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Incidence,risk factors and survival outcomes of post-transplant tertiary hyperparathyroidism in kidney recipients 认领 引用
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作者 Shmuel Hanson Jorge Menendez Lorenzo +3 位作者 Chukwuma Austin Chukwu Anirudh Rao Rachel Middleton Philip A Kalra 《World Journal of Transplantation》 2026年第1期153-166,共14页
BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp... BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival. 展开更多
关键词 Post-transplant tertiary hyperparathyroidism Kidney transplantation Parathyroid hormone Parathyroidectomy Calcimimetics Graft survival Risk factors Mineral bone disorder Fibroblast growth factor 23 Treatment outcomes
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Importance of understanding a diagnostic-treatment algorithm for primary hyperparathyroidism-induced acute pancreatitis during pregnancy 认领 引用
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作者 Kenya Kamimura Shuji Terai 《World Journal of Gastroenterology》 SCIE CAS 2025年第18期134-138,共5页
In this article,we have commented on the article by Augustin et al.The authors presented a systematic review of the diagnosis,treatment,and outcomes of primary hyperparathyroidism-induced acute pancreatitis in pregnan... In this article,we have commented on the article by Augustin et al.The authors presented a systematic review of the diagnosis,treatment,and outcomes of primary hyperparathyroidism-induced acute pancreatitis in pregnant women.Since acute pancreatitis during pregnancy could cause maternal as well as fetal adverse outcomes,understanding this pathology is essential.Although there are various etiologies of acute pancreatitis during pregnancy,primary hyperparathyroidism is one of the causes that complicate hypercalcemia.Along with conventional treatment for acute pancreatitis,parathyroidectomy can effectively normalize calcium levels and improve acute pancreatitis.Augustin et al have provided vital information that can enable physicians to understand and treat hyperparathyroidism-induced acute pancreatitis in pregnant women,which could contribute to better maternal and fetal outcomes.In addition,since primary hyperparathyroidism is associated with multiple endocrine neoplasia,further consideration regarding screening for multiple endocrine neoplasia might lead to better prognoses. 展开更多
关键词 Primary hyperparathyroidism Acute pancreatitis Pregnancy Multiple endocrine neoplasia Hyperparathyroidism-induced acute pancreatitis Multiple endocrine neoplasia type 1
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Reversible dilated cardiomyopathy caused by primary hyperparathyroidism:A case report 认领 引用
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作者 Wei Jiang Yu-Zhi Qiu +6 位作者 Hu-Tao Xi Hui-Hui Ma Xin Wu Xiao-Mei Yuan Wen-Yan Wang Hong Kong Xiao-Ping Li 《World Journal of Cardiology》 2025年第5期98-106,共9页
BACKGROUND Dilated cardiomyopathy(DCM)is a common cause of systolic heart failure,and is the most prevalent type of non-ischemic cardiomyopathy.Primary hyperparathyroidism(PHPT)is characterized by hypercalcemia and ex... BACKGROUND Dilated cardiomyopathy(DCM)is a common cause of systolic heart failure,and is the most prevalent type of non-ischemic cardiomyopathy.Primary hyperparathyroidism(PHPT)is characterized by hypercalcemia and excessive secretion of parathyroid hormone(PTH).Generally,PHPT is asymptomatic and is incidentally identified during routine laboratory assessments.CASE SUMMARY This case report details a 52-year-old man diagnosed with DCM and refractory hypercalcemia,who presented with clinical manifestations including dyspnea,recurrent anorexia,and abdominal distention.Laboratory investigations indicated an elevated serum PTH level,and the sestamibi scan suggested the presence of a parathyroid adenoma.Hence,the patient underwent a parathyroidectomy,which pathologically confirmed the diagnosis of a parathyroid adenoma.Postoperatively,the patient's hypercalcemia was corrected,the dimensions of the cardiac chambers were reduced,and there was a marked improvement in cardiac function.CONCLUSION Our findings emphasize the importance of PTH assessment in patients with DCM and concurrent hypercalcemia. 展开更多
关键词 Dilated cardiomyopathy Primary hyperparathyroidism Hypercalcemia Parathyroid hormone Parathyroid adenoma Heart failure Chronic kidney disease Case report
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Persistent challenges in the diagnosis of acute pancreatitis due to primary hyperparathyroidism during pregnancy 认领 引用
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作者 Thang Viet Luong Linh Duy Le +1 位作者 Nam Van Duc Nguyen Hai Nguyen Ngoc Dang 《World Journal of Gastroenterology》 SCIE CAS 2025年第7期1-9,共9页
In this manuscript,we provide critical commentary on the systematic review by Augustin et al,which investigated acute pancreatitis induced by primary hyperparathyroidism during pregnancy.Although this is an infrequent... In this manuscript,we provide critical commentary on the systematic review by Augustin et al,which investigated acute pancreatitis induced by primary hyperparathyroidism during pregnancy.Although this is an infrequent complication,it poses severe risks to both maternal and fetal health.Due to its infrequent occurrence in clinical practice,this review is based on an analysis of individual case reports over the past 55 years.While this is not the first study to utilize this sampling method for primary hyperparathyroidism-induced acute pancreatitis,it is unique in that it has a sufficiently large sample size with statistically significant results.Our discussion focuses on the diagnostic challenges associated with this condition,which are grounded in the mechanisms of parathyroid hormone secretion and variations in serum calcium levels.We also address the limitations of the current review and suggest potential strategies to increase diagnostic accuracy and improve health outcomes for both mothers and fetuses during pregnancy. 展开更多
关键词 Primary hyperparathyroidism Acute pancreatitis Pregnancy Diagnostic algorithm Parathyroid hormone Systematic review
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Recurrent acute pancreatitis and primary hyperparathyroidism in patients presenting to the emergency department:Diagnostic challenges 认领 引用
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作者 Faruk Danış Emre Kudu 《World Journal of Clinical Cases》 2025年第17期1-6,共6页
We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis,a rare clinical condition in pediatric patients presenting to the emergency department.As... We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis,a rare clinical condition in pediatric patients presenting to the emergency department.As emergency medicine clinicians,we frequently encounter diverse and complex cases,and such rare conditions pose significant challenges in the diagnostic process.This article will discuss the management and diagnostic approach of such cases encountered in the emergency department. 展开更多
关键词 Pancreatitis Recurrent pancreatitis Primary hyperparathyroidism Hypercalcemia Emergency medicine Pediatric pancreatitis Parathyroid adenoma Abdominal pain Multidisciplinary approach Imaging techniques
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Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism in juvenile patient 认领 引用
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作者 Milena M Lackovic Bojan D Joksimovic +2 位作者 Jelena C Babovic Esma R Isenovic Zoran M Gluvic 《World Journal of Clinical Cases》 2025年第17期70-73,共4页
Acute pancreatitis recurrence should always alert clinicians to primary hyperparathyroidism,especially in younger patients and those with a hereditary condition.When parathyroid abnormalities are adequately recognized... Acute pancreatitis recurrence should always alert clinicians to primary hyperparathyroidism,especially in younger patients and those with a hereditary condition.When parathyroid abnormalities are adequately recognized and addressed,more recurrent attacks of acute pancreatitis are unlikely to occur. 展开更多
关键词 Acute pancreatitis Parathyroid hormone Primary hyperparathyroidism Ultrasound Scintigraphy Dual-energy X-ray absorptiometry
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Clinical Evaluation of the Efficacy of Calcitriol Combined with Low-Calcium Dialysate in the Treatment of Secondary Hyperparathyroidism 认领 引用
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作者 Peipei Wu Yuping Qin 《Journal of Clinical and Nursing Research》 2025年第6期299-304,共6页
Objective:To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism(SHPT).Methods:Eighty-nine patients with SHPT who visited t... Objective:To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism(SHPT).Methods:Eighty-nine patients with SHPT who visited the hospital from February 2023 to February 2025 were included in the study.They were divided into an observation group(n=45)and a control group(n=44)using a random number table method.The observation group received calcitriol combined with low-calcium dialysate treatment,while the control group received calcitriol combined with conventional dialysate treatment.The differences in intact parathyroid hormone(iPTH),calcium and phosphorus metabolism indicators,renal function indicators,and adverse reaction rates were compared and evaluated before and after treatment between the two groups.Results:Compared with before treatment,the levels of iPTH,serum phosphorus,and calcium-phosphorus product were significantly reduced in both groups after treatment,and the observation group had lower levels than the control group(P0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The combination of calcitriol and low-calcium dialysate for the treatment of SHPT can effectively reduce the levels of iPTH,serum phosphorus,and calcium-phosphorus product,increase blood calcium levels,and has a low incidence of adverse reactions.It has no significant effect on renal function and is a safe and effective treatment method. 展开更多
关键词 Calcitriol Hemodialysis Low-calcium dialysate Secondary hyperparathyroidism Clinical efficacy
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Secondary hyperparathyroidism in patients undergoing maintenance hemodialysis combined with hemoperfusion Cost-effectiveness analysis of efficacy 认领 引用
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作者 Liu Qian Hu Xiu +2 位作者 Wu Xiaolong Liu Minglin Song Bin 《Science International Innovative Medicine》 2025年第2期35-40,共6页
Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodial... Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 195 patients with MHD and SHPT at Deyang People's Hospital from April 2024 to April 2025 were enrolled.Patients were randomly assigned to a control group receiving standard HD treatment and an experimental group receiving HD combined with HP therapy.The experimental group underwent 1 year of observation(97 cases in the experimental group,98 cases in the control group).During treatment,changes in parathyroid hormone(PTH),serum calcium,serum phosphorus,and inflammatory factors were monitored,along with analysis of treatment-related economic benefits and safety.Results:The experimental group demonstrated significantly better reductions in PTH,serum phosphorus,and inflammatory factors compared to the control group(P<0.05).Although the total treatment cost was slightly higher,the unit cost per therapeutic effect was lower,resulting in a superior cost-effectiveness ratio.Conclusion:Combined HD and HP therapy can significantly improve SHPT-related indicators in MHD patients,demonstrating safety,controllability,and high cost-effectiveness,making it a clinically applicable and recommended treatment option. 展开更多
关键词 maintenance hemodialysis secondary hyperparathyroidism hemoperfusion cost-effect-iveness analysis
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Deep learning-based localization of preoperative parathyroid glands in secondary hyperparathyroidism patients using dual-phase unenhanced and contrast-enhanced computed tomography data 认领 引用
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作者 Fuqiang Li Yao Zhang +2 位作者 Yijing Wen Xiaomei Wang Hao Yang 《Intelligent Oncology》 2025年第4期299-307,共9页
Introduction:Accurate preoperative localization of parathyroid glands(PGs)is crucial for patients with secondary hyperparathyroidism scheduled for parathyroidectomy.However,despite its importance,localization remains ... Introduction:Accurate preoperative localization of parathyroid glands(PGs)is crucial for patients with secondary hyperparathyroidism scheduled for parathyroidectomy.However,despite its importance,localization remains challenging since current preoperative imaging modalities for PG localization vary in sensitivity and accessibility.Materials and methods:In this study,we developed a deep learning model for PG identification using a dual-phase computed tomography(CT)dataset,including unenhanced CT and contrast-enhanced(CE)CT data,and validated the model’s sensitivity in clinical application.A retrospective study was conducted using 94 CT images obtained from 47 patients(one plain CT image and one CE CT image per patient).The data were randomly assigned to a training set(38 cases,76 CT images)and a test set(9 cases,18 CT images)based on per-patient splits.A three-dimensional U-Net model was trained using the training set and then validated using the test set.An analysis was conducted to compare the model’s and clinicians’sensitivity in detecting PGs based on various imaging modalities.An error analysis and an intermodal imaging complementarity analysis were performed to provide references for subsequent model enhancement and application.Results:The dual-phase CT model identified PGs with a diagnostic sensitivity of 94.44%.This was significantly higher than the sensitivity achieved by clinicians using ultrasonography(61.11%,P=0.0013)and CT(72.22%,P=0.0238).Additionally,the sensitivity achieved using the dual-phase CT model was comparable to that achieved using technetium-99m-methoxyisobutylisonitrile single-photon emission CT/CT(86.11%,P=0.429).We also found that combining predictions from this model with other imaging modalities further improved the PG detection rates.Conclusions:The study findings suggest that using a deep learning model with plain and CE CT data could improve PG identification prior to thyroidectomy or parathyroidectomy. 展开更多
关键词 Preoperative localization Deep learning Dual-phase CT Parathyroid glands Secondary hyperparathyroidism
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Paricalcitol in hemodialysis patients with secondary hyperparathyroidism and its potential benefits 认领 引用 被引量：13
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作者 Xiu Chen Feng Zhao +4 位作者 Wei-Juan Pan Jia-Mei Di Wei-Nan Xie Ling Yuan Zhi Liu 《World Journal of Clinical Cases》 SCIE 2021年第33期10172-10179,共8页
BACKGROUND Secondary hyperparathyroidism(SHPT)is a common complication in patients with end-stage renal disease and it is also common in hemodialysis patients.SHPT can increase bone fragility and calcification of bloo... BACKGROUND Secondary hyperparathyroidism(SHPT)is a common complication in patients with end-stage renal disease and it is also common in hemodialysis patients.SHPT can increase bone fragility and calcification of blood vessels and soft tissues,which greatly increases the risk of death.AIM To discuss the outcome,safety and other potential benefits of paricalcitol injection in hemodialysis patients with SHPT.METHODS We recruited 40 patients who received hemodialysis at our hospital for chronic renal failure with SHPT between March and December 2019.They received paricalcitol injection for 24 wk(starting dose,0.06–0.08μg/kg),three times per week.They were followed up at the baseline(week 0),week 4,week 12 and week 24.The primary outcome indicator was the percentage of patients with a>30%decrease in intact parathyroid hormone(iPTH)levels at week 24 compared with the baseline.The secondary outcome indicators included percentage decrease in iPTH levels at week 24,standard-reaching rate of iPTH(percentage of patients with iPTH down to 130–585 pg/mL),changes in serum levels of calcium(Ca),phosphate(P),Ca×P product,alkaline phosphatase(ALP),creatinine(Cre),hemoglobin(Hb),and C-reactive protein(CRP),and incidence of adverse events(AEs).RESULTS After 24 wk of treatment,iPTH levels decreased significantly(598.88±381.29 pg/mL vs 888.84±376.88 pg/mL,P0.05).After 24 wk of treatment,serum P levels decreased compared with the baseline(1.91±0.40 mmol/L vs 2.16±0.66 mmol/L)(t=2.830,P<0.05).Ca×P product decreased significantly compared with the baseline(56.38±13.22 mg2/dL2 vs 63.97±20.30 mg2/dL2)(t=2.717,P<0.05).No serious adverse events occurred.CONCLUSION Paricalcitol was a safe and effective treatment for hemodialysis patients with SHPT.It decreased serum levels of iPTH,ALP and P and maintained stability of serum Ca levels. 展开更多
关键词 Paricalcitol Hemodialysis Secondary hyperparathyroidism Drug efficacy Drug safety
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Primary Hyperparathyroidism:A Tale of Two Cities Revisited-New York and Shanghai 认领 引用 被引量：6
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作者 Jian-min Liu Natalie E. Cusano +9 位作者 Barbara C. Silva Lin Zhao Xiao-yan He Bei Tao Li-hao Sun Hong-yan Zhao Wen-wei Fan Megan E. Romano Guang Ning John P. Bilezikian 《Bone Research》 SCIE CAS 2013年第2期162-169,共8页
In the 1970s, with the advent of biochemical multichannel screening in the United States and other western countries, the clinical presentation of primary hyperparathyroidism （PHPT） changed from a symptomatic to an ... In the 1970s, with the advent of biochemical multichannel screening in the United States and other western countries, the clinical presentation of primary hyperparathyroidism （PHPT） changed from a symptomatic to an asymptomatic disorder. However, in Asian countries, like China, PHPT did not show this evolution, but rather continued to be a symptomatic disease with target organ involvement. In this paper, we revisit the clinical features of PHPT in New York and Shanghai, representative United States and Chinese cites, over the past decade. The questions we address are whether the disease evolved in China to a more asymptomatic one and, whether in the United States further changes are evident. The results indicate that while PHPT con- tinues to present primarily as an asymptomatic disease in the United States, a new phenotype characterized by normal serum calcium and high parathyroid hormone levels, normocalcemic PHPT, has emerged. Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China. However, most patients with PHPT in China still manifest classical symptoms, i.e. nephrolithiasis and fractures. A comparison of the two cohorts shows that Chinese patients with PHPT are younger, with higher serum calcium and PTH levels, and lower 25-hydroxyvitamin D levels than patients in New York. Normocalcemic PHPT has not yet been recognized in Shanghai. In summary, although the phenotypes of PHPT in both cities are evolving towards less evident disease, sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States. 展开更多
关键词 normocalcemic primay hyperparathyroidism asymptomatic symptomatic
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11C-Choline PET/CT in the Management of Primary Hyperparathyroidism 认领 引用
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作者 Maria R. Alvarez Rodrigo Arrangoiz +5 位作者 Miguel Á ngel Olarte Cecilia Carreras Maria M. Leó n S. Fernando Cordera 《International Journal of Otolaryngology and Head & Neck Surgery》 2020年第5期149-160,共12页
Primary hyperparathyroidism (PHPT) is a relative common medical problem caused by the inappropriate secretion of parathyroid hormone (PTH) by one or more parathyroid glands. The diagnosis is established by serum calci... Primary hyperparathyroidism (PHPT) is a relative common medical problem caused by the inappropriate secretion of parathyroid hormone (PTH) by one or more parathyroid glands. The diagnosis is established by serum calcium and PTH levels and once the diagnosis is established imaging studies help localize the hyperfunctioning adenoma in preparation for curative surgery. Until now, the imaging studies most commonly utilized in PHPT are ultrasonography and 99mTc-Sesta-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy. However, these studies often fail to localize the adenoma and inappropriately delay patient referral to a potentially curative surgery. We present the case of a 64-year-old female with symptomatic PHPT who had 3 negative 99mTc-Sestamibi Scans over a period of 5 years who eventually had a PET/CT with 11C-Choline that identified a right lower parathyroid adenoma. She underwent a right lower parathyroidectomy and had a successful outcome. We present a review the current imaging techniques used in the management of PHPT including 99mTc-Sesta-MIBI scintigraphy and its limitations and novel use of PET/CT with 11C-Choline and 18F-Choline in this disease and emphasize the fact that, according to current guidelines, failure to localize the adenoma should not delay referral for curative surgery. 展开更多
关键词 Primary Hyperparathyroidism Evaluation of Primary Hyperparathyroidism 11C-Choline 18F-Fluorocholine PET/CT Treatment of Primary Hyperparathyroidism
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Effect of calcium supplementation on severe hypocalcemia in patients with secondary hyperparathyroidism after total parathyroidectomy 认领 引用 被引量：5
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作者 Jun Liu Xue-Feng Fan +2 位作者 Meng Yang Lin-Ping Huang Ling Zhang 《World Journal of Clinical Cases》 SCIE 2022年第13期4033-4041,共9页
BACKGROUND Severe hypocalcemia(SH)is a dreaded complication of total parathyroidectomy(TPTX)without auto-transplantation.AIM To compare conventional and preventive calcium supplementation(CS)regimens in terms of SH oc... BACKGROUND Severe hypocalcemia(SH)is a dreaded complication of total parathyroidectomy(TPTX)without auto-transplantation.AIM To compare conventional and preventive calcium supplementation(CS)regimens in terms of SH occurrence after TPTX.METHODS This retrospective study included patients who underwent TPTX between January 2015 and May 2018 at the China-Japan Friendship Hospital.From January 2015 to May 2016,conventional CS was performed in patients who underwent TPTX,with calcium amounts adjusted according to postoperative serum calcium levels.From October 2016 to May 2018,preventive CS was performed according to preoperative alkaline phosphatase(ALP)levels.The patients were defined as lowrisk(ALP500 U/L)for SH.All preoperative blood samples were collected in the fasting state on the day before surgery.Postoperative blood samples were obtained at 6-7 AM from the first postoperative day.RESULTS A total of 271 patients were included.These patients were 47.7±11.1 years old,and 57.6%were male.Their mean body mass index(BMI)was 22.9±3.8 kg/m2.There were no significant differences in sex,age,BMI,preoperative ALP,serum calcium,serum phosphorus,calcium-phosphorus ratio,and intact parathyroid hormone(iPTH)between the two CS groups.Compared with conventional CS,preventive CS led to lower occurrence rates of hypocalcemia within 48 h(46.0%vs 74.5%,P<0.001)and SH(31.7%vs 64.1%,P<0.001).Multivariable analysis showed that preoperative iPTH levelsodds ratio(OR)=1.001,95%confidence interval(CI:1.000-1.001,P=0.009),preoperative ALP amounts(OR=1.002,95%CI:1.001-1.003,P=0.002),preoperative serum phosphorus levels(OR=8.729,95%CI:1.518-50.216,P=0.015)and preventive CS(OR=0.132,95%CI:0.067-0.261,P<0.001)were independently associated with SH.In patients with preoperative ALP≥500 U/L,only preventive CS(OR=0.147,95%CI:0.038-0.562.P=0.005)was independently associated with SH.CONCLUSION This study suggests that preventive CS could reduce the occurrence of SH,indicating its critical value for hypocalcemia after TPTX. 展开更多
关键词 End-stage renal disease Secondary hyperparathyroidism Parathyroidectomy Hypocalcemia Calcium supplementation
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Postsurgical Evaluation of Secondary Nephrogenic Hyperparathyroidism 认领 引用 被引量：3
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作者 Jiao-ping MI Zhen-peng LIAO +2 位作者 Xiao-feng PEI Hai-yu HONG Yun-ping FAN 《Current Medical Science》 SCIE CAS 2019年第2期259-264,共6页
Parathyroidectomy is useful for the treatment of secondary hyperparathyroidism(SHPT)caused by chronic renal failure.The following three types of parathyroidectomy can be performed:subtotal parathyroidectomy,total para... Parathyroidectomy is useful for the treatment of secondary hyperparathyroidism(SHPT)caused by chronic renal failure.The following three types of parathyroidectomy can be performed:subtotal parathyroidectomy,total parathyroidectomy and total parathyroidectomy plus autologous transplantation(tPTX+AT).Each of the three types of surgery has advantages and disadvantages.The present study retrospectively analyzed the efficacy of tPTX+AT for the treatment of SHPT over 1 year.Thirty-seven patients who were diagnosed with secondary nephrogenic hyperparathyroidism and treated with tPTX+AT were selected between September 2014 and October 2016 and followed up for 1 year.Their average age was 66.5±46.0 years,and the average time of dialysis was 48.1±8.2 months.The patients1 conditions,including the levels of intact parathyroid hormone(iPTH)and bone metabolism,were compared preoperatively and 1 and 7 days and 1,3,6 and 12 months after surgery.In addition,the postoperative complications,pathological data,SHPT recurrence and prognosis were examined.The results showed that the postoperative level of ostalgia and cutaneous pruritus significantly decreased in the patients.An inspection of the parathyroid tissues during the operation confimied the presence of parathyroid gland hyperplasia with no carcinoma detected?Three patients with hoarseness recovered within 1 month,and 1 patient with unilateral recurrent laryngeal nerve injury improved after 6 months of voice training.Conipared to the preoperative condition,the postoperative serum iPTH,serum calcium and serum phosphate levels were significantly decreased(P0.05).The ALP levels continuously decreased at 3,6 and 12 months(P<0.01).In conclusion,tPTX+AT significantly improves the quality of life and serum biomarker levels of these patients.The convenient surgical removal of the hyperplastic parathyroid gland for postoperative recurrence supports tPTX+AT as the recommended treatment for relevant patients. 展开更多
关键词 nephrogenic hyperparathyroidism parathyroidectomy transplantation,autologous
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Huge brown tumor of the rib in an unlocatable hyperparathyroidism patient with “self-recovered” serum calcium and parathyroid hormone: A case report 认领 引用 被引量：1
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作者 Wen-Da Wang Ning Zhang +1 位作者 Qiang Qu Xiao-Dong He 《World Journal of Clinical Cases》 SCIE 2019年第24期4321-4326,共6页
BACKGROUND The brown tumor is a kind of complication of hyperparathyroidism(HPT). The ultimate therapy usually is the resolution of HPT. We herein report an unlocatable HPT patient who received resection of a huge bro... BACKGROUND The brown tumor is a kind of complication of hyperparathyroidism(HPT). The ultimate therapy usually is the resolution of HPT. We herein report an unlocatable HPT patient who received resection of a huge brown tumor of the rib, and experienced "self-recovery" of serum calcium and parathyroid hormone.CASE SUMMARY A 34-year-old female patient who suffered from a gradually increasing mass of the left chest wall since 2007 came to our hospital for treatment. The patient had a history of serum Ca and parathyroid hormone(PTH) increasing since June 2015 and received zoledronic acid treatment for 17 mo. When she came to our hospital in November 2017 after discontinuing medical treatment for 3 mo, the serum Ca and PTH levels were within normal ranges. The patient had no imaging abnormalities of parathyroid ultrasound or 99 m Tc-methoxyisobutyl isonitrile.Enhanced computed tomography revealed a local soft tissue mass of 96 mm × 113 mm with bone erosion of the left 8 th rib, and the mass presented irregular enhancement with an unclear boundary between the mass and spleen. The mass was thought to likely be caused by HPT, but a malignancy could not be ruled out.Resection of the mass was performed, and the pathology proved that the mass was a brown tumor. A diagnosis of unlocatable HPT was considered. Since the serum Ca and PTH levels were both normal pre-and post-operation, the patient did not receive exploratory surgery for HPT, and received regular follow-up.CONCLUSION The huge brown tumor of the rib and "self-recovered" serum PTH and Ca levels are relatively rare in HPT patients. An exploratory operation may be deferred for these patients, and long-term follow-up should be performed. 展开更多
关键词 Brown tumor Hyperparathyroidism Unlocatable Self-recovered Resection Case report
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Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease 认领 引用 被引量：7
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作者 ZHENG Yi-xiong XU Shao-ming WANG Ping, CHEN Li 《Journal of Zhejiang University-SCIENCE B》 EI CAS 2007年第9期626-631,共6页
The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting... The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra-sonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of asso-ciated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients. 展开更多
关键词 Hyperparathyroidism Thyroid diseases Imaging diagnosis Surgical treatment
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Update on the current management of persistent and recurrent primary hyperparathyroidism after parathyroidectomy 认领 引用 被引量：1
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作者 Efstathios T Pavlidis Theodoros E Pavlidis 《World Journal of Clinical Cases》 SCIE 2023年第10期2213-2225,共13页
Primary hyperparathyroidism(pHPT)is the third most common endocrine disease.The surgical procedure aims for permanent cure,but recurrence has been reported in 4%-10%of pHPT patients.Preoperative localization imaging i... Primary hyperparathyroidism(pHPT)is the third most common endocrine disease.The surgical procedure aims for permanent cure,but recurrence has been reported in 4%-10%of pHPT patients.Preoperative localization imaging is highly valuable.It includes ultrasound,computed tomography(CT),single-photonemission CT,sestamibi scintigraphy and magnetic resonance imaging.The operation has been defined as successful when postoperative continuous eucalcemia exists for more than the first six months.Ongoing hypercalcemia during this period is defined as persistence,and recurrence is defined as hypercalcemia after six months of normocalcemia.Vitamin D is a crucial factor for a good outcome.Intraoperative parathyroid hormone(PTH)monitoring can safely predict the outcomes and should be suggested.PTH≤40 pg/mL or the traditional decrease≥50%from baseline minimizes the likelihood of persistence.Risk factors for persistence are hyperplasia and normal parathyroid tissue on histopathology.Risk factors for recurrence are cardiac history,obesity,endoscopic approach and low-volume center(at least 31 cases/year).Cases with double adenomas or four-gland hyperplasia have a greater likelihood of persistenceecurrence.A 6-mo calcium>9.7 mg/dL and eucalcemic parathyroid hormone elevation at 6 mo may be associated with recurrence necessitating long-term follow-up.18F-fluorocholine positron emission tomography and 4-dimensional CT in persistent and recurrent cases can be valuable before reoperation.With these novel advances in preoperative imaging and localization as well as intraoperative PTH measurement,the recurrence rate has dropped to 2.5%-5%.Sixmonth serum calcium≥9.8 mg/dL and parathyroid hormone≥80 pg/mL indicate a risk of recurrence.Negative sestamibi scintigraphy,diabetes and elevated osteocalcin levels are predictors of multiglandular disease,which brings an increased risk of persistence and recurrence.Bilateral neck exploration was considered the gold-standard diagnostic method.Minimally invasive parathyroidectomy and neck exploration are both effective surgical techniques.Multidisciplinary diagnostic and surgical management is required to prevent persistence and recurrence.Long-term follow-up,even up to 10 years,is necessary. 展开更多
关键词 Parathyroid hormone Minimally invasive parathyreoidectomy Hyperparathyroidism Primary Reoperation Persistent Recurrent hypercalcemia
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Diagnosis Performance of 99mTc-MIBI and Multimodality Imaging for Hyperparathyroidism 认领 引用 被引量：4
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作者 周俊 陆涤宇 +1 位作者 夏亮 程小杰 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2017年第4期582-586,共5页
This study aimed to examine the diagnosis performance of^（99m）Tc-methoxyisobutylisonitrisonitrile （^（99m）Tc-MIBI） and multimodality imaging [ultrasound, single-photon emission computed tomography/computed tomogr... This study aimed to examine the diagnosis performance of^（99m）Tc-methoxyisobutylisonitrisonitrile （^（99m）Tc-MIBI） and multimodality imaging [ultrasound, single-photon emission computed tomography/computed tomography（SPECT/CT）] for hyperparathyroidism（HPT）. From Nov. 2009 to Dec. 2015, clinical data of a total of 43 HPT patients（16 males and 27 females; 26–70 years old, average age： 51.60±10.66 years old） were retrospectively analyzed. Among them, 19 patients with primary hyperparathyroidism（PHPT） underwent ^（99m）Tc-MIBI planar imaging, 24 [15 with PHPT and 9 with secondary hyperparathyroidism（SHPT）] underwent SPECT/CT hybrid imaging, and 41（33 with PHPT and 8 with SHPT） had neck ultrasound imaging. Final diagnosis was determined by pathological examination after surgery. The positive rate was compared between different imaging modalities, and the correlation analysis was conducted between imaging results and lesion size or serum parathyroid hormone（PTH） level. The results showed that the total positive rates of^（99m）Tc-MIBI imaging, ultrasound, and the two combined imaging in the 43 HPT cases were 90.70%（39/43）, 58.54%（24/41）, and 100%（41/41）, respectively. According to lesion numbers, the positive rates were 79.10%（53/67）, 53.23%（33/62）, and 88.71%（55/62）, respectively. SPECT/CT hybrid images were positive in all the 24 patients who underwent this examination. The mean maximum diameters of the lesions in ^（99m）Tc-MIBI positive and negative patients were 1.96±0.95 cm and 1.36±0.67 cm respectively, with statistically significant difference noted（P=0.03）. The T/NT of ^（99m）Tc-MIBI imaging at the early phase was correlated positively with serum PTH level（r=0.40, P=0.01）. The T/NT of ^（99m）Tc-MIBI imaging at both the early phase and the delay phase was correlated positively with lesion size（r=0.51, and r=0.45, respectively; P〈0.01 for both）. It was concluded that ^（99m）Tc-MIBI imaging presents significant value for location diagnosis of HPT, especially when combined with SPECT/CT hybrid imaging or ultrasound. The ^（99m）Tc-MIBI uptake correlates positively with serum PTH level and lesion size. 展开更多
关键词 hyperparathyroidism 99mTc-methoxyisobutylisonitrisonitrile planar imaging SPECT/CT hybrid ultrasound
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Primary hyperparathyroidism in a woman with multiple tumors: A case report 认领 引用
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作者 Can-Can Hui Xue Zhang +1 位作者 Jian-Ran Sun Da-Tong Deng 《World Journal of Clinical Cases》 SCIE 2019年第19期3132-3137,共6页
BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocr... BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocrine neoplasm.We have reviewed the literature and found that it is rare for patients with hyperparathyroidism to have benign tumors with multiple organs at the same time.This report describes a patient with a PTA and four nonfunctional adenomas.CASE SUMMARY We report a case of primary hyperparathyroidism in a 39-year-old woman with multiple organ tumors.The patient was admitted to hospital because of hypercalcemia.Laboratory,imaging,and histological examinations confirmed a left parathyroid neoplasm.Right thyroid adenoma was discovered during hospitalization.She had a medical history of uterine fibroids,right benign mammary gland tumor,and meningioma.The patient recovered after surgical and conservative treatments.CONCLUSION Primary hyperparathyroidism with multiple organ tumors is uncommon,and further studies should be conducted to determine if there is genetic heterogeneity. 展开更多
关键词 Primary hyperparathyroidism Parathyroid neoplasm Thyroid adenoma Meningioma Breast neoplasm Case report
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ROLE OF 99Tc^m-SESTAMIBI DUAL-PHASE PARATHYROID SCINTIGRAPHY IN PREOPERATIVE LOCALIZATION IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM 认领 引用
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作者 李彪 张佳胤 +7 位作者 江旭峰 弋贵芝 张立颖 王超 管樑 李培勇 朱承谟 宁光 《Journal of Shanghai Second Medical University(Foreign Language Edition)》 2007年第2期133-136,共4页
Objective To evaluate the application of 99Tcm-sestamibi dual-phase parathyroid scintigraphy in the preoperative localization in patients with primary hyperparathyroidism and to compare the diagnostic efficacy of vari... Objective To evaluate the application of 99Tcm-sestamibi dual-phase parathyroid scintigraphy in the preoperative localization in patients with primary hyperparathyroidism and to compare the diagnostic efficacy of various imaging modalities. Methods Ninety-two consecutive patients, diagnosed as hyperparathyroidism and presented with hypercalcaemia as the predominant symptom, were included. All the patients underwent dual-phase parathyroid scintigraphy using 99Tcm-sestamibi and parathyroid ultrasound scan. Among them, 48 patients underwent parathyroid computed tomography (CT). All patients were referred for parathyroidectomy. Results 99Tcm-sestamibi dual-phase parathyroid scintigraphy revealed the diagnostic sensitivity of 76.5%, 80%, 75% and 33.3% for the subgroup of single adenomas, multiple adenomas, ectopic parathyroid and parathyroid hyperplasia respectively. The specificity was 100% for all leisons. 99Tcm-sestamibi dual-phase parathyroid scintigraphy was proved to be superior to the other imaging modalities (ultrasound and CT) in terms of the preoperative diagnostic accuracy. The lesion weight was found to be an underlying factor leading to the false negative result. Conclusion 99Tcm-sestamibi dual-phase parathyroid scintigraphy was found to have higher diagnostic accuracy in comparison with other imaging modalities and is recommended preoperatively in order to reduce the sugery time and unnecessary neck exploration. 展开更多
关键词 primary hyperparathyroidism scintigraphy sestamibi SPECT
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