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Frontiers in Endocrinology 2023
Topics: Humans; Parathyroid Diseases; Parathyroid Glands
PubMed: 38027097
DOI: 10.3389/fendo.2023.1323778 -
Bipolar Disorders Feb 2024Although potential adverse effects of lithium treatment on renal and endocrine systems have been extensively investigated, most prior studies are limited by selected...
OBJECTIVES
Although potential adverse effects of lithium treatment on renal and endocrine systems have been extensively investigated, most prior studies are limited by selected populations and short follow-up.
METHODS
Within the Psychiatric Services of the Central Denmark Region, we identified all patients with bipolar disorder and ≥1 serum-lithium (se-Li) measurements between January 1, 2013, and July 20, 2022, and reference patients with bipolar disorder matched on age, sex, and baseline creatinine. Outcomes were diagnoses of renal, thyroid and parathyroid disease, and blood tests measuring creatinine, estimated glomerular filtration rate (eGFR), thyroid-stimulating hormone (TSH), parathyroid hormone (PTH) and calcium. Analyses included unadjusted multilevel regression to describe changes in biochemical markers, and adjusted Cox regression to compare rates of disease/biochemical outcomes between lithium users and reference patients.
RESULTS
Among 1646 lithium users (median age 36 years, 63% women) and 5013 reference patients, lithium users had decreasing TSH and eGFR, stable PTH, and increasing calcium levels over time. Lithium use was associated with increased rates of renal, thyroid and parathyroid disease, and levels of biochemical markers outside normal ranges (hazard rate ratios: 1.07-11.22), but the absolute number of severe outcomes was low (e.g., chronic kidney disease: N = 10, 0.6%). Notably, the rate of blood testing was substantially higher among lithium users than among reference patients (e.g., mean number of creatinine tests during the second year of follow-up: lithium users = 2.5, reference patients = 1.4).
CONCLUSIONS
Severely adverse renal and endocrine outcomes are rare during lithium treatment. Observational studies of long-term lithium treatment are prone to detection bias.
Topics: Humans; Female; Adult; Male; Bipolar Disorder; Lithium; Thyroid Gland; Cohort Studies; Calcium; Lithium Compounds; Creatinine; Parathyroid Diseases; Thyrotropin; Biomarkers
PubMed: 37300391
DOI: 10.1111/bdi.13356 -
The American Surgeon Jan 1984Parathyroid cysts are a rare cause of primary hyperparathyroidism. A case is presented of a 25-year-old black man who presented with hyperparathyroidism and at operation...
Parathyroid cysts are a rare cause of primary hyperparathyroidism. A case is presented of a 25-year-old black man who presented with hyperparathyroidism and at operation was found to have a 2.5 cm parathyroid cyst at the left inferior position. The cyst contained clear fluid, and the wall was thickened and composed of hyperplastic parathyroid tissue. The remaining glands were smaller but also hyperplastic. Subtotal parathyroidectomy was performed. This case presents many of the typical features of parathyroid cysts. The pertinent literature is reviewed. Parathyroid cysts present as two distinct groups, functioning and nonfunctioning. The former are more common in men, and the cyst is more likely to be secondary to degenerative changes in a hyperplastic gland. In contrast, nonfunctioning parathyroid cysts are more common in women and present as neck masses or incidental findings at operation. The different proposed etiologies for parathyroid cysts are discussed. Preoperative diagnosis is rare but important as it may prevent an unnecessary neck exploration or thyroidectomy. The diagnosis should be suspected with any cystic neck mass that yields clear fluid on aspiration, especially if it is in the inferior position. The fluid should be submitted for parathormone evaluation. Aspiration alone has been curative in some cases.
Topics: Adult; Cysts; Humans; Hyperparathyroidism; Male; Parathyroid Diseases
PubMed: 6691631
DOI: No ID Found -
Journal of Nuclear Medicine : Official... May 1991
Comparative Study Meta-Analysis
Topics: Costs and Cost Analysis; Humans; Magnetic Resonance Imaging; Meta-Analysis as Topic; Parathyroid Diseases; Radiography; Radionuclide Imaging; Sensitivity and Specificity; Ultrasonography
PubMed: 1827150
DOI: No ID Found -
Endocrine Reviews Sep 2023Recent data suggest an increase in the overall incidence of parathyroid disorders, with primary hyperparathyroidism (PHPT) being the most prevalent parathyroid disorder....
Recent data suggest an increase in the overall incidence of parathyroid disorders, with primary hyperparathyroidism (PHPT) being the most prevalent parathyroid disorder. PHPT is associated with morbidities (fractures, kidney stones, chronic kidney disease) and increased risk of death. The symptoms of PHPT can be nonspecific, potentially delaying the diagnosis. Approximately 15% of patients with PHPT have an underlying heritable form of PHPT that may be associated with extraparathyroidal manifestations, requiring active surveillance for these manifestations as seen in multiple endocrine neoplasia type 1 and 2A. Genetic testing for heritable forms should be offered to patients with multiglandular disease, recurrent PHPT, young onset PHPT (age ≤40 years), and those with a family history of parathyroid tumors. However, the underlying genetic cause for the majority of patients with heritable forms of PHPT remains unknown. Distinction between sporadic and heritable forms of PHPT is useful in surgical planning for parathyroidectomy and has implications for the family. The genes currently known to be associated with heritable forms of PHPT account for approximately half of sporadic parathyroid tumors. But the genetic cause in approximately half of the sporadic parathyroid tumors remains unknown. Furthermore, there is no systemic therapy for parathyroid carcinoma, a rare but potentially fatal cause of PHPT. Improved understanding of the molecular characteristics of parathyroid tumors will allow us to identify biomarkers for diagnosis and novel targets for therapy.
Topics: Humans; Adult; Hyperparathyroidism, Primary; Parathyroid Neoplasms; Parathyroidectomy; Genetic Testing; Renal Insufficiency, Chronic
PubMed: 36961765
DOI: 10.1210/endrev/bnad009 -
The Australian and New Zealand Journal... May 1999Parathyroid cysts are relatively uncommon. They may be non-functioning or associated with primary hyperparathyroidism. Three patients are presented, including one with a...
Parathyroid cysts are relatively uncommon. They may be non-functioning or associated with primary hyperparathyroidism. Three patients are presented, including one with a large mediastinal parathyroid cyst, and these cases illustrate the range of pathological and clinical features.
Topics: Adenoma; Adult; Aged; Cysts; Female; Humans; Hyperparathyroidism; Male; Middle Aged; Parathyroid Diseases; Parathyroid Neoplasms; Radiography
PubMed: 10353566
DOI: 10.1046/j.1440-1622.1999.01587.x -
Medicine Jul 2018Parathyroid cysts are lesions that represent 1-5% of neck masses. They are subdivided into two categories: functioning and non-functioning.The aim of the present review... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Parathyroid cysts are lesions that represent 1-5% of neck masses. They are subdivided into two categories: functioning and non-functioning.The aim of the present review is to give a detailed account of all reported cases of parathyroid cysts in the literature and to analyze statistically the available data.
METHODS
A bibliographic research was performed from 1905 until 2016. A database with the patients' characteristics was made and analyzed statistically.
RESULTS
A total of 218 articles were found, reporting 359 cases of cysts. Mean age of patients was 49.24 y/o and the male/female ratio was 1:1.85. The most common locations were left thyroid lobe (113/358 patients, 31.6%), and superior mediastinum (69/358 patients, 19.3%), while the most common symptoms were neck mass (148/355 patients, 41.7%), compressive symptoms (73/355 patients, 206%) and hyperparathyroidism (62/355 patients, 17.5%). Non-functioning cysts were more frequent (220/357 patients, 61.6%). Regarding dimensions, mean diameter was 4.88 cm. Ultrasound and FNA are used for their diagnosis, while cystic fluid analysis may help the differential diagnosis. Recurrences were mentioned in 27/97 patients (27.8%) with available data. No deaths due to parathyroid cysts were mentioned in the literature.
CONCLUSION
Parathyroid cysts should be taken into consideration in case of parathyroid dysfunction or asymptomatic neck mass. The surgeon's careful manipulations on the cyst are crucial for a definitive treatment.
Topics: Adult; Aged; Biopsy, Fine-Needle; Cysts; Female; Humans; Length of Stay; Parathyroid Diseases; Recurrence; Ultrasonography
PubMed: 29995785
DOI: 10.1097/MD.0000000000011399 -
Journal of Tissue Engineering and... Oct 2020Parathyroid glands (PTGs) are important endocrine organs being mainly responsible for the secretion of parathyroid hormone (PTH) to regulate the balance of calcium (Ca)... (Review)
Review
Parathyroid glands (PTGs) are important endocrine organs being mainly responsible for the secretion of parathyroid hormone (PTH) to regulate the balance of calcium (Ca) /phosphorus (P) ions in the body. Once PTGs get injured or removed, their resulting defect or loss of PTH secretion should disturb the level of Ca/P in blood, thus damaging other related organs (bone, kidney, etc.) and even causing death. Recently, tissue-engineered PTGs (TE-PTGs) have attracted lots of attention as a potential treatment for the related diseases of PTGs caused by hypoparathyroidism and hyperparathyroidism, including tetany, muscle cramp, nephrolithiasis, nephrocalcinosis, and osteoporosis. Although great progress has been made in the establishment of TE-PTGs with an effective strategy to integrate the key factors of cells and biomaterials, its regulatory secretion of PTH to mimic its natural rhythms in the body remains a huge challenge. This review comprehensively describes an overview of PTGs from physiology and pathology to cytobiology and tissue engineering. The state of the arts in TE-PTGs and the feasible strategies to regulate PTH secretion behaviors are highlighted to provide an important foundation for further investigation.
Topics: Animals; Clinical Trials as Topic; Humans; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Social Control, Formal; Tissue Engineering
PubMed: 32511868
DOI: 10.1002/term.3080 -
Clinics in Dermatology 2006Dermatologic manifestations of parathyroid-related disorders, although rare in sporadic cases, are not uncommon in familial syndromes. Patients with familial... (Review)
Review
Dermatologic manifestations of parathyroid-related disorders, although rare in sporadic cases, are not uncommon in familial syndromes. Patients with familial hyperparathyroidism have several types of skin lesions. In multiple endocrine neoplasia 1, patients commonly have angiofibromas (85%) and collagenomas (70%), lesions that show loss of one 11q13 allele, the molecular abnormality in multiple endocrine neoplasia 1. They can also present with lipomas or café-au-lait spots. Cutaneous amyloidosis, an entity that can occur sporadically, has been described in multiple endocrine neoplasia 2a and is usually localized to the interscapular area. Metastatic calcification is an entity commonly encountered in patients with hyperparathyroidism and renal failure. It can be complicated by infections and necrosis. It is best treated by controlling hypercalcemia, hyperphosphatemia, hyperparathyroidism, antibiotics, and analgesia. Parathyroidectomy is reserved for refractory cases. Hypoparathyroidism presenting in the context of polyglandular failure type 1 is characterized by mucocutaneous candidiasis. Pseudohypoparathyroidism, an inherited disorder with end-organ unresponsiveness to parathyroid hormone, is characterized by Albright hereditary osteodystrophy. Patients present with short stature, round facies, brachydactyly, and short fourth or fifth metacarpals.
Topics: Humans; Multiple Endocrine Neoplasia; Parathyroid Diseases; Skin Neoplasms
PubMed: 16828410
DOI: 10.1016/j.clindermatol.2006.04.003 -
The Journal of Clinical Endocrinology... May 2023Taking care of patients with parathyroid disorders during pregnancy requires consideration of the physiological fundamental changes in bone and mineral metabolism...
Taking care of patients with parathyroid disorders during pregnancy requires consideration of the physiological fundamental changes in bone and mineral metabolism occurring in these women. Diagnostic and therapeutic procedures regarding primary hyperparathyroidism (PHPT) and hypoparathyroidism significantly differ from the nonpregnant population. PHPT should preferably be cured by parathyroidectomy before pregnancy since in women with hypercalcemic PHPT, maternal and fetal pregnancy complications seem to increase according to the degree of hypercalcemia. Parathyroidectomy, if needed during pregnancy, is preferentially performed in the second trimester. Conservative treatment is recommended for milder cases and is mainly restricted to hydration, with only limited evidence regarding drug treatment. Women with hypoparathyroidism can be informed that there are no major concerns regarding disease-associated infertility and that the risk of pregnancy complications is low if the disease is properly managed. Regular active surveillance is recommended, as requirements for calcium and active vitamin D may change during the course of pregnancy in either direction, with an overall trend for rather reduced doses. Any woman suffering from parathyroid disorders during pregnancy requires further surveillance in the postpartum period and during lactation, as there is an increased risk of hypercalcemia after delivery. Newborns of mothers with parathyroid diseases should, depending on disease severity, be carefully monitored for calcium levels in the first days (to weeks) after delivery since intrauterine exposure to hyper- or hypocalcemia may impact their postnatal regulation of calcium metabolism.
Topics: Pregnancy; Humans; Female; Infant, Newborn; Calcium; Hypercalcemia; Parathyroid Diseases; Pregnancy Complications; Hypoparathyroidism; Parathyroidectomy; Hyperparathyroidism, Primary
PubMed: 36546344
DOI: 10.1210/clinem/dgac734