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Id: biblio-1123621
Autor: Fuenzalida P, Magdalena; Purto H, Dalay; Rioseco R, Clara; Kutscher C, Sofía; Amenábar M, María Paz; Tagle V, Rodrigo; Jara C, Aquiles.
Título: Hiperkalemia postoperatoria en síndrome de hueso hambriento post-paratiroidectomía por hiperparatiroidismo secundario en enfermedad renal crónica terminal / Hyperkalemia-associated hungry bone syndrome post-parathyroidectomy in end-stage denal disease
Fonte: Rev. chil. endocrinol. diabetes;13(4):154-158, 2020. ilus, tab.
Idioma: es.
Resumo: Introducción: El hiperparatiroidismo secundario (HPTS) es una complicación de la enfermedad renal crónica terminal (ERCT). A pesar de nuevas terapias médicas como calcimiméticos, en HPTS refractarios la paratiroidectomía (PTX) continúa siendo necesaria. Una complicación frecuente en estos pacientes posterior a la PTX es el síndrome de hueso hambriento (SHH), caracterizado por una profunda y prolongada hipocalcemia asociada a hipofosfatemia, secundaria a un excesivo aumento de su captación ósea. Una complicación menos descrita, pero con consecuencias graves e incluso fatales, es la hiperkalemia. El propósito de este trabajo consiste en enfatizar el riesgo de hiperkalemia por SHH a partir de un caso clínico, señalar los mecanismos fisiopatológicos, factores de riesgo y consideraciones terapéuticas. Caso clínico: Mujer de 35 años, con ERCT de causa desconocida, HPTS refractario con PTX total e implante de glándulas en antebrazo hace 9 años. Ingresa por recurrencia de HPTS. Cintigrama MIBI SPECT/CT® evidenció implante hiperfuncionante, indicándose PTX del injerto. Exámenes preoperatorios: calcemia 8.6 mg/dL, fosfatasas alcalinas 1115 UI/L (VN <100), PTH intacta (PTHi) 3509 pg/ml y kalemia 4.8 mEq/L. Biopsia: hiperplasia paratiroidea nodular. En postoperatorio inmediato presentó hiperkalemia de 7.1 mEq/L con cambios electrocardiográficos, requiriendo hemodiálisis de urgencia. Posteriormente desarrolló hipocalcemia, hipofosfatemia e hipomagnesemia, de difícil control. Discusión: El SHH post HPTS puede coexistir con hiperkalemia postoperatoria inmediata grave, incluso fatal si no se identifica y corrige a tiempo. El mecanismo fisiopatológico aún no está bien dilucidado. Varios factores pudieran intervenir, incluyendo aumento del metabolismo celular, traumatismo tisular, fármacos anestésicos, fluidos perioperatorios y flujo de iones transmembrana. El nivel de potasio previo a la cirugía, menor edad, género masculino, tiempo entre la última hemodiálisis y la cirugía, y duración de la PTX, son factores de riesgo para hiperkalemia postoperatoria. El conocimiento de esta grave complicación permitirá estar preparado para monitorizar y eventualmente tratar.

Introduction: Secondary Hyperparathyroidism (SHPT) is a complication of End-Stage Renal Disease (ESRD). Although new medical therapies (i.e.calcimimetics,) parathyroidectomy (PTX) continues to be necessary in refractory cases. A well-known complication after PTX is an entity called Hungry Bone Syndrome (HBS), characterized by deep and prolonged hypocalcemia associated with hypophosphatemia, secondary to an excessive increase in bone formation. A less reported complication, but with severe or even fatal consequences, is hyperkalemia. The purpose of this work consists of emphasizing the risk of hyperkalemia in HBS, reporting a clinical case that points out the physiopathological mechanisms, risk factors, and therapeutic considerations. Clinical case: 35-year-old woman with ESRD of unknown cause with refractory SHPT with total PTX and forearm gland grafts nine years ago. She presented SHPT recurrency. MIBI SPECT/CT® scan showed a hyperfunctioning implant, indicating graft PTX. Preoperative tests: calcemia 8.6 mg/dL, phosphatemia 7.3 mg/dL, alkaline phosphatases 1115 UI/L (VN<100), intact PTH (iPTH) 3509 pg/ml and kalemia 4.8 mEq/L. Biopsy: parathyroid nodular hyperplasia. In the immediate postoperative period, she presented hyperkalemia at 7.1 mEq/L with electrocardiographic changes, requiring emergency hemodialysis. Later she developed hypocalcemia, hypophosphatemia, and hypomagnesemia of difficult control. Discussion: HBS post PTX can coexist with severe immediate postoperative hyperkalemia, which can be even fatal if not detected and corrected. The physiopathological mechanism is still not entirely elucidated. Various factors could interfere, including an increase in cell metabolism, tissue traumatism, anesthetic drugs, intraoperative fluids, and transmembrane ion flow. Preoperative potassium levels, younger age, male gender, the time elapsed between last hemodialysis and surgery, and duration of PTX are risk factors for post-surgical hyperkalemia. Knowing this severe complication will allow the medical team to be prepared for monitoring and eventually treating it.
Descritores: Doenças Ósseas Metabólicas/etiologia
Paratireoidectomia/efeitos adversos
Hiperpotassemia/etiologia
Hiperparatireoidismo Secundário/cirurgia
-Insuficiência Renal Crônica/complicações
Hiperparatireoidismo Secundário/complicações
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1150525
Autor: Sánchez De Guzmán, Gabriel; Ariza, Anibal.
Título: Hiperparatiroidismo primario: conceptos para el cirujano general / Primary hyperparathyroidism: concepts for the general surgeon
Fonte: Rev. colomb. cir;36(1):110-119, 20210000. tab, fig.
Idioma: es.
Resumo: Durante las últimas décadas, la incidencia del hiperparatiroidismo primario ha venido en aumento, muy probablemente relacionado con la mayor accesibilidad a los estudios diagnósticos; sin embargo, la forma más común de presentación clínica del hiperparatiroidismo primario es asintomática, en más del 80 % de los pacientes. En la actualidad, es menos frecuente el diagnóstico por las complicaciones renales (urolitiasis) u óseas (osteítis fibrosa quística) asociadas. Un tumor benigno de la glándula paratiroides (adenoma único), es la principal causa de esta enfermedad. Por tanto, su tratamiento usualmente es quirúrgico. A pesar de ello, no es frecuente el manejo de esta patología por el cirujano general. En este artículo se revisan conceptos claves para el diagnóstico y manejo de esta enfermedad para el médico residente y especialista en Cirugía general

During the last decades, the incidence of primary hyperparathyroidism has been increasing, most probably related to the greater accessibility to diagnostic studies; however, the most common form of clinical presentation of primary hyperparathyroidism is asymptomatic in more than 80% of patients. Diagnosis is less frequent due to associated renal (urolithiasis) or bone (osteitis fibrosa cystica) complications. A benign tumor of the parathyroid gland (single adenoma) is the main cause of this disease. Therefore, its treatment is usually surgical. Despite this, the management of this pathology by the general surgeon is not frequent. This article reviews key concepts for the diagnosis and management of this disease for the resident physician and specialist in General Surgery
Descritores: Glândulas Paratireoides
-Neoplasias das Paratireoides
Paratireoidectomia
Hiperparatireoidismo Primário
Limites: Humanos
Responsável: CO113


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Texto completo SciELO Cuba
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Id: biblio-1144435
Autor: González Fernández, Ramón Filiberto; Pavel Polo, Ismael; Infante Amorós, Adalberto; Domínguez Álvarez, Carlos; López Díaz, Adlín.
Título: Cirugía Radioguiada en el tratamiento del hiperparatiroidismo primario / Radioguided Surgery in the Treatment of Primary Hyperparathyroidism
Fonte: Rev. cuba. cir;59(3):e1008, jul.-set. 2020. tab.
Idioma: es.
Resumo: RESUMEN Introducción: El tratamiento quirúrgico ha evolucionado desde la exploración abierta bilateral del cuello hasta la cirugía de invasión mínima. En este momento, la paratiroidectomía mínimamente invasiva en pacientes con hiperparatiroidismo primario es la técnica de elección. Objetivo: Describir los resultados del tratamiento quirúrgico del hiperparatiroidismo primario con el uso de la sonda gamma transoperatoria. Métodos: Se realizó un estudio descriptivo y longitudinal, de tipo serie de casos. La muestra estuvo constituida por 29 pacientes con tratamiento quirúrgico radioguiada para el hiperparatiroidismo primario en el Hospital Clínico Quirúrgico Hermanos Ameijeiras entre marzo de 2007 a diciembre de 2014. Resultados: De los 29 pacientes, 21 no presentaban enfermedad tiroidea asociada, tenían una mediana de edad de 52 años, con predominio femenino (80,9 por ciento), la enfermedad renal resultó ser el síntoma más frecuente (52,4 por ciento), el adenoma paratiroideo fue el diagnóstico anatomopatológico con mayor por ciento (85,7 por ciento). Presentaron complicaciones posoperatorias el 38,1 por ciento y la hipocalcemia transitoria estuvo en un 28,6 por ciento. La media de la estadía posoperatoria fue de 3,37 días y la curación de 90,5 por ciento. En los ocho pacientes con enfermedad tiroidea asociada tenían una mediana de edad de 58 años y predominio femenino (62,5 por ciento). Prevaleció el dolor articular y la fatiga (50 por ciento) como síntomas previos y como diagnóstico anatomopatológico el adenoma paratiroideo (62,5 por ciento). Las complicaciones presentes en un 37,5 por ciento y la más frecuente la hipocalcemia transitoria (25,0 por ciento). La curación estuvo en 62,5 por ciento y la media de la estadía posoperatoria en 2,47 días. Conclusiones: Los resultados alcanzados evidencian la utilidad de la cirugía radioguiada en el tratamiento del hiperparatiroidismo primario(AU)

ABSTRACT Introduction: Surgical treatment has evolved from bilateral open neck exploration to minimally invasive surgery. Currently, minimally invasive parathyroidectomy in patients with primary hyperparathyroidism is the technique of choice. Objective: To describe the outcomes of surgical treatment of primary hyperparathyroidism with the use of the intraoperative gamma probe. Methods: A descriptive and longitudinal study of case series was carried out. The sample consisted of 29 patients who received radioguided surgical treatment for primary hyperparathyroidism at Hermanos Ameijeiras Clinical-Surgical Hospital between March 2007 and December 2014. Results: Of the 29 patients, 21 did not present associated thyroid disease. Their median age was 52 years. They were predominantly female (80.9%). Kidney disease was the most frequent symptom (52.4 percent). Parathyroid adenoma was the anatomopathological diagnosis with the highest percentage value (85.7 percent). 38.1 percent presented postoperative complications and transient hypocalcemia accounted for 28.6 percent. The mean for postoperative stay was 3.37 days and for healing was 90.5 percent. In the eight patients with associated thyroid disease, the mean age was 58 years, and there was predominance of the female sex (62.5 percent). Joint pain and fatigue, accounting for 50 percent, prevailed as previous symptoms; while parathyroid adenoma, accounting for 62.5 percent, prevailed as anatomopathological diagnosis. Complications were present in 37.5 percent and the most frequent was transient hypocalcemia (25.0 percent). Healing accounted for 62.5 percent and the mean postoperative stay was 2.47 days. Conclusions: The results obtained show the usefulness of radioguided surgery in the treatment of primary hyperparathyroidism(AU)
Descritores: Paratireoidectomia/métodos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Hiperparatireoidismo Primário/terapia
-Epidemiologia Descritiva
Estudos Longitudinais
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1130045
Autor: Perez, Betiana Mabel; Kitaigrodsky, Ariela Verónica; Diehl, María; Rosa-Diez, Guillermo; Figari, Marcelo; Kozak, Andrea; Plantalech, Luisa Carmen.
Título: Recidiva del hiperparatiroidismo secundario a enfermedad renal crónica en diálisis luego de la paratiroidectomía / Recurrence of secondary hyper¬parathyroidism in dialysis patients after parathyroidectomy
Fonte: Actual. osteol;16(1):12-25, Ene - abr. 2020. ilus, graf, tab.
Idioma: es.
Resumo: La paratiroidectomía (PTX) es la terapia de elección en el hiperparatiroidismo secundario a enfermedad renal crónica (HPT-ERC) resistente al tratamiento médico. El objetivo del presente estudio fue evaluar el resultado de la PTX a largo plazo y sus factores predictores. Métodos: estudio unicéntrico retrospectivo observacional. Se incluyeron 92 pacientes con HPT-ERC en diálisis, en quienes se realizó la primera PTX en el Hospital Italiano de Buenos Aires entre 2006 y 2015 con seguimiento ≥ 6 meses. Se consideró persistencia del HPTERC con PTH > 300 pg/ml en el semestre posoperatorio, y recidiva con PTH > 500 pg/ml luego. Resultados: edad: 43,6±12,8 años, 50% mujeres, mediana 4,6 años de diálisis, PTH preoperatoria mediana 1639 pg/ml. A 39 se les realizó PTX subtotal (PTXS) y a 53 total con autoimplante (PTXT+AI). Se observó persistencia en 16 pacientes (17,4%). Presentaron recidiva 30 de 76 pacientes con adecuada respuesta inicial (39,5%; IC 95 28,5-50,5). La mediana de tiempo hasta la recidiva fue de 4,7 años (RIC 2,3-7,5). Los pacientes con recidiva presentaron mayor calcemia preoperatoria (mediana 9,9 vs. 9,3 mg/dl, p=0,035; OR ajustado 2,79) y menor elevación de fosfatasa alcalina en el posoperatorio (333 vs. 436 UI/l, p=0,031; OR ajustado 0,99). La recidiva se presentó más frecuentemente luego de la PTXT+AI (48,9%; OR ajustado 4,66), que en la PTXS (25,8%). Conclusiones: el tiempo en diálisis con inadecuado control metabólico constituye el principal factor para la recurrencia del HPT. Se postula que la mayor calcemia preoperatoria está relacionada con un HPT más severo y se asocia a recurrencia. Llamativamente, hallamos menores elevaciones de la fosfatasa alcalina durante el posoperatorio en pacientes con recurrencia. Hipotetizamos que esto pueda asociarse con menor mineralización en el posoperatorio e hiperfosfatemia sostenida, con consecuente estímulo paratiroideo. La menor recurrencia del HPT luego de la PTXS se vincula al sesgo generado en la selección del tipo de cirugía. (AU)

Parathyroidectomy is an effective therapy for refractory secondary hyperparathyroidism (sHPT). Continued dialysis represents risk for recurrent sHPT. The aim of this study was to estimate the proportion of recurrence and determine its predictors. Methods: We conducted a retrospective observational study of 92 adults in chronic dialysis, who underwent their first parathyroidectomy in this center between 2006 and 2015. We considered persistence of sHPT if PTH was > 300 pg/ml during the first postoperative semester, and recurrence if it was > 500 pg/ml afterwards. Results: Age 43.6+-12 y/o, 50% female, 4.6 years on dialysis, median preoperative PTH 1636 pg/ml (IQR 1226-2098). Subtotal parathyroidectomy (sPTX) was performed in 39, Total with autotransplantation (TA-PTX) in 53 patients. Persistence of sHPT occurred in 16 patients; relapse in 30 out of 76 with adequate initially response (39.5%; 95CI 28,5-50,5). Median time to recurrence: 4.7 y. Recurring patients had higher preoperative calcemia (9.9 vs 9.3 mg/dl; adj OR 2.79) and lower postoperative elevation of ALP (333 vs 436 UI/ml; adj OR 0.99). Recurrence presented more frequently in TA-PTX (48.9%; adj OR 4.66) than sPTX (25.8%). Conclusions: Time on dialysis with inadequate metabolic control remains the most important risk factor for sHPT recurrence. Higher preoperative levels of calcemia, related to sHPT severity, are associated with recurrence. Lower elevations of ALP during postoperative period in recurring patients are an interesting finding. We hypothesize that patients with less significant postoperative mineralization may have chronically higher levels of phosphatemia, stimulating parathyroid glands. Fewer recurrence in sPTX is associated to a bias in the procedure selection. (AU)
Descritores: Paratireoidectomia/estatística & dados numéricos
Hiperparatireoidismo Secundário/complicações
-Recidiva
Vitamina D/uso terapêutico
Calcitriol/análogos & derivados
Calcitriol/uso terapêutico
Cálcio/sangue
Estudos Retrospectivos
Diálise Renal
Fosfatase Alcalina/sangue
Insuficiência Renal Crônica/etiologia
Insuficiência Renal Crônica/terapia
Hiperparatireoidismo Secundário/cirurgia
Hiperparatireoidismo Secundário/diagnóstico
Hiperparatireoidismo Secundário/terapia
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Tipo de Publ: Estudo Observacional
Responsável: AR2.1 - Biblioteca Central


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Texto completo SciELO Chile
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Id: biblio-1058646
Autor: Arnold, Jorge; Martínez, Waldo; Oksenberg, Sebastian; Oksenberg, Danny.
Título: Pancreatitis aguda por hipercalcemia en el embarazo: caso clínico / Acute pancreatitis due to hypercalcemia during pregnancy: report of one case
Fonte: Rev. méd. Chile;147(8):1078-1081, ago. 2019. graf.
Idioma: es.
Resumo: Acute pancreatitis during pregnancy is uncommon and usually associated with gallstones. However other etiologies must be considered. We report a 24 years old woman with a 32 weeks pregnancy consulting for abdominal pain, nausea and vomiting. She had elevated lipase and amylase levels, a corrected serum calcium of 13.1 mg/dl and a serum phosphate of 1.6 mg/dl. A magnetic resonance colangiopancreatography showed an enlarged pancreas with inflammatory changes and a normal Wirsung duct. A parathyroid nodule was found on cervical ultrasonography. The patient was treated initially with cinacalcet with partial response. A parathyroidectomy was performed at 39 weeks of pregnancy with a good maternal and fetal evolution.
Descritores: Pancreatite/etiologia
Complicações na Gravidez/etiologia
Hipercalcemia/complicações
-Pancreatite/cirurgia
Pancreatite/diagnóstico por imagem
Neoplasias das Paratireoides/diagnóstico por imagem
Complicações na Gravidez/cirurgia
Adenoma/diagnóstico por imagem
Dor Abdominal/etiologia
Paratireoidectomia/métodos
Resultado do Tratamento
Colangiopancreatografia por Ressonância Magnética/métodos
Limites: Humanos
Feminino
Gravidez
Adulto Jovem
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Brasil
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Id: lil-798179
Autor: Kaya, Cafer; Tam, Abbas Ali; Dirikoç, Ahmet; Kılıçyazgan, Aylin; Kılıç, Mehmet; Türkölmez, Şeyda; Ersoy, Reyhan; Çakır, Bekir.
Título: Hypocalcemia development in patients operated for primary hyperparathyroidism: Can it be predicted preoperatively?
Fonte: Arch. endocrinol. metab. (Online);60(5):465-471, Oct. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Objective Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Postoperative hypocalcemia is a morbidity of parathyroid surgeries, and it may extend hospitalization durations. The purpose of this study is to determine the predictive factors related to the development of hypocalcemia and hungry bone syndrome (HBS) in patients who underwent parathyroidectomy for PHP. Materials and methods Laboratory data comprising parathyroid hormone (PTH), calcium, phosphate, 25-OHD, albumin, magnesium, alkaline phosphatase (ALP), blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH) of the patients were recorded preoperatively, on the 1st and 4th days postoperatively, and in the 6th postoperative month, and their neck ultrasound (US) and bone densitometry data were also recorded. Results Hypocalcemia was seen in 63 patients (38.4%) on the 1st day after parathyroidectomy. Ten patients (6.1%) had permanent hypocalcemia in the 6th month after surgery. Out of the patients who underwent parathyroidectomy for PHP, 22 (13.4%) had HBS. The incidence of postoperative hypocalcemia was higher in patients who underwent parathyroidectomy for PHP, who had parathyroid hyperplasia, and who had osteoporosis. Preoperative PTH, ALP, and BUN values were higher in those patients who developed HBS. Furthermore, HBS was more common in patients who had osteoporosis, who had parathyroid hyperplasia, and who underwent thyroidectomy simultaneously with parathyroidectomy. Conclusions As a result, patients who have the risk factors for development of hypocalcemia and HBS should be monitored more attentively during the perioperative period.
Descritores: Complicações Pós-Operatórias/etiologia
Paratireoidectomia/efeitos adversos
Hiperparatireoidismo/cirurgia
Hiperparatireoidismo/complicações
Hipocalcemia/etiologia
-Hormônio Paratireóideo/sangue
Fosfatos/sangue
Período Pós-Operatório
Valores de Referência
Fatores de Tempo
Nitrogênio da Ureia Sanguínea
Calcifediol/sangue
Cálcio/sangue
Valor Preditivo dos Testes
Medição de Risco/métodos
Fosfatase Alcalina/sangue
Magnésio/sangue
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Texto completo SciELO Brasil
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Id: biblio-1038494
Autor: Rosario, Pedro Weslley; Calsolari, Maria Regina.
Título: Serum PTH reference values in an adult Brazilian population: implications for the diagnosis of hyperparathyroidism
Fonte: Arch. endocrinol. metab. (Online);63(2):182-185, Mar.-Apr. 2019. tab.
Idioma: en.
Resumo: ABSTRACT Objective: To define serum parathyroid hormone (PTH) reference values in carefully selected subjects following the recommended pre-analytical guidelines. Subjects and methods: First, 676 adults who would be submitted to thyroidectomy were evaluated. Patients using interfering medications or with malabsorption syndrome, hypomagnesemia, hyper- or hypophosphatemia, hypo- or hypercalcemia, 25-hydroxyvitamin D < 30 ng/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, urinary calcium/creatinine ratio ≥ 0.25, thyroid dysfunction, parathyroid adenoma detected during surgery were excluded. The sample consisted of 312 subjects. Results: The median, minimum, maximum, and 2.5th and 97.5th percentiles of the PTH values obtained were 30, 7.2, 78, 10.1, and 52 pg/mL, respectively. Thus, the reference range was 10 to 52 pg/mL. PTH > 65 pg/mL, the upper limit of normal according to the manufacturer of the kit, was observed in only one subject (0.3%). Considering the upper limit proposed by the kit's manufacturer, 1/6 hypercalcemic patients and 4/8 normocalcemic patients with PHPT had normal PTH. Using the upper limit established in this study, only one normocalcemic patient had normal PTH. Thus, the sensitivity of PTH in detecting asymptomatic primary hyperparathyroidism (PHPT) using the values recommended by the kit and established in this study was 64% and 93%, respectively (50% versus 87.5% for normocalcemic PHPT). Conclusion: The upper reference limit of PTH obtained for a rigorously selected sample was 20% lower than that provided by the assay, which increased its sensitivity in detecting PHPT.
Descritores: Hormônio Paratireóideo/sangue
Nódulo da Glândula Tireoide/sangue
Hiperparatireoidismo/diagnóstico
-Hormônio Paratireóideo/normas
Valores de Referência
Tireoidectomia
Vitamina D/análogos & derivados
Vitamina D/sangue
Brasil
Cálcio/urina
Estudos Prospectivos
Paratireoidectomia
Sensibilidade e Especificidade
Pré-Menopausa/sangue
Pós-Menopausa/sangue
Hiperparatireoidismo/sangue
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME


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Vieira, José Gilberto Henriques
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Id: biblio-1019358
Autor: Ohe, Monique Nakayama; Bonanséa, Teresa Cristina Piscitelli; Santos, Rodrigo Oliveira; Neves, Murilo Catafesta das; Santos, Livia Marcela; Rosano, Marcello; Kunii, Ilda Sizue; Castro, Marise Lazaretti; Vieira, José Gilberto Henriques.
Título: Prediction of bone mass changes after successful parathyroidectomy using biochemical markers of bone metabolism in primary hyperparathyroidism: is it clinically useful?
Fonte: Arch. endocrinol. metab. (Online);63(4):394-401, July-Aug. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To measure type 1 serum amino-terminal propeptide procollagen (P1NP) and type 1 cross-linked C-terminal telopeptide collagen (CTX) before parathyroidectomy (PTX) in PHPT patients, correlating these measurements with bone mineral density (BMD) changes. Subjects and methods 31 primary hyperparathyroidism (HPTP) were followed from diagnosis up to 12-18 months after surgery. Serum levels of calcium, parathyroid hormone (PTH) vitamin D, CTX, P1NP, and BMD were measured before and 1 year after surgery. Results One year after PTX, the mean BMD increased by 8.6%, 5.5%, 5.5%, and 2.2% in the lumbar spine, femoral neck (FN), total hip (TH), and distal third of the nondominant radius (R33%), respectively. There was a significant correlation between BMD change 1 year after the PTX and CTX (L1-L4: r = 0.614, p < 0.0003; FN: r = 0.497, p < 0.0051; TH: r = 0.595, p < 0.0005; R33%: r = 0.364, p < 0.043) and P1NP (L1-L4: r = 0,687, p < 0,0001; FN: r = 0,533, p < 0,0024; TH: r = 0,642, p < 0,0001; R33%: r = 0,467, p < 0,0079) preoperative levels. The increase in 25(OH)D levels has no correlation with BMD increase (r = -0.135; p = 0.4816). On linear regression, a minimum preoperative CTX value of 0.331 ng/mL or P1NP of 37.9 ng/mL was associated with a minimum 4% increase in L1-L4 BMD. In TH, minimum preoperative values of 0.684 ng/mL for CTX and 76.0 ng/mL for P1NP were associated with a ≥ 4% increase in BMD. Conclusion PHPT patients presented a significant correlation between preoperative levels of turnover markers and BMD improvement 1 year after PTX.
Descritores: Fragmentos de Peptídeos/metabolismo
Peptídeos/metabolismo
Densidade Óssea
Paratireoidectomia/reabilitação
Pró-Colágeno/metabolismo
Colágeno Tipo I/metabolismo
Hiperparatireoidismo Primário/metabolismo
-Hormônio Paratireóideo/sangue
Fragmentos de Peptídeos/sangue
Período Pós-Operatório
Vitamina D/sangue
Biomarcadores/sangue
Cálcio/sangue
Valor Preditivo dos Testes
Pró-Colágeno/sangue
Hiperparatireoidismo Primário/cirurgia
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1054916
Autor: KUO, JOSEPH; MAH, YONE-HAN; WU, JUI-TENG; SHIAO, CHIH-CHUNG.
Título: Primary hyperparathyroidism presenting as major depression with psychotic features
Fonte: Arch. Clin. Psychiatry (Impr.) = Rev. psiquiatr. clín. (São Paulo) = Psiquiatria clínica;46(6):169-170, Nov.-Dec. 2019. graf.
Idioma: en.
Descritores: Transtornos Psicóticos/etiologia
Transtorno Depressivo Maior/etiologia
Hiperparatireoidismo Primário/diagnóstico
-Glândulas Paratireoides/patologia
Glândulas Paratireoides/diagnóstico por imagem
Escalas de Graduação Psiquiátrica
Transtornos Psicóticos/diagnóstico
Cintilografia
Cálcio/sangue
Paratireoidectomia
Ultrassonografia
Transtorno Depressivo Maior/diagnóstico
Transtorno Depressivo Maior/tratamento farmacológico
Diagnóstico Diferencial
Hiperparatireoidismo Primário/cirurgia
Hiperparatireoidismo Primário/complicações
Hiperparatireoidismo Primário/sangue
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Carta
Responsável: BR66.1 - Divisão de Biblioteca e Documentação


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Id: lil-357026
Autor: Loja Oropeza, David; Manrique, Helard; Solís Villanueva, José; Calderón Ticona, Jorge Richard; Flores, Neil.
Título: Crisis hipercalcémica e hiperparatiroidismo primario / Hypercalcemic crisis and primary hyperparathyroidism
Fonte: An. Fac. Med. (Perú);62(4):332-341, oct. 2001. ilus, tab.
Idioma: es.
Resumo: Presentamos el caso de una mujer de 45 años de edad con hiperparatiroidismo primario de varios años de evolución debido a un adenoma paratiroideo. Inicialmente ella cursó con nefrolitiasis y estreñimiento pertinaz, luego compromiso neuromuscular y enfermedad ósea caracterizada por osteítis fibrosa quística, osteoporosis severa y fractura patológica. Fue admitida por pancreatitis aguda asociada a crisis hipercalcémica que resolvió. Después de la paratiroidectomía, la paciente desarrolló el síndrome del hueso hambriento, del cual se recuperó. En el seguimiento está asintomática. Se discute el curso clínico, diagnóstico y tratamiento.
Descritores: Pancreatite
Hipercalcemia
Hiperparatireoidismo
Paratireoidectomia
Limites: Humanos
Feminino
Tipo de Publ: Relatos de Casos
Responsável: PE13.1 - Oficina de Biblioteca, Hemeroteca y Centro de Documentación



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