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primary hyperparathyroidism guidelines

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https://www.readbyqxmd.com/read/29723896/mineralocorticoid-receptor-blockers-and-aldosterone-to-renin-ratio-a-randomized-controlled-trial-and-observational-data
#1
Stefan Pilz, Christian Trummer, Nicolas Verheyen, Verena Schwetz, Marlene Pandis, Felix Aberer, Martin R Grübler, Andreas Meinitzer, Antonia Bachmann, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo A Sechi, Winfried März, Barbara Obermayer-Pietsch, Andreas Tomaschitz
Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT)...
May 3, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29644071/clinical-management-of-patients-on-peritoneal-dialysis-in-italy-results-from-the-atena-study
#2
Carlo Crepaldi, Alessandro Possidoni, Flavia Caputo, Roberto Dell'Aquila, Emilio Giulio Galli, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Roberto Russo
Background: In Italy, few studies have examined the clinical management of peritoneal dialysis (PD) patients, resulting in a lack of information and awareness. Methods: A total of 378 PD patients (64.7 ± 14.3 years, 58.9% males) were enrolled across 15 centres in a 12-month retrospective and 6-month prospective study. The primary objective was to evaluate the achievement of Kidney Disease Outcomes Quality Initiative and Kidney Disease Improving Global Outcomes guidelines on recommended target values for anaemia, high blood pressure and mineral metabolism...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29623209/concurrent-primary-hyperparathyroidism-and-pheochromocytoma-in-a-chinese-lady-with-neurofibromatosis-type-1
#3
Cheuk-Lik Wong, Chun-Kit Fok, Vicki Ho-Kee Tam
We report a case of elderly Chinese lady with neurofibromatosis type-1 presenting with longstanding palpitation, paroxysmal hypertension and osteoporosis. Biochemical testing showed mild hypercalcaemia with non-suppressed parathyroid hormone level suggestive of primary hyperparathyroidism, and mildly elevated urinary fractionated normetanephrine and plasma-free normetanephrine pointing to a catecholamine-secreting pheochromocytoma/paraganglioma. Further scintigraphic investigation revealed evidence of a solitary parathyroid adenoma causing primary hyperparathyroidism and a left pheochromocytoma...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29616419/clinical-presentation-and-management-of-patients-with-primary-hyperparathyroidism-in-italy
#4
F Saponaro, F Cetani, A Repaci, U Pagotto, C Cipriani, J Pepe, S Minisola, C Cipri, F Vescini, A Scillitani, A Salcuni, S Palmieri, C Eller-Vainicher, I Chiodini, B Madeo, E Kara, E Castellano, G Borretta, L Gianotti, F Romanelli, V Camozzi, A Faggiano, S Corbetta, L Cianferotti, M L Brandi, M L De Feo, A Palermo, G Vezzoli, F Maino, M Scalese, C Marcocci
PURPOSE: Evaluation of the phenotype of primary hyperparathyroidism (PHPT), adherence to International Guidelines for parathyroidectomy (PTx), and rate of surgical cure. METHOD: From January 2014-January 2016, we performed a prospective, multicenter study in patients with newly diagnosed PHPT. Biochemical and instrumental data were collected at baseline and during 1-year follow-up. RESULTS: Over the first year we enrolled 604 patients (age 61 ± 14 years), mostly women (83%), referred for further evaluation and treatment advice...
April 3, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29532143/primary-hyperparathyroidism-is-underdiagnosed-and-suboptimally-treated-in-the-clinical-setting
#5
Jacob Enell, Haytham Bayadsi, Ewa Lundgren, Joakim Hennings
PURPOSE: To evaluate whether patients presenting with laboratory results consistent with primary hyperparathyroidism (pHPT) are managed in accordance with guidelines. METHODS: The laboratory database at a hospital in Sweden, serving 127,000 inhabitants, was searched for patients with biochemically determined pHPT. During 2014, a total of 365 patients with biochemical laboratory tests consistent with pHPT were identified. Patients with possible differential diagnoses or other reasons for not being investigated according to international guidelines were excluded after scrutinizing records, after new blood tests, and clinical assessments by endocrine surgeons...
March 12, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29400579/occult-urolithiasis-in-asymptomatic-primary-hyperparathyroidism
#6
Yu-Kwang Donovan Tay, Minghao Liu, Leonardo Bandeira, Mariana Bucovsky, James A Lee, Shonni J Silverberg, Marcella D Walker
OBJECTIVE: Recent international guidelines suggest renal imaging to detect occult urolithiasis in all patients with asymptomatic primary hyperparathyroidism (PHPT), but data regarding their prevalence and associated risk factors are limited. We evaluated the prevalence and risk factors for occult urolithiasis. METHODS: Cross-sectional analysis of 96 asymptomatic PHPT patients from a university hospital in the United States with and without occult nephrolithiasis...
May 2018: Endocrine Research
https://www.readbyqxmd.com/read/29390544/anesthetic-management-of-primary-hyperparathyroidism-during-pregnancy-a-case-report
#7
Hong Zeng, Zhengqian Li, Xiaoqing Zhang, Ning Wang, Yang Tian, Jun Wang
RATIONALE: Primary hyperparathyroidism (PHPT) during pregnancy is rare. Nevertheless, hypercalcemia secondary to gestational PHPT may be masked by physiological changes in calcium homeostasis during pregnancy. Gestational PHPT constitutes a serious danger to mother and fetus. Surgery is the only curative treatment when conservative treatment could not control the condition. Due to the lack of guidelines concerning PHPT during pregnancy, the optimal anesthetic management of PHPT during pregnancy needs to be individualized...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29357552/re-surgery-for-primary-hyperparathyroidism-adherence-to-consensus-guidelines-in-an-academic-health-system
#8
Dean G Assimos
No abstract text is available yet for this article.
February 2018: Journal of Urology
https://www.readbyqxmd.com/read/29350243/current-opinions-on-nephrolithiasis-associated-with-primary-hyperparathyroidism
#9
REVIEW
Xiaoming Cong, Luming Shen, Xiaojian Gu
Nephrolithiasis is a common urological disease and could be secondary to primary hyperparathyroidism (PHPT). PHPT is traditionally characterised with hypercalcaemia. Recently, a normocalcemic PHPT has been officially recognised at the International Workshops. Regarding this new phenotype, nephrolithiasis is frequently found in studies that evaluate low bone mass. However, until now, no study on aetiology of nephrolithiasis considered normocalcemic PHPT. Hypercalciuria related to PHPT is considered as an important risk factor of stone formation in hypercalcemic PHPT, but the precise relationships between hypercalcemic PHPT and nephrolithiasis and between normocalcemic PHPT and nephrolithiasis remain unclear...
January 19, 2018: Urolithiasis
https://www.readbyqxmd.com/read/29276732/normocalcemic-primary-hyperparathyroidism-associated-with-progressive-cortical-bone-loss-a-case-report
#10
Joseph R Tucci
The existence of normocalcemic primary hyperparathyroidism (NPHP) was acknowledged at the Third and Fourth International Proceedings on primary hyperparathyroidism PHPT but data relating to its clinical presentation, natural history, and skeletal status were limited and there was no information nor guidelines as to definitive therapy. Herein are reported biochemical, hormonal, and densitometry data in a postmenopausal woman seen initially for osteoporosis who was found to have increased serum PTH levels and normal serum total and ionized calcium levels without evidence of secondary hyperparathyroidism...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/29120658/-primary-hyperparathyroidism-new-clinical-forms-of-the-disease
#11
Kateřina Zajíčková
Primary hyperparathyroidism (PHPT) has been increasingly diagnosed incidentally in its asymptomatic form owing to calcium screening tests. This form of PHPT represents 80% in developed countries. Although PHPT patients are asym-ptomatic, target organ (bone and kidney) involvement is frequently observed. Mild PHPT is associated with a reduction of bone mineral densityand, moreover, with increased risk of vertebral fractures. The extent of a patient evaluation and indications for parathyroidectomy are based on expert guidelines from 2014...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28938410/sex-difference-in-the-clinical-presentation-of-primary-hyperparathyroidism-influence-of-menopausal-status
#12
COMPARATIVE STUDY
Elena Castellano, Roberto Attanasio, Alberto Boriano, Micaela Pellegrino, Francesca Garino, Laura Gianotti, Giorgio Borretta
Context: Female-to-male ratio in primary hyperparathyroidism (PHPT) is 3:1, but data on sex impact on the clinical presentation are limited. Design: We evaluated, retrospectively, sex difference in biochemistry and clinical presentation at diagnosis in a monocentric series of 417 patients with PHPT: 93 men (58.6 ± 14.5 years), and 324 women (61.7 ± 12.8 years), of whom 54 were premenopausal (pre-F) and 270 postmenopausal (post-F). Results: Men were significantly younger (P = 0...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28923463/hyperparathyroidism
#13
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...
January 13, 2018: Lancet
https://www.readbyqxmd.com/read/28806302/surgery-for-primary-hyperparathyroidism-adherence-to-consensus-guidelines-in-an-academic-health-system
#14
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
#15
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
#16
REVIEW
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
#17
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...
January 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28580574/primary-hyperparathyroidism-in-pregnancy-a-review-of-literature
#18
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
#19
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
#20
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
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