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Journal of Clinical Densitometry : the... 2013Primary hyperparathyroidism is an endocrine disorder characterized by elevated or inappropriate normal levels of parathyroid hormone in a setting of hypercalcemia. The... (Review)
Review
Primary hyperparathyroidism is an endocrine disorder characterized by elevated or inappropriate normal levels of parathyroid hormone in a setting of hypercalcemia. The inclusion of calcium on the basic metabolic bone panel has allowed this disorder to be diagnosed even in the absence of symptoms. Nevertheless, the skeleton can be a target of excess parathyroid hormone activity even during its asymptomatic presentation. Bone turnover markers a surrogate index of the process of the remodeling process at the level of bone, and thus can be useful to monitor skeleton involvement in primary hyperparathyroidism.
Topics: Bone Remodeling; Bone and Bones; Calcimimetic Agents; Diphosphonates; Estrogens; Humans; Hypercalcemia; Hyperparathyroidism, Primary; Parathyroidectomy; Selective Estrogen Receptor Modulators
PubMed: 23374737
DOI: 10.1016/j.jocd.2012.11.004 -
Mineral and bone disorder and management in the China Dialysis Outcomes and Practice Patterns Study.Chinese Medical Journal Dec 2019Despite a growing population of patients starting hemodialysis in China, little is known about markers of mineral bone disease (MBD) and their management. We present...
BACKGROUND
Despite a growing population of patients starting hemodialysis in China, little is known about markers of mineral bone disease (MBD) and their management. We present data on prevalence and correlates of hypocalcemia, hyperphosphatemia, and secondary hyperparathyroidism from the China Dialysis Outcomes and Practice Patterns Study (DOPPS), with evaluation of whether these laboratory markers triggered changes in management.
METHODS
We compared the frequency of measurement and prevalence of poor control of MBD markers in China DOPPS with other DOPPS regions. We also used generalized estimating equations to assess correlates of MBD markers, and separate models to assess predictors of vitamin D and phosphate binder prescriptions in the China DOPPS.
RESULTS
Severe hyperphosphatemia (>7 mg/dL) and secondary hyperparathyroidism (>600 pg/mL) were common (27% and 21% prevalence, respectively); both were measured infrequently (14.9% and 3.2% of patients received monthly measurements in China). Frequency of dialysis sessions was positively associated with hyperphosphatemia; presence of residual kidney function was negatively associated with both hyperphosphatemia and secondary hyperparathyroidism. Laboratory measures indicating poor control of MBD were not associated with subsequent prescription of active vitamin D or phosphate binder.
CONCLUSIONS
There are substantial opportunities for improvement and standardization of MBD management in China. Development of country-specific guidelines may yield realistic targets and standardization of medication use accounting for availability and cost.
Topics: Adult; Aged; Bone Diseases; China; Female; Humans; Hyperparathyroidism, Secondary; Hyperphosphatemia; Male; Middle Aged; Minerals; Parathyroid Hormone; Renal Dialysis
PubMed: 31856047
DOI: 10.1097/CM9.0000000000000533 -
Nefrologia : Publicacion Oficial de La... 2009FGF23 is a recently identified hormone regulating mineral and vitamin D metabolism. In patients with chronic kidney disease (CKD), circulating FGF23 levels are... (Review)
Review
FGF23 is a recently identified hormone regulating mineral and vitamin D metabolism. In patients with chronic kidney disease (CKD), circulating FGF23 levels are progressively elevated to compensate for persistent phosphate retention, which result in reduced renal production of 1,25-dihydroxyvitamin D and thereby stimulate secretion of parathyroid hormone, suggesting its critical role in the pathogenesis of altered mineral homeostasis in CKD. Furthermore, it has recently been shown that FGF23 directly acts on parathyroid gland and mediate secretion of parathyroid hormone in the presence of Klotho as a cofactor, although such effects are not yet confirmed in patients with CKD. FGF23 can also be used as a predictor of mortality as well as future development of refractory hyperparathyroidism in patients undergoing dialysis therapy, where FGF23 levels are markedly elevated in response to hyperphosphatemia and active vitamin D treatment. This brief review summarizes recent insights into the role of FGF23 in the pathogenesis of mineral and bone disorders in CKD.
Topics: Bone Diseases; Fibroblast Growth Factor-23; Fibroblast Growth Factors; Humans; Hyperparathyroidism, Secondary; Kidney Diseases; Minerals
PubMed: 19820750
DOI: 10.3265/Nefrologia.2009.29.5.5400.en.full -
Brazilian Journal of Otorhinolaryngology 2022Surgical treatment of hyperparathyroidism related to chronic kidney disease is a real challenge for Brazilian public health care. High cost medications and long waiting...
INTRODUCTION
Surgical treatment of hyperparathyroidism related to chronic kidney disease is a real challenge for Brazilian public health care. High cost medications and long waiting lines to perform preoperative exams, especially technetium Tc 99m Sestamibi (MIBI) are some of the reasons. Despite the reality that the aid of localization exams are questionable in this scenario, doctors are too apprehensive in performing surgery without it.
OBJECTIVE
The study aimed at evaluating the efficacy of surgery for renal hyperparathyroidism without preoperative MIBI.
METHODS
A total of 114 patients were surgically treated. Total parathyroidectomy with autotransplantation and subtotal parathyroidectomy were carried out without preoperative MIBI.
RESULTS AND CONCLUSION
Among the 114 patients undergoing surgery, 37 had secondary hyperparathyroidism in dialysis replacement, and 77 patients had post-renal transplant persistent disease. We were successful in 107 cases with only 7 failures (93.8% of success rate). Among these failures, only one parathyroid gland was not found in 4 cases, 2 parathyroid glands were not found in 2 cases and in 1 patient the 4 glands were found but this patient remained hypercalcemic and a postoperative diagnosis of supernumerary parathyroid gland was made. Surgery for treatment of renal hyperparathyroidism proved to be an effective (93.8%) and reproductible procedure, even without MIBI.
Topics: Humans; Hyperparathyroidism, Secondary; Parathyroid Glands; Parathyroidectomy; Preoperative Care; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Sestamibi
PubMed: 33303418
DOI: 10.1016/j.bjorl.2020.10.009 -
Proceedings of the Royal Society of... Nov 1951
Topics: Humans; Parathyroid Diseases; Pseudohypoparathyroidism
PubMed: 14900195
DOI: No ID Found -
Postgraduate Medical Journal Jun 1959
Topics: Disease; Humans; Hyperparathyroidism; Parathyroid Diseases; Parathyroid Glands
PubMed: 13657812
DOI: 10.1136/pgmj.35.404.330 -
Proceedings of the Royal Society of... Mar 1959
Topics: Disease; Humans; Parathyroid Diseases; Parathyroid Glands; Pseudohypoparathyroidism
PubMed: 13633992
DOI: No ID Found -
Frontiers in Endocrinology 2023
Topics: Humans; Parathyroid Diseases; Parathyroid Glands
PubMed: 38027097
DOI: 10.3389/fendo.2023.1323778 -
Reumatologia Clinica 2012Primary hyperparathyroidism (PHPT) is characterized by the autonomous production of parathyroid hormone (PTH), in which there is hypercalcemia or normal-high serum... (Review)
Review
Primary hyperparathyroidism (PHPT) is characterized by the autonomous production of parathyroid hormone (PTH), in which there is hypercalcemia or normal-high serum calcium levels in the presence of elevated or inappropriately normal serum PTH concentrations. Exceptionally in symptomatic patients, a diagnostic can be established on the basis of clinical data. PHPT must always be evaluated in patients with clinical histories of nephrolithiasis, nephrocalcinosis, osseous pain, subperiosteal resorption, and pathologic fractures, as well as in those with osteoporosis-osteopenia, a personal history of neck irradiation, or a family history of multiple endocrine neoplasia syndrome (types 1 or 2). Diagnosis of PHPT is biochemical. Asymptomatic hypercalcemia without guiding signs or symptoms is the most frequent manifestation of the disease. For differential diagnosis, PTH must be measured, as well as phosphate, chloride, 25-hydroxyvitamin D, 1,25 dyhidroxyvitamin D and calcium-to-creatinine clearance. The diagnosis and differential diagnosis of primary hyperparathyroidism will be discussed here.
Topics: Algorithms; Bone Diseases, Metabolic; Cardiovascular Diseases; Chlorides; Creatinine; Diagnosis, Differential; Gastrointestinal Diseases; Humans; Hypercalcemia; Hyperparathyroidism, Primary; Hyperparathyroidism, Secondary; Kidney Diseases; Nephrolithiasis; Neuromuscular Diseases; Parathyroid Hormone; Parathyroid Neoplasms; Phosphates; Vitamin D
PubMed: 22089066
DOI: 10.1016/j.reuma.2011.06.001 -
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