Laurel Barrios, Iram Shafqat, Usman Alam, Nabilah Ali, Chrysanta Patio, Carolyn F Filarski, Hakimah Bankston, Jon Mallen-St Clair, Michael Luu, Zachary S Zumsteg, Kenneth Adashek, Yufei Chen, Monica Jain, Glenn D Braunstein, Wendy L Sacks, Allen S Ho
BACKGROUND: Although higher thyroidectomy volume has been linked with lower complication rates, its association with incidental parathyroidectomy remains less studied. The volume relationship is even less clear for central neck dissection, where individual parathyroid glands are at greater risk. METHODS: Patients undergoing thyroidectomy with or without central neck dissection were evaluated for incidental parathyroidectomy, hypoparathyroidism, and hypocalcemia...
January 11, 2021: Surgery
Geng-He Chang, Fong-Fu Chou, Ming-Shao Tsai, Yao-Te Tsai, Ming-Yu Yang, Ethan I Huang, Hui-Chen Su, Cheng-Ming Hsu
Patients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database...
January 12, 2021: Scientific Reports
Geraldine Yanlei Lei, Kon Voi Tay, Cheryl Hern Qi Chong, Thomas Ho
Penile gangrene is a rare but fatal complication of calciphylaxis in end-stage renal disease (ESRD). To date, there are no guidelines on its management, and outcomes are generally poor with high mortality rate. We present a case of a diabetic patient with ESRD presenting with dry gangrene of the glans penis due to calciphylaxis and successfully treated with intravenous sodium thiosulfate (STS) and early total parathyroidectomy. We further analysed existing literatures on cases that utilized STS in the treatment of penile calciphylaxis...
December 29, 2020: International Journal of Surgery Case Reports
Satyanarayana V Sagi, Hareesh Joshi, Jamie Trotman, Terence Elsey, Ashwini Swamy, Jeyanthy Rajkanna, Nazir A Bhat, Firas J S Haddadin, Samson O Oyibo, Soo-Mi Park
Summary: Familial hypocalciuric hypercalcaemia (FHH) is a dominantly inherited, lifelong benign disorder characterised by asymptomatic hypercalcaemia, relative hypocalciuria and variable parathyroid hormone levels. It is caused by loss-of-function pathogenic variants in the calcium-sensing receptor (CASR) gene. Primary hyperparathyroidism (PHPT) is characterised by variable hypercalcaemia in the context of non-suppressed parathyroid hormone levels. Unlike patients with FHH, patients with severe hypercalcaemia due to PHPT are usually symptomatic and are at risk of end-organ damage affecting the kidneys, bone, heart, gastrointestinal system and CNS...
September 23, 2020: Endocrinology, Diabetes & Metabolism Case Reports
Tomohiro Saito, Masahide Mizobuchi, Toma Hamada, Motonori Sugiyama, Nozomi Miyazawa, Tomoki Morikawa, Kei Matsumoto, Osamu Yoshitake, Takeshi Aoki, Masahiko Murakami, Hirokazu Honda
We report a case of a 32-year-old man who was undergoing chronic hemodialysis and had hyperphosphatemia and secondary hyperparathyroidism (SHPT) with multiple tumoral calcinosis (TC) lesions refractory to drug therapy. Total parathyroidectomy and autotransplantation were performed, and he recovered from TC within 3 months. Several soft-tissue calcifications were present, but neither computed tomography (CT) before diagnosis nor CT performed 12 months after surgery detected evidence of vascular calcification (VC), despite persistence of hyperphosphatemia...
January 12, 2021: Clinical Nephrology
Theodosios S Papavramidis, Angeliki Chorti, George Tzikos, Panagiotis Anagnostis, Pantelis Pantelidis, Ioannis Pliakos, Stavros Panidis, Maria Papaioannou, Sohail Bakkar, Ethem Unal, Antonios Michalopoulos
PURPOSE: Intraoperative imaging of parathyroid glands (PGs) has been developed in order to reduce the risk of unintentional parathyroidectomy during total thyroidectomy. This novel modality is based on their intrinsic characteristic of autofluorescence (AF) after near-infrared light exposure. The aim of this study was to assess the effect of this method on the risk of unintentional PG excision (total or partial) during total thyroidectomy. METHODS: This was a single-blind, randomized-controlled trial including adult patients who underwent scheduled total thyroidectomy between December 2019 and March 2020...
January 11, 2021: Endocrine
Hao Kong, Zhen Zhang, Hong Zhang
INTRODUCTION: Hyperparathyroid crisis is a rare and potentially life-threatening complication of severe calcium intoxication. Parathyroidectomy is the only curative method for hyperparathyroid crisis. Several case reports and case series have been published on the medical and surgical treatments for hyperparathyroid crisis, however, few reports have focused on the associated perioperative anesthetic management. PATIENT CONCERNS: A 48-year-old Chinese woman presented with a 2-week history of nausea and vomiting and complained of mental status alteration including confusion and agitation in the 24 hours prior to her admission...
January 8, 2021: Medicine (Baltimore)
Bhamini Vadhwana, Chelise Currow, David Bowers, Thomas Groot-Wassink
BACKGROUND: Primary hyperparathyroidism (PHPT) is associated with a poorer quality of life. The role of neuropsychiatric symptoms in asymptomatic patients who do not display classical features of PHPT remains undefined. It is unclear whether parathyroidectomy provides immediate benefit beyond the long-term risk reduction of adverse effects. The aim of the study is to assess the effect on quality of life in patients with asymptomatic PHPT undergoing parathyroidectomy. METHODS: Consecutive patients with PHPT undergoing parathyroidectomy by a single surgeon were recruited from a single center between 2014 and 2019...
January 8, 2021: Journal of Surgical Research
Claire E Graves, Richard Hwang, Catherine M McManus, James A Lee, Jennifer H Kuo
BACKGROUND: Reduced creatinine clearance is an indication for surgery in asymptomatic primary hyperparathyroidism, and a significant proportion of patients undergoing parathyroidectomy have chronic kidney disease. The purpose of this study was to evaluate the kinetics of intraoperative parathyroid hormone decline during parathyroidectomy in patients who have chronic kidney disease compared with those with who have normal renal function. METHODS: This is a single-center, retrospective study of patients with primary hyperparathyroidism undergoing parathyroidectomy (n = 646)...
January 7, 2021: Surgery
Pierre-Yves Charles, Emmanuel Letavernier, Sophie Périé, Mathieu Gauthé, Michel Daudon, Jean-Philippe Haymann
Parathyroidectomy (PTX) is routinely performed in hypercalciuric renal stone patients with primary hyperparathyroidism (PHPT). However, some data indicate a persistent stone activity following PTX, raising the issue of the link between PHPT and stone disease. We performed an observational study on 30 renal stone patients diagnosed with PHPT. Patients were selected among 1448 hypercalciuric patients referred in our department for a diagnostic evaluation. Patients with no parathyroid surgery or any biological follow-up were excluded...
January 9, 2021: Urolithiasis
Liubov G Yanevskaya, Tatiana Karonova, Ilya V Sleptsov, Marina Evgenevna Boriskova, Aluza Ramilevna Bakhtiyarova, Roman A Chernikov, Karina Alexandrovna Pogosian, Alena Timurovna Andreeva, Denis Andreevich Lebedev, Elena Nikolaevna Grineva, John P Bilezikian
OBJECTIVE: The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy. MATERIALS AND METHODS: Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. History and anthropometric data, laboratory results (iPTH, total and  iCa, phosphorus, ALP, 24-h urinary calcium, 25(OH)D) and imaging data (ultrasonography, scintigraphy, CT/MRI scan, DXA) were analyzed...
January 1, 2021: Endocrine Connections
Elske Quak, Audrey Lasne Cardon, Renaud Ciappuccini, Charline Lasnon, Vianney Bastit, Véronique Le Henaff, Barbara Lireux, Gauthier Foucras, Cyril Jaudet, Celia Berchi, Jean-Michel Grellard, Justine Lequesne, Bénédicte Clarisse, Stéphane Bardet
BACKGROUND: The common endocrine disorder primary hyperparathyroidism (PHPT) can be cured by surgery. Preoperative localization of parathyroid adenoma (PTA) by imaging is a prerequisite for outpatient minimally invasive parathyroidectomy (MIP). Compared to inpatient bilateral cervical exploration (BCE) which is performed if imaging is inconclusive, MIP is superior in terms of cure and complication rates and less costly. The imaging procedure F18-choline (FCH) PET/CT outperforms Tc99m-sestaMIBI (MIBI) SPECT/CT for PTA localization, but it is much costlier...
January 7, 2021: BMC Endocrine Disorders
Shuai Lu, Maoqi Gong, Yejun Zha, Aimin Cui, Wei Tian, Xieyuan Jiang
BACKGROUND: Multiple pathological manifestations are rarely present in patients with primary hyperparathyroidism (PHPT). Here we described a case of a young woman who presented with multiple skeletal destructions and received an unclear diagnosis at several hospitals. CASE PRESENTATION: A 30-year-old woman was admitted to our hospital due to pain in both knees and walking difficulty that lasted for 6 and 2 years, respectively. Her laboratory test results revealed a high parathyroid hormone level (822 pg/ml) and hypercalcemia (2...
January 7, 2021: BMC Endocrine Disorders
Ezra Y Koh, Willemijn Y van der Plas, Roderick R Dulfer, Robert A Pol, Schelto Kruijff, Joris I Rotmans, Natasha Appelman-Dijkstra, Abbey Schepers, Martin H de Borst, Ewout J Hoorn, Tessa M van Ginhoven, Els J M Nieveen van Dijkum, Liffert Vogt, Anton F Engelsman
No abstract text is available yet for this article.
January 7, 2021: Langenbeck's Archives of Surgery
Midori Minezaki, Yuichi Takashi, Kentaro Ochi, Ryo Mitsuoka, Yuka Yamao, Tadachika Kudo, Daiji Kawanami, Kunihisa Kobayashi, Ichiro Abe
INTRODUCTION: Cinacalcet is a calcimimetic that modulates the functions of calcium-sensing receptor and is currently used to treat patients with primary hyperparathyroidism (PHPT). Although it was reported that cinacalcet treatment reduced the size of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism, whether or not cinacalcet treatment can reduce the size of parathyroid adenomas in patients with PHPT has been unknown. MATERIALS AND METHODS: We recruited nine (male: one, female: eight) patients with PHPT due to parathyroid adenomas who did not undergo parathyroidectomy...
January 6, 2021: Journal of Bone and Mineral Metabolism
Carolyn D Seib, Insoo Suh, Tong Meng, Amber Trickey, Alexander K Smith, Emily Finlayson, Kenneth E Covinsky, Manjula Kurella Tamura, Electron Kebebew
Importance: Parathyroidectomy provides definitive management for primary hyperparathyroidism (PHPT), reducing the risk of subsequent fracture, nephrolithiasis, and chronic kidney disease (CKD), but its use among older adults in the US is unknown. Objective: To identify patient characteristics associated with the use of parathyroidectomy for the management of PHPT in older adults. Design, Setting, and Participants: This population-based, retrospective cohort study used 100% Medicare claims from beneficiaries with an initial diagnosis of PHPT from January 1, 2006, to December 31, 2016...
January 6, 2021: JAMA Surgery
Juulia K Virtanen, Sari H Mölsä, Karoliina A Hagner, Hanna M Salonen, Susanne Kilpinen
Case summary: A 16-year-old neutered female Korat cat presented with chronic vomiting, mild azotaemia and mild hypercalcaemia. Physical examination revealed bilateral palpable masses on each side of the trachea. Laboratory results were consistent with primary hyperparathyroidism, diagnostic imaging findings with cystic thyroid or parathyroid masses, and fine-needle aspiration cytology with thyroid hyperplasia or adenoma. In order to confirm whether one or two of the masses were the cause of the hyperparathyroidism, cystic fluid was aspirated from both for parathyroid hormone concentration measurement...
July 2020: JFMS Open Reports
Rahim Khan, James Martin, Gautam Das
To study impact of observation (OBV) vs parathyroidectomy (PTX) on biochemistry, bone mineral density (BMD) and fracture risk calculated by Fracture Risk Assessment (FRAX) tool in primary hyperparathyroidism (PHPT). Retrospective study of 60 patients (OBV - 26; PTX - 34 patients). Mean adjusted calcium improved in both groups [OBV - 2.76 ± 0.07 vs 2.51 ± 0.20 mmol/L; p < 0.00001, PTX - 2.87 ± 0.21 vs 2.36 ± 0.12 mmol/L; p < 0.00001]. Mean parathyroid hormone level declined in both but more in PTX group [OBV - 11...
December 15, 2020: Journal of Clinical Densitometry
Hirotaka Komaba, Markus Ketteler, John Cunningham, Masafumi Fukagawa
Disturbances in mineral and bone metabolism are common in patients with chronic kidney disease (CKD), especially those undergoing dialysis. Renal osteodystrophy, which describes an alteration of bone morphology, is an important component of this systemic disorder and may explain the elevated risk of fracture which adversely affects morbidity and mortality. The most common form of renal osteodystrophy is high-turnover bone disease (osteitis fibrosa), which is induced by secondary hyperparathyroidism (SHPT). During the past decade, there has been considerable advances in the management of SHPT, with the introduction of the calcimimetic agents, the optimized use of nutritional and active vitamin D, and the accumulated experience with surgical parathyroidectomy...
January 2, 2021: Calcified Tissue International
E Goñi-Gironés, S Fuertes-Cabero, I Blanco-Sáiz, I Casáns-Tormo, P García-Talavera San Miguel, J Martín-Gil, C Sampol-Bas, P Abreu-Sánchez, R Díaz-Expósito, S Vidal-Sicart
Parathyroidectomy has evolved over the years from bilateral neck exploration to a single gland approach using minimally invasive surgery. The precise presurgical localization of the problem gland, using functional techniques, such as double-phase scintigraphy with [99m Tc] Tc-MIBI including SPECT-CT and PET-CT with [18 F]-Choline and morphological ones, such as ultrasound have played a crucial role in this paradigm's shift. Radioguided surgery techniques have also adapted and grown with new contributions known for their indication in other fields...
December 29, 2020: Revista Española de Medicina Nuclear e Imagen Molecular
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