Afefah Ismail, Julie Wulf Christensen, Martin Krakauer, Susanne Bonnichsen Søndergaard, Bo Zerahn, Birte Nygaard, Finn Noe Bennedbæk, Bent Kristensen, Lars Thorbjørn Jensen
BACKGROUND: In patients with primary hyperparathyroidism (PHPT) locating hyperfunctioning glands (HPGs) is crucial when planning minimally invasive surgery. Dual-isotope subtraction scintigraphy with 99m Tc-MIBI/123 Iodide using SPECT/CT and planar pinhole imaging (Method A) has previously shown a sensitivity >93%. However, the method is costly and time consuming and entails a high radiation dose. 11 C-Choline PET/CT (Method B) is an appealing candidate method unencumbered by these disadvantages...
November 19, 2020: Diagnostics
Mariko Aoyama, Hiromitsu Takizawa, Kiyoshige Yamamoto, Tomohiro Inui, Naoki Miyamoto, Shinichi Sakamoto, Tomoko Kobayashi, Hisanori Uehara, Akira Tangoku
The intraoperative identification and preservation of the parathyroid glands are vital techniques, which are largely dependent on a surgeon's experience. Therefore, a simple and reproducible technique to identify the parathyroid glands during surgery is needed. Parathyroid tissue shows near-infrared (NIR) autofluorescence, which enables the intraoperative identification of the parathyroid gland. We herein present two cases that underwent surgery on the parathyroid glands, which were observed using the NIR fluorescence imaging system LIGHTVISION® (Shimazu, Kyoto, Japan)...
October 2020: Gland Surgery
Francisco Laxague, Cristian Agustin Angeramo, Enrique Dante Armella, Agustin Cesar Valinoti, Norberto Aristides Mezzadri, Juan Manuel Fernández Vila
INTRODUCTION: We aim to determine the utility of intraoperative parathyroid hormone (IOPTH) monitoring in patients with matching preoperative ultrasound and mibi SPECT for primary hyperparathyroidism for a single adenoma. METHODS: All patients who underwent minimally invasive parathyroidectomy (MIP) for pseudohypoparathyroidism (PHP) for a single parathyroid adenoma, were included. An Ultrasound and mibi SPECT were performed in all patients. We defined matching studies when both coincided in the localization of the adenoma...
November 19, 2020: Cirugía Española
Kimberly M Ramonell, Herbert Chen, Brenessa Lindeman, Jessica Fazendin
BACKGROUND: Re-operative parathyroidectomy in patients with recurrent or persistent hyperparathyroidism can be challenging. We review our experience to determine the optimal number of localization studies prior to re-operation. METHODS: From 2001 to 2019, 251 patients underwent re-operative parathyroidectomy. Parathyroidectomies were stratified to 4 groups based upon the number of positive localization studies obtained: A) ZERO, B) 1-positive, C) 2-positive, D) 3-positive...
November 17, 2020: American Journal of Surgery
Jaime Jimeno-Fraile, Higinio Cao, Juan Sancho-Insenser, Leyre Lorente-Poch, Antonio Sitges-Serra
BACKGROUND: Hyperparathyroidism in patients on chronic hemodialysis presents with bone pain, pruritus, and extra-skeletal calcifications. Little attention has been paid to low plasma protein concentrations and muscle weakness in these patients. The present study was undertaken to characterize the impact of subtotal parathyroidectomy for chronic hemodialysis on body composition, muscle strength, plasma proteins, quality of life, and long-term clinical course. METHODS: We performed a prospective observational before-after assessment study of consecutive chronic hemodialysis patients referred for parathyroidectomy...
November 17, 2020: Surgery
Diani Kartini, Filipus Dasawala, Maria Francisca Ham
INTRODUCTION: Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome with common presenting signs and symptoms secondary to primary hyperparathyroidism (PHPT), which is managed surgically. Traditionally, either subtotal parathyroidectomy (SPTX) or total parathyroidectomy with autologous transplantation (TPTX) is the approach of choice. However, recent studies showed comparable persistence and recurrence rate in a subset of MEN1 patients (two or more concordant preoperative imaging results) who underwent less than subtotal parathyroidectomy (LSPTX)...
November 10, 2020: International Journal of Surgery Case Reports
Alanna Jane Quinn, Éanna J Ryan, Stephen Garry, Danielle L James, Michael R Boland, Orla Young, Michael J Kerin, Aoife J Lowery
Importance: Intraoperative parathyroid hormone (ioPTH) is a surgical adjunct that has been increasingly used during minimally invasive parathyroidectomy (MIP). Despite its growing popularity, to our knowledge a meta-analysis comparing MIP with ioPTH vs MIP without ioPTH has not yet been conducted. Objective: To evaluate the safety and efficacy of MIP with ioPTH for treatment of primary hyperparathyroidism. Data Sources: A systematic search of the databases PubMed, Embase, Scopus, Web of Science, and Cochrane Collaboration was performed to identify studies that compared MIP with and without ioPTH...
November 19, 2020: JAMA Otolaryngology—Head & Neck Surgery
Spyridon Karras, Cedric Annweiler, Dimitris Kiortsis, Ioannis Koutelidakis, Kalliopi Kotsa
We have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Group B), in a small cohort of patients with co-existing NPHPT and prediabetes. Sixteen patients were categorized in each group. Glycemic parameters (levels of fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), and fasting insulin (fIns)), the homeostasis model assessment for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR), and a 75-g oral glucose tolerance test were evaluated at baseline and after 32 weeks for both groups...
November 16, 2020: Nutrients
Michał Wasiak, Michał Popow, Magdalena Bogdańska, Aleksandra Starzyńska-Kubicka, Paweł Małdyk, Piotr Wasilewski
Brown tumours, known also as osteitis fibrosa cystica, are benign osteolytic lesions found in 5-15% of patients with hyperparathyroidism, and commonly located in mandibles, the shafts of long bones, the pelvis or ribs. As they compromise bone strength, pathological fractures can be a typical effect of their presence; but given the complex nature of the disease process in this case, such fractures require an interdisciplinary approach directed at orthopaedic treatment, plus management of the underlying hyperparathyroidism...
December 2020: Trauma Case Reports
Payam Entezami, Lindsay Boven, Erin Ware, Brent A Chang
BACKGROUND: Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) is a novel surgical approach that has gained increasing traction as a remote access approach for parathyroid surgery. The primary aim of this systematic review is to assess the feasibility and safety of this approach. METHODS: Several databases were screened for relevant citations. The quality of studies and risk of bias were evaluated using the MINORS scoring system. RESULTS: Nine articles containing 78 cases of TOEPVA met the inclusion criteria...
October 25, 2020: American Journal of Otolaryngology
Barbara C Silva, John P Bilezikian
Both hypoparathyroidism (HypoPT), as well as its pathological counterpart, primary hyperparathyroidism (PHPT), can lead to skeletal abnormalities. Chronic deficiency of PTH in patients with HypoPT is associated with a profound reduction in bone remodeling, with consequent increases in bone density, and abnormalities in microarchitecture and bone strength. It is still not clear whether there is an increase in fracture risk in HypoPT. While standard therapy with calcium supplements and active vitamin D does not restore bone homeostasis, treatment of HypoPT with PTH appears to correct some of those abnormalities...
November 16, 2020: Reviews in Endocrine & Metabolic Disorders
Shaohua Chen, Kaixiang Sheng, Ying Shen, Hua Jiang, Xin Lei, Lihui Qu, Chunping Xu, Jianghua Chen, Ping Zhang
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in end-stage renal disease (ESRD) patients, and parathyroidectomy (PTX) is an effective treatment intervention of SHPT. However, the curative impact of PTX on left ventricular function still remains incompletely understood. To evaluate the impact of parathyroidectomy on left ventricular function in ESRD patients, we conducted this retrospective study. METHODS: Between Oct 1, 2010 and Oct 1, 2016, ESRD patients presented with SHPT who underwent parathyroidectomy were enrolled...
November 13, 2020: BMC Nephrology
Jessica Fazendin, Brenessa Lindeman, Herbert Chen
No abstract text is available yet for this article.
December 2020: Annals of Surgery
Masaki Hatano, Izuru Kitajima, Kazuya Isawa, Yutaka Hirota, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Masaki Nakamura, Seizo Yamamoto, Yoshihumi Ubara
INTRODUCTION: Currently, there are no reports of diaphyseal femoral fracture equivalent to atypical femoral fractures (AFFs) in patients receiving long-term hemodialysis (HD). CASE REPORT: A 56-year-old Japanese man receiving long-term HD for 34 years was admitted to our hospital due to a delay in postoperative healing. The patient began maintenance hemodialysis at 22 years of age. The patient then underwent surgical parathyroidectomy (PTX) for secondary hyperparathyroidism at 43 years of age, which resulted in decreased levels of parathyroid hormone (PTH)...
November 12, 2020: Archives of Osteoporosis
Mehboob A Rehan, Asma Rashid, Kenneth Krell, Cristina Gabutti, Reema Singh
Depending on each institution's laboratory test, mean serum calcium levels range between 8.8 and 10.8 mg/dL and hypercalcemia is defined as two standard deviations above the mean. According to recent epidemiological studies, 90% of cases of hypercalcemia are due to hyperparathyroidism or malignancy. Milk Alkali syndrome (MAS) also known as Calcium Alkali syndrome (CAS) is the third biggest cause of hypercalcemia, but its incidence seems to be higher than previously thought. Here we present a case of Calcium Alkali Thiazide syndrome (CATS) in a 57-year-old female who was on calcium and vitamin D supplements (after parathyroidectomy) while also taking thiazide diuretic for hypertension...
October 8, 2020: Curēus
Shaowei Xu, Zhifeng Li, Manbin Xu, Hanwei Peng
OBJECTIVE: To assess the efficiency of the carbon nanoparticles (CNs) in lymph node identification and parathyroid gland (PG) protection during thyroidectomy for non-anaplastic thyroid carcinoma (N-ATC). METHODS: A systematic literature search for relevant literatures published up to December 2018 in PubMed, EMBASE, Web of Science and Cochrane Library was performed. Both English and Chinese literatures were retrieved and analyzed. Randomized controlled trials or nonrandomized controlled trials comparing the use of CNs with the use of methylene blue or a blank control in patients undergoing thyroidectomy for N-ATC were enrolled in this study...
2020: PloS One
Ottavio Piccin, Pasquale D'Alessio, Eleonora Cioccoloni, Luca Burgio, Cristina Poggi, Paola Altieri, Valentina Vicennati, Andrea Repaci, Uberto Pagotto, Ottavio Cavicchi
PURPOSE: Preoperative imaging in patients with primary hyperparathyroidism provides important localization information, allowing the surgeon to perform a focused surgery. However there are no evidence-based guidelines suggesting which preoperative imaging should be used, resulting in a risk of excessive prescription of exams and waste of economic resources. The main purpose of this study was to describe our experience on the performance of various imaging techniques for the preoperative localization of abnormal parathyroid gland/s, with a focus on the sensitivity and specificity of each technique...
October 31, 2020: American Journal of Otolaryngology
Symeon Tournis, Konstantinos Makris, Etienne Cavalier, George Trovas
Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders characterized by parathyroid hormone (PTH)-dependent hypercalcemia. Cardinal features include low trauma fractures, nephrolithiasis and chronic kidney disease. Several experimental studies established that parathyroid hormone exerts actions on the cardiovascular (CV) system, including vasodilatation and positive inotropic and chronotropic effects. Observational studies, especially in severe cases, report a higher prevalence of hypertension, diabetes mellitus, lipid abnormalities, endothelial dysfunction, arrhythmias and left ventricular hypertrophy in patients with PHPT, while the risk of CV events seems to be increased in severe cases...
November 5, 2020: Current Pharmaceutical Design
Jacek Gawrychowski, Grzegorz J Kowalski, Grzegorz Buła, Adam Bednarczyk, Dominika Żądło, Zbigniew Niedzielski, Agata Gawrychowska, Henryk Koziołek
BACKGROUND: Primary hyperparathyroidism (pHPT) is an endocrine disorder characterized by hypercalcemia and caused by the presence of disordered parathyroid glands. Parathyroidectomy is the only curative therapy for pHPT, but despite its high cure rate of 95-98%, there are still cases where hypercalcemia persists after this surgical procedure. The aim of this study was to present the results of a surgical treatment of patients due to primary hyperparathyroidism and failures related to the thoracic location of the affected glands...
November 2, 2020: Journal of Clinical Medicine
Sinem Gulcan-Kersin, Tarik Kirkgoz, Mehmet Eltan, Turkay Rzayev, Pinar Ata, Hulya Bilgen, Eren Ozek, Abdullah Bereket, Serap Turan
INTRODUCTION: Neonatal severe hyperparathyroidism (NSHPT) is a rare cause of neonatal hypercalcemia caused by a loss of function mutation in the calcium-sensing receptor (CaSR). Hypercalcemia in NSHPT can be life-threatening. Maintenance of serum calcium within a safe range is the primary goal of treatment through hydration, forced diuresis, and bisphosphonate treatment, nevertheless most cases require parathyroidectomy. We report a case with NSHPT diagnosed on the first day of life (DoL) and successfully treated with cinacalcet as the first-line treatment from the 2nd DoL up to the age of 18 months...
November 4, 2020: Hormone Research in Pædiatrics
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