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[PMID]:29489687
[Au] Autor:Li L; Yang H; Li J; Yu Y; Wang F; Zhu X; Liu G
[Ad] Endereço:Department of Neurology, PLA 44 Hospital.
[Ti] Título:Misdiagnosis of idiopathic hypoparathyroidism: A case report and literature review.
[So] Source:Medicine (Baltimore);97(9):e9884, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Idiopathic hypoparathyroidism (IHP) is a rare endocrine condition, which is frequently represented by neuropsychiatric disorders. Hence, the misdiagnosis rate of the disease is rather high, especially for neurologists. PATIENT CONCERNS: We reported a case of misdiagnosed, atypical IHP. In addition, the literature on IHP and the misdiagnosis published in China in the past 2 decades has been reviewed and summarized. DIAGNOSES: Blood testing confirmed that parathyroid hormone (PTH) = 0 pg/mL and the final diagnosis was IHP. INTERVENTIONS AND OUTCOMES: With calcium and vitamin D supplementation, the patient's myasthenia improved significantly, and muscle enzymes returned to normal gradually. One-year follow-up demonstrated that the patient's myasthenia disappeared, and the blood calcium and PTH levels were normal. In addition, the literature on IHP and the misdiagnosis published in China in the past 2 decades has been reviewed and summarized. LESSONS: The misdiagnosis rate of IHP in China was high in the past 2 decades, which might be attributed to the misdiagnosis as epilepsy or mental diseases. A clinician should be able to understand the disease and emphasize the screening of high-risk population, especially for those patients with hypocalcemia, hyperphosphatemia, and increased blood creatine kinase with unknown causes or nontypical clinical symptoms.
[Mh] Termos MeSH primário: Erros de Diagnóstico/efeitos adversos
Hipoparatireoidismo/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Hipoparatireoidismo/tratamento farmacológico
Hormônio Paratireóideo/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Parathyroid Hormone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009884


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[PMID]:29442028
[Au] Autor:Ng PY; Ong AJ; Gale LS; Dass CR
[Ti] Título:Treatment of bone disorders with parathyroid hormone: success and pitfalls.
[So] Source:Pharmazie;71(8):427-433, 2016 08 01.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Bone diseases such as osteoporosis, osteoarthritis, bone tumours and bone fractures are rather common and not just in the elderly. Parathyroid hormone (PTH) is responsible for maintaining calcium homeostasis, increasing bone mineral density (BMD), increasing cortical and trabecular bone thickness and thus increasing bone strength. Teriparatide (PTH 1-34) has the same effects as endogenous PTH and is pharmacologically used to treat bone diseases such as osteoporosis, osteoarthritis, bone fractures and bone tumours. This review discusses how PTH 1-34 plays a role in managing bone diseases. Clinical studies have shown that short or intermittent dosing of PTH 1-34 has minimal adverse effects, while long-term dosing (over two years) has been linked to de novo osteoarthritis and bone deformation. Currently PTH therapy is only approved in the treatment of post-menopausal osteoporosis, however it is also proven to have effects in treating osteoarthritis, bone tumours and bone fractures. If the patient undergoing therapy is closely monitored, the major pitfalls are very unlikely to take place, thus it is highly recommended that patients be closely monitored by a medical practitioner.
[Mh] Termos MeSH primário: Doenças Ósseas/tratamento farmacológico
Hormônio Paratireóideo/efeitos adversos
Hormônio Paratireóideo/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Conservadores da Densidade Óssea/uso terapêutico
Difosfonatos/uso terapêutico
Seres Humanos
Hormônio Paratireóideo/fisiologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Diphosphonates); 0 (Parathyroid Hormone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6008


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[PMID]:28450657
[Au] Autor:Hendarto H; Pramono LA; Harbuwono DS; Yunir E; Subekti I
[Ad] Endereço:Department of Internal Medicine, Faculty of Medicine and Health Science, Syarif Hidayatullah Islamic State University (UIN), Jakarta, Indonesia. hari.hendarto@uinjkt.ac.id.
[Ti] Título:Parathyroid Adenoma in a Young Female Presenting Multiple Fractures and Postoperative Hungry Bone Syndrome.
[So] Source:Acta Med Indones;49(1):69-73, 2017 Jan.
[Is] ISSN:0125-9326
[Cp] País de publicação:Indonesia
[La] Idioma:eng
[Ab] Resumo:A young 18-year-old female patient with general bone pain and history of multiple fractures brought her to our medical attention. Laboratory work showed hypercalcemia and high parathyroid hormone levels in the blood. Radiograph imaging revealed severe scoliosis with multiple vertebrae fractures with decreased bone mineral density. Sestamibi showed parathyroid adenoma. This case emphasizes the importance of maintaining a primary hyperparathyroidism as a differential diagnosis when a young patient presents with a multiple pathologic fractures history.
[Mh] Termos MeSH primário: Adenoma/diagnóstico por imagem
Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/diagnóstico por imagem
Escoliose/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adenoma/cirurgia
Adolescente
Densidade Óssea
Cálcio/sangue
Diagnóstico Diferencial
Feminino
Fraturas Múltiplas/diagnóstico
Seres Humanos
Hipercalcemia/etiologia
Dor/etiologia
Neoplasias das Paratireoides/cirurgia
Radiografia
Tecnécio Tc 99m Sestamibi
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Parathyroid Hormone); 971Z4W1S09 (Technetium Tc 99m Sestamibi); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29177267
[Au] Autor:Mazokopakis E; Papadomanolaki M; Skarakis SN; Tsekouras K
[Ad] Endereço:Department of Internal Medicine, Naval Hospital of Crete, Souda 73 200, Chania, Crete, Greece. emazokopakis@yahoo.gr.
[Ti] Título:Primary and secondary hyperparathyroidism among vitamin D deficient Hashimoto's thyroiditis patients and the need for a parathyroid scan.
[So] Source:Hell J Nucl Med;20(3):258-259, 2017 Sep-Dec.
[Is] ISSN:1790-5427
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:The patients with Hashimoto thyroiditis must be investigated mainly for secondary hyperparathyroidism due to vitamin D deficiency/insufficiency. Parathyroid scintigraphy has no place in the diagnosis of primary, secondary or tertiary hyperparathyroidism or in the decision for surgical treatment. Parathyroid scintigraphy is a useful preoperative technique for the localization of the pathological parathyroid glands.
[Mh] Termos MeSH primário: Doença de Hashimoto/sangue
Doença de Hashimoto/diagnóstico por imagem
Hiperparatireoidismo/sangue
Hiperparatireoidismo/diagnóstico por imagem
Cintilografia/métodos
Deficiência de Vitamina D/sangue
Vitamina D/sangue
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Diagnóstico Diferencial
Feminino
Seres Humanos
Masculino
Glândulas Paratireoides/diagnóstico por imagem
Hormônio Paratireóideo/sangue
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Deficiência de Vitamina D/diagnóstico por imagem
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Biomarkers); 0 (Parathyroid Hormone); 1406-16-2 (Vitamin D)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1967/s002449910613


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[PMID]:29352112
[Au] Autor:Furuya M; Kikuta J; Fujimori S; Seno S; Maeda H; Shirazaki M; Uenaka M; Mizuno H; Iwamoto Y; Morimoto A; Hashimoto K; Ito T; Isogai Y; Kashii M; Kaito T; Ohba S; Chung UI; Lichtler AC; Kikuchi K; Matsuda H; Yoshikawa H; Ishii M
[Ad] Endereço:Department of Immunology and Cell Biology, Graduate School of Medicine & Frontier Biosciences, Osaka University, Osaka, 565-0871, Japan.
[Ti] Título:Direct cell-cell contact between mature osteoblasts and osteoclasts dynamically controls their functions in vivo.
[So] Source:Nat Commun;9(1):300, 2018 01 19.
[Is] ISSN:2041-1723
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Bone homeostasis is regulated by communication between bone-forming mature osteoblasts (mOBs) and bone-resorptive mature osteoclasts (mOCs). However, the spatial-temporal relationship and mode of interaction in vivo remain elusive. Here we show, by using an intravital imaging technique, that mOB and mOC functions are regulated via direct cell-cell contact between these cell types. The mOBs and mOCs mainly occupy discrete territories in the steady state, although direct cell-cell contact is detected in spatiotemporally limited areas. In addition, a pH-sensing fluorescence probe reveals that mOCs secrete protons for bone resorption when they are not in contact with mOBs, whereas mOCs contacting mOBs are non-resorptive, suggesting that mOBs can inhibit bone resorption by direct contact. Intermittent administration of parathyroid hormone causes bone anabolic effects, which lead to a mixed distribution of mOBs and mOCs, and increase cell-cell contact. This study reveals spatiotemporal intercellular interactions between mOBs and mOCs affecting bone homeostasis in vivo.
[Mh] Termos MeSH primário: Reabsorção Óssea/diagnóstico por imagem
Comunicação Celular/fisiologia
Osteoblastos/citologia
Osteoclastos/citologia
Osteogênese/fisiologia
[Mh] Termos MeSH secundário: Animais
Diferenciação Celular
Feminino
Corantes Fluorescentes/química
Expressão Gênica
Genes Reporter
Proteínas de Fluorescência Verde/genética
Proteínas de Fluorescência Verde/metabolismo
Homeostase/fisiologia
Concentração de Íons de Hidrogênio
Microscopia Intravital/métodos
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Osteoblastos/efeitos dos fármacos
Osteoblastos/fisiologia
Osteoclastos/efeitos dos fármacos
Osteoclastos/fisiologia
Hormônio Paratireóideo/farmacologia
Cultura Primária de Células
Crânio/citologia
Crânio/diagnóstico por imagem
Crânio/efeitos dos fármacos
Crânio/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fluorescent Dyes); 0 (Parathyroid Hormone); 0 (enhanced green fluorescent protein); 147336-22-9 (Green Fluorescent Proteins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1038/s41467-017-02541-w


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[PMID]:29384970
[Au] Autor:Lou S; Wang L; Wang Y; Jiang Y; Liu J; Wang Y
[Ad] Endereço:Department of Spine Surgery.
[Ti] Título:Combination therapy of anabolic and nonbisphosphonates antiresorptive agents for the treatment of osteoporosis: A meta-analysis.
[So] Source:Medicine (Baltimore);96(52):e9534, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: According to the mechanisms of action, combination therapy of anabolic and antiresorptive agents may produce more effect for the treatment of osteoporosis. However, the combination therapy of anabolic agents and bisphosphonates reports no benefit and even reduced the anabolic effects of anabolic agents. This study aims to assess the effect of combination therapy of anabolic and nonbisphosphonates antiresorptive agents in adults with osteoporosis. METHODS: Medline, EMBASE, and Cochrane Library were searched from January 1, 1980 to November 1, 2017 for randomized controlled trials (RCTs) of adults with osteoporosis treated in combination therapy of anabolic and nonbisphosphonates antiresorptive agents compared with monotherapy of either agent alone. The primary outcome was the incidence of fractures. The secondary outcomes were the bone mineral density (BMD) changes at lumbar spine and total hip. Continuous outcomes were expressed as standardized mean difference (SMD) and 95% confidence interval (CI), while dichotomous outcomes were expressed as risk ratio (RR) and 95% CI. The meta-analysis was performed using a random-effects model. I statistic (I > 50% as a threshold indicates significant heterogeneity) was used to assess the heterogeneity. RESULTS: A total of 10 trials with a total of 1042 patients were included. The pooled results showed that the combination therapy demonstrated a significant advantage over a monotherapy in the BMD improvement at the lumbar spine (SMD 1.18; 95% CI, 0.63 to 1.72; I = 93%) and the total hip (SMD 0.89; 95% CI, 0.48 to 1.29; I = 88%) and further reduce the fracture risk (RR, 0.45; 95%CI, 0.21 to 0.94; I = 0%). CONCLUSIONS: Low-to-moderate-quality evidence shows that the combination therapy of anabolic and nonbisphosphonates antiresorptive agents is superior to monotherapy in improving the BMD and reducing the fracture risk. However, further high methodological quality studies are needed to determine the antifracture efficacy, cost-effectiveness and safety of this strategy of combination therapy.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Fraturas Ósseas/prevenção & controle
Osteoporose/tratamento farmacológico
[Mh] Termos MeSH secundário: Densidade Óssea/efeitos dos fármacos
Conservadores da Densidade Óssea/administração & dosagem
Difosfonatos/uso terapêutico
Quimioterapia Combinada
Seres Humanos
Hormônio Paratireóideo/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Teriparatida/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Diphosphonates); 0 (Parathyroid Hormone); 10T9CSU89I (Teriparatide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009534


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[PMID]:29338022
[Au] Autor:Schreiber PW; Bischoff-Ferrari HA; Boggian K; Bonani M; van Delden C; Enriquez N; Fehr T; Garzoni C; Hirsch HH; Hirzel C; Manuel O; Meylan P; Saleh L; Weisser M; Mueller NJ; Swiss Transplant Cohort Study (STCS)
[Ad] Endereço:University Hospital Zurich and University Zurich, Division of Infectious Diseases and Hospital Epidemiology, Zurich, Switzerland.
[Ti] Título:Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.
[So] Source:PLoS One;13(1):e0191167, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; P<0.001) and median intact parathyroid hormone levels decreased by 68.4% (from 208.7 to 66.0 ng/l; P<0.001). Median ß-Crosslaps (CTx) and total procollagen type 1 amino-terminal propeptide (P1NP) decreased by 65.1% (from 1.32 to 0.46ng/ml; P<0.001) and 60.6% (from 158.2 to 62.3ng/ml; P<0.001), respectively. Kidney recipients with incident fractures had significantly lower levels of 1, 25-(OH)2 vitamin D at time of transplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.
[Mh] Termos MeSH primário: Osso e Ossos/metabolismo
Transplante de Rim
Transplante de Fígado
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Densidade Óssea
Remodelação Óssea/fisiologia
Colágeno Tipo I/sangue
Feminino
Fraturas Ósseas/etiologia
Taxa de Filtração Glomerular
Seres Humanos
Transplante de Rim/efeitos adversos
Transplante de Fígado/efeitos adversos
Masculino
Meia-Idade
Hormônio Paratireóideo/sangue
Fragmentos de Peptídeos/sangue
Peptídeos/sangue
Fosfatos/sangue
Pró-Colágeno/sangue
Estudos Prospectivos
Vitamina D/análogos & derivados
Vitamina D/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers); 0 (Collagen Type I); 0 (PTH protein, human); 0 (Parathyroid Hormone); 0 (Peptide Fragments); 0 (Peptides); 0 (Phosphates); 0 (Procollagen); 0 (collagen type I trimeric cross-linked peptide); 0 (procollagen Type I N-terminal peptide); 1406-16-2 (Vitamin D); 64719-49-9 (25-hydroxyvitamin D); 66772-14-3 (1,25-dihydroxyvitamin D)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191167


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[PMID]:29037849
[Au] Autor:Li Q; Zhao X; Wang S; Zhou Z
[Ad] Endereço:College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu 210095, China.
[Ti] Título:Letrozole induced low estrogen levels affected the expressions of duodenal and renal calcium-processing gene in laying hens.
[So] Source:Gen Comp Endocrinol;255:49-55, 2018 Jan 01.
[Is] ISSN:1095-6840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Estrogen regulates the calcium homeostasis in hens, but the mechanisms involved are still unclear fully. In this study, we investigated whether letrozole (LZ) induced low estrogen levels affected the calcium absorption and transport in layers. In the duodenum, we observed a significant decrease of mRNA expressions of Calbindin-28k (CaBP-28k) and plasma membrane Ca -ATPase (PMCA 1b) while CaBP-28k protein expression was declined in birds with LZ treatment, and the mRNA levels of duodenal transient receptor potential vanilloid 6 (TRPV6) and Na /Ca exchanger 1 (NCX1) were not affected. Interestingly, we observed the different changes in the kidney. The renal mRNA expressions of TRPV6 and NCX1 were unregulated while the PMCA1b was down-regulated in low estrogen layers, however, the CaBP-28k gene and protein expressions were no changed in the kidney. Furthermore, it showed that the duodenal estradiol receptor 2 (ESR2) transcripts rather than parathyroid hormone 1 receptor (PTH1R) and calcitonin receptor (CALCR) played key roles to down-regulate calcium transport in LZ-treated birds. In conclusion, CaBP-28k, PMCA 1b and ESR2 genes in the duodenum may be primary targets for estrogen regulation in order to control calcium homeostasis in hens.
[Mh] Termos MeSH primário: Cálcio/metabolismo
Galinhas/genética
Duodeno/metabolismo
Estrogênios/metabolismo
Regulação da Expressão Gênica/efeitos dos fármacos
Rim/metabolismo
Nitrilos/farmacologia
Triazóis/farmacologia
[Mh] Termos MeSH secundário: Animais
Cálcio/sangue
Proteínas de Ligação ao Cálcio/metabolismo
Galinhas/sangue
Galinhas/metabolismo
Duodeno/efeitos dos fármacos
Estrogênios/sangue
Feminino
Rim/efeitos dos fármacos
Hormônio Paratireóideo/sangue
RNA Mensageiro/genética
RNA Mensageiro/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcium-Binding Proteins); 0 (Estrogens); 0 (Nitriles); 0 (Parathyroid Hormone); 0 (RNA, Messenger); 0 (Triazoles); 7LKK855W8I (letrozole); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE


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[PMID]:29341554
[Au] Autor:Tesic-Rajkovic S; Radovanovic-Dinic B; Mitic B; Dinic-Radovic V; Jovanovic M
[Ti] Título:Hyperparathyroidism as a cause of recurrent acute pancreatitis: A case report.
[So] Source:Vojnosanit Pregl;73(11):1064-7, 2016 Nov.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: One of the more uncommon etiological factors responsible for the development of acute pancreatitis (AP) is hypercalcemia. Hyperparathyroidism (HPT), as a cause of hypercalcemia, is responsible for 1.5­13% of AP according to a number of studies. A mechanism of the development of AP in hyperparathyroidism is still unclear. Case report: We presented a 47-year-old female patient, who had five episodes of AP in total before the etiological factors were finally determined. The patient had certain comorbidities which were considered to be potential causes of AP. She had chronic renal insufficiency (she was on a regular hemodialysis program), systemic lupus erythematosus and mioma uteri. She used to regularly take an antiepileptic drug (combination of sodium valproate and valproic acid). During the fifth episode of AP, the serum calcium level was for the first time elevated to twice the normal value. Level of parathyroid hormone was several times higher. A static scintigraphy found hyperplasia or hyperfunctional adenoma of the right inferior and superior parathyroid glands. Abdominal multislice computed tomography (MSCT) scan verified the enlargement of the entire pancreas, as well as the presence of heterogeneous structures with diffuse amorphous calcifications. The lytic lesions in the pelvic bones could be seen in both sides. Parathyroidectomy was being postponed by an endocrine surgeon because of the poor overall condition of the patient. In the next period the patient had five more episodes of AP. The condition was significantly contributed by increasingly more frequent and longer episodes of metrorrhagia. Despite all therapeutic measures that were taken, systemic inflammatory response syndrome (SIRS) developed, and fatal outcome occurred. Conclusion: In case of recurrent pancreatitis, hyperparathyroidism is to be considered even if a significant elevation of serum calcium is not present. This is especially the case for patients with chronic renal insufficiency or impaired vitamin D metabolism, who have a higher risk of secondary hyperthyroidism.
[Mh] Termos MeSH primário: Hipercalcemia/etiologia
Hiperparatireoidismo/complicações
Pancreatite/etiologia
[Mh] Termos MeSH secundário: Doença Aguda
Biomarcadores/sangue
Cálcio/sangue
Evolução Fatal
Feminino
Seres Humanos
Hipercalcemia/sangue
Hipercalcemia/diagnóstico
Hipercalcemia/terapia
Hiperparatireoidismo/sangue
Hiperparatireoidismo/diagnóstico por imagem
Hiperparatireoidismo/terapia
Meia-Idade
Tomografia Computadorizada Multidetectores
Pancreatite/sangue
Pancreatite/diagnóstico por imagem
Pancreatite/terapia
Hormônio Paratireóideo/sangue
Cintilografia
Recidiva
Fatores de Risco
Síndrome de Resposta Inflamatória Sistêmica/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (PTH protein, human); 0 (Parathyroid Hormone); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150210121T


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[PMID]:29309106
[Au] Autor:Poskurica M; Poskurica M; Petrovic D
[Ti] Título:Secondary hyperparathyroidism in chronic renal disease - etiopathogenesis, diagnosis and treatment.
[So] Source:Vojnosanit Pregl;73(4):376-81, 2016 Apr.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Mh] Termos MeSH primário: Hiperparatireoidismo Secundário/etiologia
Insuficiência Renal Crônica/complicações
[Mh] Termos MeSH secundário: Seres Humanos
Hiperparatireoidismo Secundário/diagnóstico
Hiperparatireoidismo Secundário/tratamento farmacológico
Hiperparatireoidismo Secundário/fisiopatologia
Hormônio Paratireóideo/biossíntese
Hormônio Paratireóideo/secreção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Parathyroid Hormone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141218024P



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