Imaging diagnostics of hyperparathyroidism.

[Imaging diagnostics of hyperparathyroidism]. Radiologe. 2013 Mar;53(3):261-76 Authors: Delorme S, Zechmann C, Haberkorn U Abstract Primary hyperparathyroidism is diagnosed by the presence of hypercalcemia, hypercalciuria and elevated serum levels of parathyroid hormone and is treated surgically by removal of the enlarged gland. Both ultrasound and 99m-Tc-MIBI scintigraphy are used to localize enlarged parathyroid glands. With sonography, enlarged parathyroid glands are hypoechoic and are most frequently found dorsally or caudally to the thyroid and medially to the carotid arteries. Ectopic parathyroid glands in the mediastinum can be detected by scintigraphy only. Computed tomography and magnetic resonance imaging are not primarily indicated. The sensitivity of ultrasound is 90% at best. Causes for false negative ultrasound examinations are ectopic glands in the mediastinum, small glands weighing less than 200 mg and large goiters which make assessment of the retrothyroid space difficult. Ultrasound and scintigraphy in combination can achieve a sensitivity of more than 90%. A combination of both is indicated prior to minimally invasive resection and in cases of recurrence or persistence of hyperparathyroidism after resection. PMID: 23503778 [PubMed - in process]
Source: Der Radiologe - Category: Radiology Authors: Tags: Radiologe Source Type: research

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CONCLUSIONS: AMBP can help detect hypertension in patients with PHPT that remains unrecognized with routine office-based blood pressure measurement. In addition, AMBP detects loss of normal dipping pattern in BP that persists in almost half of the patients even after successful parathyroidectomy, perhaps because of permanent vascular damage induced by PHPT. PMID: 31789012 [PubMed - as supplied by publisher]
Source: Minerva Endocrinologica - Category: Endocrinology Tags: Minerva Endocrinol Source Type: research
ConclusionLocal anaesthesia with hypnoanalgesia, compared with sedation during minimally invasive parathyroid surgery, improved early postoperative outcomes, making outpatient management more efficient.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Conclusion: CKD-MBD is common among patients on hemodialysis in our center. Screening for CKD-MBD and appropriate use of phosphate binder and Vitamin D when indicated are highly recommended.
Source: Annals of African Medicine - Category: African Health Authors: Source Type: research
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Source: Gynecological Endocrinology - Category: Endocrinology Authors: Source Type: research
AbstractThere are many causes of hypercalcaemia including hyperparathyroidism, drugs, granulomatous disorders and malignancy. Parathyroid hormone (PTH) related hypercalcaemia is most commonly caused by primary hyperparathyroidism (PHPT) and more rarely by familial hypocalciuric hypercalcaemia (FHH). Algorithms for diagnosis of PTH related hypercalcaemia require assessment of a 24-h urinary calcium and creatinine excretion to calculate calcium/creatinine clearance ratio and radiological investigations including ultrasound scan and99mTc-sestamibi-SPECT/CT. To illustrate investigations and management of parathyroid-related hy...
Source: Reviews in Endocrine and Metabolic Disorders - Category: Endocrinology Source Type: research
Naples et  al1 reviewed the Cleveland Clinic experience primary hyperparathyroidism (PHP) regarding the time course from diagnosis of hypercalcemia to the surgical treatment of PHP. They reviewed the records of 219 patients with sporadic PHP and found that symptomatic and asymptomatic patients experience del ays in referral to surgical consultation. The average duration of time from an elevated calcium to surgery for those patients with clear indications by the current guidelines is 3.9 years. Such delay occurs with costly office visits and medical testing, and the cost of unnecessary consultations, dia gnostic testin...
Source: Surgery - Category: Surgery Authors: Source Type: research
Abstract There are many causes of hypercalcaemia including hyperparathyroidism, drugs, granulomatous disorders and malignancy. Parathyroid hormone (PTH) related hypercalcaemia is most commonly caused by primary hyperparathyroidism (PHPT) and more rarely by familial hypocalciuric hypercalcaemia (FHH). Algorithms for diagnosis of PTH related hypercalcaemia require assessment of a 24-h urinary calcium and creatinine excretion to calculate calcium/creatinine clearance ratio and radiological investigations including ultrasound scan and 99mTc-sestamibi-SPECT/CT. To illustrate investigations and management of parathyroid...
Source: ENDOCR REV - Category: Endocrinology Authors: Tags: Rev Endocr Metab Disord Source Type: research
AbstractThe aim of this study was to analyze dental comorbidities in untreated primary hyperparathyroidism (pHPT). Patients with pHPT subjected to parathyroidectomy (PTX) at Karolinska University Hospital, Stockholm, during 2011 –2016 (n = 982) were selected from the Scandinavian Quality Register of Thyroid, Parathyroid and Adrenal surgery and compared to a general population cohort (n = 2944), matched for age and gender. Dental data was obtained from the Swedish Dental Health Registry for the 3 years prior to PTX. The incidence rate ratios (IRRs) of tooth loss by extraction, periodon...
Source: Clinical Oral Investigations - Category: Dentistry Source Type: research
CONCLUSION: Recurrence of sHPTH after PTX remains a problem, occurring in every fifth patient. In our experience, the introduction of intraoperative PTH measurement has helped to lower the rates of persistence and recurrence. Further reductions in the recurrence rate might be achieved with novel, more accurate pre- and intraoperative imaging techniques. PMID: 31800966 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Conclusions: Patients with benign adrenocortical tumors had higher odds of detected pancreatic IPMN, as well as thyroid nodules, parathyroid tumors, benign breast masses, and prostate hyperplasia compared with patients with normal adrenal glands. These associations may have important implications for patient care and healthcare economics, regardless of whether they reflect incidental discoveries due to imaging detection or frequency bias, or a common risk for developing multiple neoplasia. PMID: 31781211 [PubMed]
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
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