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primary hyperparathyroidism guidelines

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https://www.readbyqxmd.com/read/28923463/hyperparathyroidism
#1
REVIEW
John P Bilezikian, Leonardo Bandeira, Aliya Khan, Natalie E Cusano
Primary hyperparathyroidism is a common endocrine disorder of calcium metabolism characterised by hypercalcaemia and elevated or inappropriately normal concentrations of parathyroid hormone. Almost always, primary hyperparathyroidism is due to a benign overgrowth of parathyroid tissue either as a single gland (80% of cases) or as a multiple gland disorder (15-20% of cases). Primary hyperparathyroidism is generally discovered when asymptomatic but the disease always has the potential to become symptomatic, resulting in bone loss and kidney stones...
September 15, 2017: Lancet
https://www.readbyqxmd.com/read/28806302/surgery-for-primary-hyperparathyroidism-adherence-to-consensus-guidelines-in-an-academic-health-system
#2
Eric J Kuo, Mostafa A Al-Alusi, Lin Du, Albert Shieh, Masha J Livhits, Angela M Leung, Michael W Yeh
OBJECTIVE: To determine the extent to which consensus guidelines for surgery in patients with primary hyperparathyroidism (PHPT) are followed within an academic health system. BACKGROUND: Previous studies have shown that adherence to consensus guidelines in community practice is low. METHODS: Adults with biochemically confirmed PHPT who received primary care within an academic health system were identified from 2005 to 2015. Multivariable logistic regression was used to analyze predictors of parathyroidectomy (PTx)...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28759830/forearm-nonunion-caused-by-hyperparathyroidism-with-7-years-follow-up-a-case-report
#3
Mayuko Kinoshita, Kiyohito Naito, Kentaro Aritomi, Yoichi Sugiyama, Nana Nagura, Kenji Goto, Yoshiyuki Iwase, Kazuo Kaneko
INTRODUCTION: We report a patient who developed nonunion of both bones of the forearm associated with hyperparathyroidism (HPT). PRESENTATION OF CASE: The patient was a 71-year-old female who previously fell and hit her left hand on the ground. At 2 years after injury the patient visited our hospital, since she became aware of instability of the left forearm without an inducer due to nonunion of the radioulnar diaphysis. The patient was surgically treated to acquire forearm support...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28658490/indications-for-surgical-management-of-hyperparathyroidism-a-review
#4
Antonia E Stephen, Michael Mannstadt, Richard A Hodin
Importance: Primary hyperparathyroidism (pHPT) is a common clinical entity, with approximately 100 000 new cases diagnosed each year in the United States. Most patients with pHPT have a relatively mild form of the disease and present with few if any overt signs or symptoms. This has led to a dilemma regarding which patients should be considered for parathyroid surgery. In this article, we review the established literature on the indications for surgery in asymptomatic pHPT and discuss the most recent consensus conference guidelines...
September 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28616750/systematic-review-of-oral-manifestations-related-to-hyperparathyroidism
#5
REVIEW
Benjamin Palla, Egon Burian, Riham Fliefel, Sven Otto
OBJECTIVES: We sought to identify oral symptoms found in hyperparathyroidism and compare their rate of occurrence, as well as potential variations in sequelae between primary, secondary, and tertiary hyperparathyroidism. MATERIALS AND METHODS: Database searches were performed through EMBASE and PubMed, with a continual handsearch for relevant articles. PRISMA guidelines were followed. RESULTS: Two hundred five articles including 245 patients were analyzed with data extraction...
June 14, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28580574/primary-hyperparathyroidism-in-pregnancy-a-review-of-literature
#6
Hanna Komarowska, Barbara Bromińska, Bartosz Luftmann, Marek Ruchała
Hyperparathyroidism during pregnancy is diagnosed in 0.5-1.4% women and poses a serious challenge. Symptoms of primary hyperparathyroidism (PHP), namely fatigue, lethargy and proximal muscle weakness, are unspecific and could be mistaken as complaints naturally present during pregnancy. Thus, diagnosis is usually delayed. Moreover, the complications of PHP are very common. They occur in 67% of mothers and even in up to 80% of progeny. Appropriate management is a matter of debate. According to clinical symptoms, biochemical evaluation and trimester of pregnancy an operation or conservative management should be introduced...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28473803/contemporary-medical-management-of-primary-hyperparathyroidism-a-systematic-review
#7
REVIEW
Julius Simoni Leere, Jesper Karmisholt, Maciej Robaczyk, Peter Vestergaard
INTRODUCTION: Primary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28473363/antacid-abuse-a-rare-cause-of-severe-hypercalcaemia
#8
Ben Stoney, Gautam Bagchi
We discuss a case of an 81-year-old man who presented to hospital with a case of severe hypercalcaemia (5.07 mmol/L). The two most common causes of hypercalcaemia, making up around 90% of the cases, are malignancy and primary hyperparathyroidism. Initial investigations are guided by this knowledge. In this case, no underlying malignancy or evidence of a parathyroid adenoma causing primary hyperparathyroidism was found. Instead, on further history, it was found that this patient had troublesome dyspepsia symptoms for which he had ingested 10-12 calcium carbonate tablets a day for the preceding 2 years...
May 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28102095/significance-of-the-ionized-calcium-measurement-to-assess-calcium-status-in-osteopenic-osteoporosis-postmenopausal-outpatients
#9
Letizia Guiducci, Silvia Maffei, Laura Sabatino, Luc Zyw, Debora Battaglia, Alessandro Vannucci, Pietro Di Cecco, Cristina Vassalle
INTRODUCTION: Evaluation of calcium status is important in the osteoporotic risk assessment. Although guidelines indicate total calcium (tCa) as first-line measurement, directly measured ionized calcium (m-iCa), considered as the gold standard, is more and more often required. Aim of this study is to evaluate the agreement between m-iCa, tCa and iCa calculated from a formula based on total calcium and albumin (c-iCa) in osteopenic/osteoporotic postmenopausal outpatients. METHODS: A total of 140 postmenopausal outpatients, 41 osteopenic (OPN) and 99 osteoporotic (OP) were enrolled...
January 19, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28001017/improvement-of-bone-turnover-markers-and-bone-mineral-density-following-treatment-of-primary-aldosteronism
#10
Huai H Loh, Nor A Kamaruddin, Rozman Zakaria, Norlela Sukor
BACKGROUND: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension. METHODS: This was an open-label, prospective, case-controlled study, conducted over 12 months. Fifty-two consecutive patients referred for secondary hypertension were screened...
December 20, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27863777/concentration-of-serum-calcium-is-not-correlated-with-symptoms-or-severity-of-primary-hyperparathyroidism-an-examination-of-20-081-consecutive-adults
#11
COMPARATIVE STUDY
Deva Boone, Douglas Politz, Jose Lopez, Jamie Mitchell, Kevin Parrack, James Norman
BACKGROUND: Guidelines for operative treatment of primary hyperparathyroidism include calcium levels >1 mg/dL above normal. We sought to determine whether greater calcium concentrations were associated with increased symptoms or disease severity. METHODS: A retrospective review of a prospectively maintained database of adults undergoing parathyroidectomy for primary hyperparathyroidism, grouped according to greatest preoperative calcium level: those patients with calcium concentrations between 10...
January 2017: Surgery
https://www.readbyqxmd.com/read/27836213/parathyroidectomy-for-asymptomatic-primary-hyperparathyroidism-a-revised-cost-effectiveness-analysis-incorporating-fracture-risk-reduction
#12
REVIEW
Kyle A Zanocco, James X Wu, Michael W Yeh
BACKGROUND: Recent data demonstrate decreased fracture risk after operation for asymptomatic primary hyperparathyroidism. We performed a revised cost-effectiveness analysis comparing parathyroidectomy versus observation while incorporating fracture risk reduction. METHODS: A Markov transition-state model was created comparing parathyroidectomy and guideline-based medical observation for a 60-year-old female patient with mild asymptomatic primary hyperparathyroidism...
January 2017: Surgery
https://www.readbyqxmd.com/read/27696297/how-the-reference-values-for-serum-parathyroid-hormone-concentration-are-or-should-be-established
#13
REVIEW
J-C Souberbielle, F Brazier, M-L Piketty, C Cormier, S Minisola, E Cavalier
Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria for this population can be defined as any situation possibly inducing an increase or a decrease in PTH concentration. As recommended in the recent guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism, PTH reference values should be established in vitamin D-replete subjects with a normal renal function with possible stratification according to various factors such as age, gender, menopausal status, body mass index, and race...
March 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27613721/primary-hyperparathyroidism-review-and-recommendations-on-evaluation-diagnosis-and-management-a-canadian-and-international-consensus
#14
REVIEW
A A Khan, D A Hanley, R Rizzoli, J Bollerslev, J E M Young, L Rejnmark, R Thakker, P D'Amour, T Paul, S Van Uum, M Zakaria Shrayyef, D Goltzman, S Kaiser, N E Cusano, R Bouillon, L Mosekilde, A W Kung, S D Rao, S K Bhadada, B L Clarke, J Liu, Q Duh, E Michael Lewiecki, F Bandeira, R Eastell, C Marcocci, S J Silverberg, R Udelsman, K Shawn Davison, J T Potts, M L Brandi, J P Bilezikian
The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH)...
January 2017: Osteoporosis International
https://www.readbyqxmd.com/read/27589344/screening-for-hyperparathyroidism-by-measurement-of-calcium-in-patients-undergoing-thyroid-surgery-a-prospective-study
#15
P W Rosário, G F Mourão, M R Calsolari
This study screened for asymptomatic primary hyperparathyroidism (PHPT) by measuring calcium (Ca) before thyroid surgery. The study was prospective. A total of 676 patients without a suspicion of PHPT were studied. PHPT was defined as elevated Ca (in 2 measurements) in the presence of PTH>25 pg/ml and in the absence of hypocalciuria. PHPT was diagnosed in 5 patients (0.74%), all of them women. One of the 5 patients with PHPT had no indication for parathyroidectomy (PTx) according to current guidelines...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27532368/the-american-association-of-endocrine-surgeons-guidelines-for-definitive-management-of-primary-hyperparathyroidism
#16
Scott M Wilhelm, Tracy S Wang, Daniel T Ruan, James A Lee, Sylvia L Asa, Quan-Yang Duh, Gerard M Doherty, Miguel F Herrera, Janice L Pasieka, Nancy D Perrier, Shonni J Silverberg, Carmen C Solórzano, Cord Sturgeon, Mitchell E Tublin, Robert Udelsman, Sally E Carty
Importance: Primary hyperparathyroidism (pHPT) is a common clinical problem for which the only definitive management is surgery. Surgical management has evolved considerably during the last several decades. Objective: To develop evidence-based guidelines to enhance the appropriate, safe, and effective practice of parathyroidectomy. Evidence Review: A multidisciplinary panel used PubMed to review the medical literature from January 1, 1985, to July 1, 2015...
October 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27508075/primary-hyperparathyroidism
#17
REVIEW
Leonardo Bandeira, John Bilezikian
Over the past several generations, primary hyperparathyroidism (PHTP) has undergone a change in its clinical presentation in many countries from a symptomatic disease to an asymptomatic one. The reasons for this change in clinical presentation are related to the widespread use of biochemical screening tests, to the measurement of PTH more routinely in the evaluation of metabolic bone disease and to the status of vitamin D sufficiency in the population. Along with recognition of a broader clinical spectrum of disease, including a more recently recognized normocalcemic variant, has come an appreciation that the evaluation of classic target organs that can be affected in PHPT, such as the skeleton and the kidneys, require more advanced imaging technology for complete evaluation...
2016: F1000Research
https://www.readbyqxmd.com/read/27402205/unilateral-clearance-for-primary-hyperparathyroidism-in-selected-patients-with-multiple-endocrine-neoplasia-type-1
#18
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
https://www.readbyqxmd.com/read/27198205/impact-of-parathyroidectomy-for-primary-hyperparathyroidism-on-quality-of-life-a-case-control-study-using-short-form-health-survey-36
#19
Roderick Dulfer, Wanda Geilvoet, Annelien Morks, Esther M M van Lieshout, Casper P C Smit, Els J M Nieveen van Dijkum, Klaas In't Hof, Frits van Dam, Casper H J van Eijck, Peter W de Graaf, Tessa M van Ginhoven
BACKGROUND: Physical and mental complaints are common in patients with primary hyperparathyroidism (PHPT) and negatively impact quality of life (QOL). Subjective symptoms in current guidelines are not considered an indication for surgery. The purpose of this study was to assess the effect of parathyroidectomy on QOL in patients with PHPT. METHODS: This multicenter case-control study investigated preoperative and postoperative QOL scores in patients operated for PHPT, measured with the Short Form Health Survey-36 (SF-36) questionnaire...
August 2016: Head & Neck
https://www.readbyqxmd.com/read/27194212/primary-hyperparathyroidism
#20
REVIEW
John P Bilezikian, Natalie E Cusano, Aliya A Khan, Jian-Min Liu, Claudio Marcocci, Francisco Bandeira
Primary hyperparathyroidism (PHPT) is a common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of the four parathyroid glands. A single benign parathyroid adenoma is the cause in most people. However, multiglandular disease is not rare and is typically seen in familial PHPT syndromes. The genetics of PHPT is usually monoclonal when a single gland is involved and polyclonal when multiglandular disease is present. The genes that have been implicated in PHPT include proto-oncogenes and tumour-suppressor genes...
May 19, 2016: Nature Reviews. Disease Primers
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