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Negative sestamibi scan for primary hyperparathyroidism can mean no referral or surgery

BALTIMORE – In the treatment of primary hyperparathyroidism, clinical guidelines recommend using sestamibi scan for localizing adenoma, but increasingly endocrinologists are using sestamibi results...
Source: Clinical Endocrinology News - Category: Endocrinology Source Type: news

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Discussion: Evidence shows that a hyperfunctioning parathyroid gland may contribute to maintaining hyperaldosteronism in PA. This is based on in-vitro studies showing PTH increased aldosterone secretion from adrenocortical cells in a concentration dependent manner. Gene expression and immunohistochemistry studies show PTH receptors in aldosterone-producing adenomas and MR receptors in parathyroid cells, suggesting a bi-directional relationship. The significance of this case is in the potential for further understanding of the pathophysiology of common causes of secondary hypertension.
Source: Hypertension - Category: Cardiology Authors: Tags: Poster Abstract Presentations Source Type: research
AbstractSummaryAlthough bone disease and stone disease are the universally accepted classical manifestations of primary hyperparathyroidism, clinical parathyroid bone disease is rarely seen today in the United States (
Source: Endocrine - Category: Endocrinology Source Type: research
Nephrolithiasis is a common health problem across the globe with a prevalence of 15%–20%. Idiopathic hypercalciuria is the most common cause of nephrolithiasis, and calcium oxalate stones are the most common type of stones in idiopathic hypercalciuric patients. Calcium phosphatestones are frequently associated with other diseases such as renal tubular acidosis type 1, urinary tract infections, and hyperparathyroidism. Compared with flat abdominal flm and renal sonography, a noncontrast helical computed tomography scan of the abdomen is the diagnostic procedure of choice for detection of small and radiolucent kidney ...
Source: International Journal of Preventive Medicine - Category: International Medicine & Public Health Source Type: research
CONCLUSION Symptomatic hypercalcemia and high level of PTH without local PA should alert physicians to search for ectopic locations through imaging. VATS is a safe and effective minimally invasive procedure for the resection of ectopic mediastinal PA and it should be considered as the first line approach for resection of these ectopic tumors.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Abstract Introduction Involvement of the bone is common in primary hyperparathyroidism. The aim of the study was to assess bone turnover markers in response to surgery for primary hyperparathyroidism. Methods This was a retrospective study of patients diagnosed and treated for parathyroid disease between 2005 and 2012. Interventions studied were surgery and medical treatment. The main outcome measures studied were serum levels of calcium, intact parathyroid hormone (iPTH), bone-specific alkaline phosphatase, N-terminal cross-linking propeptide of type 1 procollagen (P1NP) and C-terminal cross-linking telopeptides ...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
This study of patients with primary hyperparathyroidism characterizes factors associated with missed parathyroid lesions on preoperative 4-dimensional computed tomographic scans and investigates patterns of commonly observed errors.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Abstract Accurate localization of parathyroid adenomas allows for minimally invasive parathyroidectomy. This results in a shorter length of stay and increased patient satisfaction. Preoperative Technetium (99mTc) sestamibi scans accurately localize parathyroid adenomas in 70 to 85 per cent of cases. If a patient has a negative scan, it is logical to believe that with a preoperative sestamibi injection, the gamma probe may fail to help find an adenoma. We hypothesized that the gamma probe would not be useful intraoperatively for patients with primary hyperparathyroidism (PHPTH) and a negative sestamibi scan. We ret...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
Herein we present the case of a male patient, 63 years old, melanoderma, complaining of swelling of the face with evolution of 4 years. On the extraoral examination, it was observed growth in the right hemimaxilla, nose wing lifting and in mouth, increase in local volume, obliterating the buccal sulcus. CT scan showed unilocular and multilocular injury circumscribed in the bone with ground glass appearance. After biopsy, the histopathologic examination revealed a presence of multinucleated giant cells in the stroma of fibrous connective tissue and trabeculae of immature bone, this, associated the presence of PTH at a conce...
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Tags: CPP - Clinical Poster Presentation Source Type: research
We describe a case of double parathyroid adenoma causing asymptomatic hypercalcemia. A presurgical technetium99m (Tc99m) sestamibi scan suggested an ipsilateral double adenoma in the left thyroid lobe. An intraoperative parathyroid hormone assay confirmed its successful removal. DISCUSSION: Although double adenomas are not yet widely acknowledged, presurgical imaging and nuclear scans can help to localize multiple lesions, and intraoperative parathyroid hormone assays can confirm the diagnosis and cure. PMID: 28746021 [PubMed - in process]
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
ffler A Abstract A 28-year-old Syrian refugee presented with right-sided knee pain and progressive deterioration of the general condition over the past months. Laboratory diagnostics revealed severe hypercalcemia due to primary hyperparathyroidism, and computed tomography (CT) scanning demonstrated disseminated osteolytic lesions throughout the skeleton. Histologically, these lesions were characterized by multinuclear giant cells (defining these lesions as so-called brown tumors). Finally, surgical removal of a jugular mass allowed the histopathologic diagnosis of a sporadic parathyroid carcinoma. I...
Source: Nuklearmedizin - Category: Radiology Authors: Tags: Internist (Berl) Source Type: research
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