathyroidism (2HPT) and end stage renal disease patients. The aim of this study to assess the impact of surgery on the evolution of quality of life (QoL) in patients with 2HPT, and to identify the variables that influence this evolution. METHODS: A series of 85 consecutive unselected patients underwent total parathyroidectomy for 2HPT in our clinic. QoL was measured using the Short-Form Health Survey(SF-36) and alleviation of symptoms was documented using an outcome tool (PAS score), based on visual analog scales, preoperatively, postoperatively and at 6 months...
November 2015: Chirurgia
Ahsan Zil-E-Ali, Aiza Latif, Anam Rashid, Asim Malik, Haseeb Ahmed Khan
Parathyroid adenoma is the main cause of primary hyperparathyroidism. It is usually asymptomatic and occurs more commonly in adults. It presents with raised parathormone (PTH) and Ca+ levels in serum. Its presentation in adolescence is rare. We report one such incidence of a 14 years old girl who presented with bone pains short stature, and generalized muscle wasting. She was found to have genu valgum at the knee joint, pectus carniatum, scoliosis and cystic changes in pelvis and calvarium. Biochemical investigations and parathyroid Tc-99mMIBI scan confirmed the diagnosis of a parathyroid adenoma...
January 2016: JPMA. the Journal of the Pakistan Medical Association
X-M Wang, Y-W Wu, Z-J Li, X-H Zhao, S-M Lv, X-H Wang
OBJECTIVE: To evaluate correlations between polymorphisms of calcium-sensing receptor (CASR) gene [A986S (rs1081725), R990G (rs1042636) and Q1011E (rs1801726)] and the risk of primary hyperparathyroidism (PHPT) among human population. METHODS: Relevant studies were retrieved from online databases using computer-based search strategies, which were then supplemented by manual search strategies. Case-control studies related to our topic were identified based on strict inclusion and exclusion criteria...
June 2016: Journal of Endocrinological Investigation
Maria Concetta Gioviale, Giuseppe Damiano, Roberta Altomare, Carolina Maione, Salvatore Buscemi, Giuseppe Buscemi, Attilio Ignazio Lo Monte
Intraoperative parathyroid hormone (PTH) monitoring in the setting of the operating room represents a valuable example of the rationale use of the laboratory diagnostic in a patient-oriented approach. Rapid intraoperative PTH (ioPTH) assay is a valid tool for an accurate evaluation of the success of parathyroid surgery. The reliability of the user-friendly portable systems as well as the collaboration between operators and surgical staff allow the one-site monitoring of the ioPTH decrements on the course of the surgical management of hyperparathyroidism...
April 2016: International Journal of Surgery
Fabio Medas, Enrico Erdas, Giulia Loi, Francesco Podda, Giuseppe Pisano, Angelo Nicolosi, Pietro Giorgio Calò
Parathyroid carcinoma is a rare malignancy representing less than 1% of primary hyperparathyroidism cases. Its management is controversial due to lack of large-scale, multicentric studies. We report 8 new cases of parathyroid carcinoma and review the literature. Preoperative diagnosis of carcinoma was possible in 2 (25%) cases. Unclear surgical margins were present in 5 (62.5%) patients; 4 of them underwent subsequent re-exploration and ipsilateral hemithyroidectomy, in one case associated to central lymph node dissection...
April 2016: International Journal of Surgery
James Goya Heaf
PURPOSE: The purpose of this paper was to review the literature concerning the treatment of chronic kidney disease-mineral bone disorder (CKD-MBD) in the elderly peritoneal dialysis (PD) patient. RESULTS: Chronic kidney disease-mineral bone disorder is a major problem in the elderly PD patient, with its associated increased fracture risk, vascular calcification, and accelerated mortality fracture risk. Peritoneal dialysis, however, bears a lower risk than hemodialysis (HD)...
November 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Xing-Mao Fu, Shao-Guang Fan, Shu-Liang Li, Yi-Sheng Chen, Hai Wu, Yan-Long Guo
PURPOSE: There is limited information on the prevalence of vitamin D deficiency among patients diagnosed with hip fracture in the Chinese Han population. Therefore, the aim of this study was to assess the effects of change in the serum levels of 25-hydroxyvitamin D [25(OH) D] and intact parathyroid hormone (iPTH) among postmenopausal women in North China with confirmed hip fracture. METHODS: This study was done from May 1, 2012 to April 30, 2014. Three hundred and forty-nine postmenopausal women who were diagnosed with first-ever hip fracture and 349 matched controls without fracture were used for this study...
2015: Journal of Translational Medicine
Shobana Sekhar, Umanath K Nayak, D Suhasini, Buggaveeti Rahul, Rabindranath Mehrotra
The purpose of this study is to determine preoperative predictors of the severity of the hypocalcaemia following parathyroidectomy. The case records of 70 patients who underwent parathyroidectomy for primary hyperparathyroidism from 2000 to 2013 was retrospectively studied. Their symptoms at presentation, biochemical parameters serum calcium, parathyroid hormone, alkaline phosphatase and parathyroid size on ultrasound were compared with their serial post-operative serum calcium levels at 24, 48, 72 and 96 h...
December 2015: Indian Journal of Otolaryngology and Head and Neck Surgery
Saurin R Shah, Amit Keshri, Sanjay Behari, Simple Patadia, Neeraj Kumari
Giant cell granuloma is a rare benign granulomatous lesion of the bone. The local aggressiveness, potentiation with trauma and complex anatomy of the skull base makes the surgical management in this location challenging. We report a series of three cases along with the clinical presentation, radiological and histopathological findings and the management issues while dealing with this lesion. A review of literature reveals the rarity of the lesion, alternate management modalities and the outcomes for such lesion involving the jaw bones and the skull base...
December 2015: Indian Journal of Otolaryngology and Head and Neck Surgery
Khalid Amer, Ali Zamir Khan, David Rew, Nicholas Lagattolla, Neeta Singh
BACKGROUND: To report the first series of video-assisted thoracoscopic surgery (VATS) resection of mediastinal ectopic parathyroid adenomas (MEPAs) in the UK. METHODS: A case series of seven cases undergoing VATS between 2004 and 2009 to treat single gland hyperparathyroidism. Methylene blue (MB) was used in 5/7 cases immediately before exploration to identify the adenomas. Carbon dioxide (CO2) up to pressures of 10 mmHg was used safely to deflate the lung in two cases...
November 2015: Annals of Cardiothoracic Surgery
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