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Seminars in Pediatric Surgery Jun 2020Parathyroid glands are critical for calcium and phosphate homeostasis. Parathyroid disease is relatively rare in the pediatric population, but there are some important... (Review)
Review
Parathyroid glands are critical for calcium and phosphate homeostasis. Parathyroid disease is relatively rare in the pediatric population, but there are some important pediatric-specific considerations and conditions. This article reviews parathyroid physiology, disorders of hyper- and hypo- function, operative management, and uniquely pediatric diagnoses such as neonatal severe hyperparathyroidism. Advances in preoperative imaging, intra-operative gland identification, and management of post-thyroidectomy hypocalcemia are also presented in detail. This article combines a review of fundamentals with recent advances in care, emphasizing pediatric-specific publications.
Topics: Adolescent; Biomarkers; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Parathyroidectomy; Perioperative Care; Postoperative Complications
PubMed: 32571508
DOI: 10.1016/j.sempedsurg.2020.150923 -
Pediatrics in Review Dec 2016
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The Journal of Emergency Medicine May 2017
Topics: Biomarkers; Diagnosis, Differential; Emergency Service, Hospital; Female; Hemorrhage; Humans; Middle Aged; Parathyroid Diseases
PubMed: 28259525
DOI: 10.1016/j.jemermed.2017.01.023 -
American Family Physician Aug 2013Disorders of the parathyroid glands most commonly present with abnormalities of serum calcium. Patients with primary hyperparathyroidism, the most common cause of... (Review)
Review
Disorders of the parathyroid glands most commonly present with abnormalities of serum calcium. Patients with primary hyperparathyroidism, the most common cause of hypercalcemia in outpatients, are often asymptomatic or may have bone disease, nephrolithiasis, or neuromuscular symptoms. Patients with chronic kidney disease may develop secondary hyperparathyroidism with resultant chronic kidney disease-mineral and bone disorder. Hypoparathyroidism most often occurs after neck surgery; it can also be caused by autoimmune destruction of the glands and other less common problems. Evaluation of patients with abnormal serum calcium levels includes a history and physical examination; repeat measurement of serum calcium level; and measurement of creatinine, magnesium, vitamin D, and parathyroid hormone levels. The treatment for symptomatic primary hyperparathyroidism is parathyroidectomy. Management of asymptomatic primary hyperparathyroidism includes monitoring symptoms; serum calcium and creatinine levels; and bone mineral density. Patients with hypoparathyroidism require close monitoring and vitamin D (e.g., calcitriol) replacement.
Topics: Absorptiometry, Photon; Asymptomatic Diseases; Bone Diseases, Metabolic; Calcitriol; Humans; Hypercalcemia; Hyperparathyroidism, Primary; Hyperparathyroidism, Secondary; Hypocalcemia; Hypoparathyroidism; Parathyroid Diseases; Renal Insufficiency, Chronic
PubMed: 23944728
DOI: No ID Found -
Khirurgiia 2024To study the features of clinical course, diagnosis and treatment of true non-functioning parathyroid cysts.
OBJECTIVE
To study the features of clinical course, diagnosis and treatment of true non-functioning parathyroid cysts.
MATERIAL AND METHODS
We retrospectively analyzed 18 patients with non-functioning true parathyroid cysts. Inclusion criteria: US-confirmed anechoic lesion of the neck without tissue component, cytological data on cystic lesion, high cystic parathyroid hormone and no laboratory signs of hyperparathyroidism.
RESULTS
Non-functioning parathyroid cysts were asymptomatic and diagnosed accidentally after ultrasound of the neck. All patients were women aged 35-77 years. Four patients had cysts near the upper parathyroid glands, 14 patients - near the lower parathyroid glands. Of these, 2 ones had cysts below the level of the clavicle. Cyst volume was 4.3-110.3 cm (24.1±26.2 cm). High cystic parathyroid hormone (2012.5±946.7 pg/ml) was observed in all patients. Simple aspiration was performed in 5 patients, aspiration with sclerotherapy - in 10 patients, cystectomy - in 3 patients. Recurrence was diagnosed in 1 patient after aspiration and 2 patients after sclerotherapy.
CONCLUSION
No pathognomonic clinical and ultrasonic symptoms, as well as specific cytological data lead to misdiagnosis. Analysis of PTH in non-functioning parathyroid cysts is essential for diagnosis. Minimally invasive treatment is preferable for true parathyroid cysts. However, these approaches are not radical.
Topics: Humans; Female; Male; Retrospective Studies; Parathyroid Diseases; Hyperparathyroidism; Parathyroid Hormone; Cysts
PubMed: 38344962
DOI: 10.17116/hirurgia202402168 -
Best Practice & Research. Clinical... Dec 2018Parathyroid disorders are not as uncommon as once believed. Both hyper- and hypoparathyroidism are more prevalent in women, but for different reasons. The female... (Review)
Review
Parathyroid disorders are not as uncommon as once believed. Both hyper- and hypoparathyroidism are more prevalent in women, but for different reasons. The female preponderance seen in primary hyperparathyroidism may be pathogenically linked, as it is more common after menopause. By contrast, higher prevalence of hypoparathyroidism in women is related to thyroid surgery, which is performed more frequently in women; thus the female to male ratio of hyper- and hypoparathyroidism is about 3:1 and 4:1 respectively. For similar reasons, the mean age of patients with hypoparathyroidism, on average, is a decade lower than that of patients with primary hyperparathyroidism. Furthermore, primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disorders, but the prevalence of hypoparathyroidism is about 34 fold lower than that of primary hyperparathyroidism. Current epidemiological data is reasonable for primary hyperparathyroidism, but inadequate for hypoparathyroidism. Further concerted efforts should be undertaken to better define the distribution, determinants and disease burden of both disorders in order to prioritize practice guidelines, disease management strategies, and research agendas.
Topics: Female; Humans; Hyperparathyroidism, Primary; Hypoparathyroidism; Male; Parathyroid Diseases; Parathyroid Glands; Prevalence; Thyroid Diseases; Thyroidectomy
PubMed: 30559041
DOI: 10.1016/j.beem.2018.12.003 -
Methodist DeBakey Cardiovascular Journal 2017The parathyroid glands are critical to maintaining calcium homeostasis through actions of parathyroid hormone (PTH). Recent clinical and molecular research has shown... (Review)
Review
The parathyroid glands are critical to maintaining calcium homeostasis through actions of parathyroid hormone (PTH). Recent clinical and molecular research has shown that direct and indirect actions of PTH also affect the heart and vasculature through downstream actions of G protein-coupled receptors in the myocardium and endothelial cells. Patients with disorders of the parathyroid gland have higher incidences of hypertension, arrhythmias, left ventricular hypertrophy, heart failure, and calcific disease which translate into increased cardiac morbidity and mortality. Importantly, clinical research also suggests that early treatment of parathyroid disorders through medical or surgical management may reverse cardiovascular remodeling and mitigate cardiac risk factors.
Topics: Heart; Heart Diseases; Humans; Parathyroid Diseases; Parathyroid Glands; Prognosis; Risk Assessment; Risk Factors
PubMed: 28740581
DOI: 10.14797/mdcj-13-2-49 -
Current Problems in Cancer Nov 1985
Review
Topics: Addison Disease; Adenoma; Calcium; Carcinoma; Diuretics; Estrogens; Female; Homeostasis; Humans; Hypercalcemia; Hyperparathyroidism; Hyperplasia; Hypertension; Hyperthyroidism; Immobilization; Kidney Calculi; Lithium; Neoplasm Metastasis; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Parathyroid Neoplasms; Pregnancy; Pregnancy Complications; Prognosis; Sarcoidosis; Vitamin A; Vitamin D
PubMed: 3905268
DOI: 10.1016/s0147-0272(85)80035-0 -
Endocrine Pathology Sep 2020Parathyroid gland excision specimens are common and sometimes underestimated cases that many surgical pathologists encounter regularly. In the vast majority of cases,... (Review)
Review
Parathyroid gland excision specimens are common and sometimes underestimated cases that many surgical pathologists encounter regularly. In the vast majority of cases, these will be spot diagnoses of sporadic primary parathyroid adenomas or, perhaps, hyperplasias commonly in the setting of renal failure. However, a small but significant number of parathyroid gland excisions may be due to heritable disease. In most cases, hereditary disease is suspected by the referring clinicians. Nevertheless, a subset of these are undetected which is significant, particularly in the setting of the multiple endocrine neoplasia (MEN), and the hyperparathyroidism jaw tumour (HPT-JT) syndromes. There have been recent advances in recognition of the morphological and immunohistochemical characteristics of these tumours and hyperplasias. While hereditary kindreds are over-represented at specialist referral centres, with awareness of the characteristic clinical and morphological features, the general surgical pathologist is frequently able to suggest the possibility of hereditary parathyroid disease. We therefore provide a succinct guide for pathologists to increase the recognition of hereditary parathyroid disease.
Topics: Diagnosis, Differential; Diagnostic Techniques, Endocrine; Genetic Diseases, Inborn; Humans; Hyperparathyroidism, Primary; Immunohistochemistry; Parathyroid Diseases; Parathyroid Glands; Pathologists; Practice Patterns, Physicians'
PubMed: 32468209
DOI: 10.1007/s12022-020-09631-4 -
American Journal of Surgery Mar 1978Cystic neck masses may be accurately diagnosed by sonography, and some nonfunctioning parathyroid cysts can be cured by percutaneous aspiration. Primary...
Cystic neck masses may be accurately diagnosed by sonography, and some nonfunctioning parathyroid cysts can be cured by percutaneous aspiration. Primary hyperparathyroidism should be considered in all patients with cystic neck masses. Parathyroid cysts can often be recognized from the characteristics of the cyst fluid which is usually clear and colorless, contains elevated parathyroid hormone levels and normal or low thyroid hormone levels, and may contain parathyroid cells. Parathyroid cysts may be multiple; all four parathyroid glands should therefore be identified and appropriately removed or hyperparathyroidism may persist.
Topics: Adult; Aged; Cysts; Female; Humans; Hyperparathyroidism; Hyperplasia; Male; Middle Aged; Parathyroid Diseases; Parathyroid Glands
PubMed: 626321
DOI: 10.1016/0002-9610(78)90073-9