Giant parathyroid adenoma: a case report and review of the literature

ConclusionsGiant parathyroid adenoma is a rare cause of primary hyperparathyroidism and usually presents symptomatically  with high calcium and parathyroid hormone levels. Giant parathyroid adenoma is diagnosed by imaging and laboratory studies. Management is typically surgical, aiming at complete resection. Patients usually recover with no long-term complications or recurrence.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research

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ConclusionThe prevalence of gestational PHPT was 2.1% in this largest Indian PHPT cohort, which is higher than that reported from the West (
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
AbstractPurposeTo evaluate the serum level of zonulin, which is an intestinal permeability (IP) biomarker, in primary hyperparathyroidism (PHPT) and to investigate the relationship between zonulin, calcium, and parathormone (PTH) levels.MethodsThe study included 34 healthy control (HC) and 39 patients with PHPT. Serum calcium, phosphorus, magnesium, creatinine, albumin, and 24  h urine calcium levels were measured in all groups. Serum levels of zonulin were measured quantitatively by enzyme-linked immunosorbent assay (ELISA). Urinary ultrasonography (to assess the presence of nephrolithiasis) and dual energy X-ray a...
Source: Endocrine - Category: Endocrinology Source Type: research
This study examined the impact of parathyroidectomy on 24-hour urinary calcium (24-hour UCa) levels and rates of resolution of hypercalciuria after surgery.
Source: Surgery - Category: Surgery Authors: Source Type: research
We describe a case harboring a homozygousCYP24A1 mutation with mild loss of function, first presenting with recurrent nephrolithiasis from the age of 22 onward, initially associated with hypercalcemia and low PTH concentrations. Over the years, hyperparathyroidism developed, resulting in more severe hypercalcemia. Also, kidney function deteriorated, most probably as a consequence of biopsy-proven nephrocalcinosis. Conventional treatment options forCYP24A1 mutation were not effective and/or tolerated (avoidance of sun exposure, diet, pamidronate, itraconazole). A total parathyroidectomy was performed resulting in a normocal...
Source: Calcified Tissue International - Category: Orthopaedics Source Type: research
Interview with Calyani Ganesan, MD, Alan Pao, and Calyani Ganesan, MD, authors of Analysis of Primary Hyperparathyroidism Screening Among US Veterans With Kidney Stones
Source: JAMA Specialty Journals Author Interviews - Category: General Medicine Authors: Source Type: podcasts
This cohort study identifies the prevalence and variation in parathyroid hormone level testing among patients with kidney stones and hypercalcemia in the Veterans Health Administration health care system.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Historically, nephrolithiasis was the most common manifestation of primary hyperparathyroidism. In a 1966 review of the first 343 cases of hyperparathyroidism at the Massachusetts General Hospital, Oliver Cope found kidney stones to be the most common clue to the diagnosis of hyperparathyroidism, occurring in 57% of cases. Although evaluation for osteoporosis and routine calcium testing are more commonly performed today for presentations of primary hyperparathyroidism, nephrolithiasis remains a strong indication for parathyroidectomy because of its well-documented advantages of decreasing urinary calcium and risk of future stone attacks.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Primary hyperparathyroidism is associated with substantial morbidity, including osteoporosis, nephrolithiasis, and chronic kidney disease. Parathyroidectomy can prevent these sequelae but is poorly utilized in many practice settings.
Source: Surgery - Category: Surgery Authors: Source Type: research
Authors: Apaydın T, Yavuz DG Abstract Parathyroid cancer is a rare malignancy and an uncommon cause of hyperparathyroidism. In the present study, we present seven cases of parathyroid carcinoma. The female ratio was 5/7 (71.4%). Median age at diagnosis was 47 years, and median follow-up duration was 60 months (IQR 29-75). Mean calcium level at diagnosis was 12.7 mg/dL (range, 11.3-13.9), and mean parathormone level was 1115 ng/L (IQR 287-1470). Two patients (28.5%) had a palpable neck mass. Coexisting brown tumor was present in three patients (42.8%), and nephrolithiasis was found in one patien...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
DR MELANIE GOLFARB (Santa Monica, CA): I commend the authors for trying to address one of the many important topics in the sometimes-nebulous disease of primary hyperparathyroidism. I say nebulous because, although we know how to diagnose and treat it, many nuances of the disease presentation, such as the underlying molecular mechanisms of the genotype and phenotype of the disease and the specific long-term outcomes, are still unknown. Kidney stone symptomatology in patients with primary hyperparathyroidism is one of the more common, and sometimes debilitating, symptoms that accompany the disease, and should always lead to...
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Western surgical association article Source Type: research
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