Omolade O Adegoke, Mustapha A Ajani, Babatope L Awosusi, Francis A Onakpoma, O Saiki, A Daniel
Parathyroid adenoma is the most common cause of primary hyperthyroidism which leads to abnormal calcium homeostasis, hypercalcemia, and reduction in bone density. A 37-year-old female referred from a private health facility with a 1-year history of upper back swelling and pain. The pain was worse when sitting down for long periods and with movement and relieved by rest. There was no antecedent history of trauma, but the patient had noticed poor appetite and weight loss. There were no constipation, no abdominal discomfort, and no symptom suggestive of hyperthyroidism or hypothyroidism...
September 2020: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Catherine Cormier, Eugénie Koumakis
Primary hyperparathyroidism (PHPT) is a disease caused by excessive and inappropriate secretion of parathyroid hormone resulting in hypercalcemia. It is usually diagnosed incidentally in the face of hypercalcemia, a complication such as osteoporosis or, more rarely, a renal complication with lithiasis. The clinical presentation reflects hypercalcemia and involves several organs, mainly the cardiovascular system, bones, and kidneys. However, most patients with PHPT are asymptomatic. The diagnosis is made based on laboratory tests...
January 20, 2021: Joint, Bone, Spine: Revue du Rhumatisme
Joseph R Esparaz, Michelle S Mathis, Robert T Russell
PURPOSE: The Accreditation Council for Graduate Medical Education (ACGME) monitors fellow case numbers. Previous literature has shown new fellowships detrimentally affecting general surgery residency case numbers. We hypothesize that an increase in pediatric otolaryngology and pediatric urology fellowships would decrease overlapping case numbers in pediatric surgery fellowships. MATERIALS AND METHODS: A review of each specialties' fellowship match results was performed...
January 19, 2021: Journal of Surgical Education
Andre Albuquerque Silveira, Marilia D'Elboux Guimarães Brescia, Climério Pereira do Nascimento, Sergio Samir Arap, Fabio Luiz de Menezes Montenegro
INTRODUCTION: Some authors advise in favor of delayed sampling of intraoperative parathormone testing (ioPTH) during parathyroidectomy in dialysis and kidney-transplanted patients. The aim of the present study was to evaluate the intensity and the role of delayed sampling in the interpretation of ioPTH during parathyroidectomy in dialysis patients (2HPT) and successful kidney-transplanted patients (3HPT) compared to those in single parathyroid adenoma patients (1HPT). METHODS: This was a retrospective study of ioPTH profiles in patients with 1HPT, 2HPT, and 3HPT operated on in a single institution...
January 15, 2021: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Alessandro Galani, Riccardo Morandi, Mira Dimko, Sarah Molfino, Carla Baronchelli, Silvia Lai, Federico Gheza, Carlo Cappelli, Claudio Casella
BACKGROUND: Primary hyperparathyroidism is an endocrine pathology that affects calcium metabolism. Patients with primary hyperparathyroidism have high concentrations of serum calcium or high concentrations of parathyroid hormone, or incorrect parathyroid hormone levels for serum calcium values. Primary hyperparathyroidism is due to the presence of an adenoma/single-gland disease in 80-85%. Multiple gland disease or hyperplasia accounts for 10-15% of cases of primary hyperparathyroidism...
January 20, 2021: World Journal of Surgical Oncology
Shrinath Shetty, Kripa Elizabeth Cherian, Sahana Shetty, Nitin Kapoor, Felix K Jebasingh, Anish Cherian, Julie Hephzibah, Anuradha Chandramohan, Reetu Amirta John, Hesarghatta S Asha, Mazhuvanchary Jacob Paul, Marie Therese Manipadam, Deepak Thomas Abraham, Nihal Thomas, Thomas Vizhalil Paul
OBJECTIVE: This prospective study was carried out to assess trabecular bone score, bone mineral density (BMD), and bone biochemistry in Indian subjects with symptomatic primary hyperparathyroidism (PHPT), and to study the influence of baseline parathyroid hormone (PTH) on recovery of these parameters following curative surgery. METHODS: This was a 2-year prospective study conducted at a tertiary care centre in southern India. Baseline assessment included demographic details, mode of presentation, bone mineral biochemistry, BMD, trabecular bone score (TBS), and bone turnover markers (BTMs)...
December 2020: Endocrine Practice
Flavia Ramos de Siqueira, Karin Carneiro de Oliveira, Wagner Vasques Dominguez, César Augusto Madid Truyts, Rosa Maria Affonso Moysés, Luciene Machado Dos Reis, Vanda Jorgetti
BACKGROUND/OBJECTIVE: Loss of renal function may induce secondary hyperparathyroidism (s-HPT), which triggers several complications leading to an extreme decline in quality of life and increased mortality in affected patients. We evaluated whether parathyroidectomy (PTx), as surgical treatment for s-HPT, modifies body composition, and hormones involved in the protein-energy metabolism of affected patients. SUBJECTS/METHODS: Overall, 30 s-HPT patients were evaluated at two times, before PTx (pre PTx) and 6 months after PTx (post PTx)...
January 18, 2021: European Journal of Clinical Nutrition
Ameya A Jategaonkar, David K Lerner, Peter Cooke, Diana Kirke, Eric M Genden, Samuel J Trosman
PURPOSE: To present the results of our implementation of a four-dimensional computed tomography- (4DCT) based parathyroid localization protocol for primary hyperparathyroidism at a safety net hospital. METHODS: We performed a retrospective review of all patients who underwent parathyroidectomy for primary hyperparathyroidism at Elmhurst Hospital Center from June 2016 - September 2019. Patients treated prior to the implementation of 4DCT during October 2018 served as historical controls for comparison...
January 12, 2021: American Journal of Otolaryngology
Süleyman Özkan Aksoy, Süleyman Cem Adiyaman, Ali Durubey Çevlik, Merih Güray Durak, Mustafa Seçil, Ali İbrahim Sevinç
BACKGROUND: Surgery is currently the only treatment option for patients with primary hyperparathyroidism (PHPT). Recently, minimally invasive parathyroidectomy (MIP) has begun to replace traditional bilateral neck exploration (BNE). OBJECTIVE: The aim of this study is to compare the results of parathyroidectomies performed in our hospital over the past decade that were guided by intra-operative parathyroid hormone (IOPTH) sampling or frozen section (FS) analysis...
January 12, 2021: American Journal of Otolaryngology
Azka Latif, Alheli Arce Gastelum, Kinaan Farhan, Sunil Jagadesh, Sangeeta Mutnuri
Primary hyperparathyroidism is rare in pregnancy, with an incidence of 1%. It is associated with maternal, fetal, and neonatal complications. Herein, we present two patients with gestational primary hyperparathyroidism who failed medical management and underwent successful parathyroidectomy. Based on our experience and review of the literature, gestational hyperparathyroidism appears to be a clear indication for early parathyroidectomy in both symptomatic and asymptomatic patients.
October 28, 2020: Proceedings of the Baylor University Medical Center
Alison Psaila, Luca Conti, Alexander P Azzopardi, David V Coppini
Primary hyperparathyroidism presenting with diffuse skeletal involvement, such as discrete osteoclastic bone lesions, is rare. We describe a 35-year-old woman who presented with a left mandibular mass that rapidly enlarged over 3 weeks. Radiological, histological, and biochemical investigations led to the diagnosis of brown tumor secondary to primary hyperparathyroidism. A neck ultrasound revealed a 1.5 × 2.3 × 4.6 cm mass at the lower pole of the left thyroid lobe, suggestive of a parathyroid adenoma. Bone scan showed additional abnormal foci of increased uptake in the maxilla, both femora, skull, and scapula...
October 15, 2020: Proceedings of the Baylor University Medical Center
Ajithraj Sathiyaraj, Priyanga Jayakumar, Matthew R McGlennon, John F Eckford, Sandy Itwaru Anne
We present the case of a 57-year-old man with known cutaneous manifestations of malignant atrophic papulosis, also known as Köhlmeier-Degos disease, who developed an almost-fatal small bowel perforation following a parathyroidectomy. He required two surgical interventions during his initial hospitalization and was started on eculizumab. Despite these therapies, the patient developed recurrent bowel perforations and ultimately died.
September 14, 2020: Proceedings of the Baylor University Medical Center
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
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