Comparison of microwave ablation treatments in patients with renal secondary and primary hyperparathyroidism.

Comparison of microwave ablation treatments in patients with renal secondary and primary hyperparathyroidism. Ren Fail. 2020 Nov;42(1):66-76 Authors: Ma H, Ouyang C, Huang Y, Xing C, Cheng C, Liu W, Yuan D, Zeng M, Yu X, Ren H, Yuan Y, Zhang L, Xu F, Cui Y, Ren W, Huang H, Qian H, Fan B, Wang N Abstract Purpose: Microwave ablation (MWA) is feasible for severe renal secondary hyperparathyroidism (SHPT) and primary hyperparathyroidism (PHPT) patients ineligible for parathyroidectomy (PTX). Here we compared the clinical manifestations and characteristics of parathyroid glands in these two groups, and summarized the techniques, safety and efficacy of MWA.Methods: Baseline clinical characteristics, ablation-related techniques, adverse events/complications, and efficacy were recorded.Results: In SHPT group, malnutrition, cardiovascular/pulmonary complications, and abnormal bone metabolism were severe. SHPT patients had more hyperplastic parathyroid glands. The volume of each gland was smaller, and the time of ablation for a single parathyroid was shorter in the SHPT group, although there were no significant differences compared with patients in the PHPT group. Three patients in both groups had recurrent laryngeal nerve injuries and all recovered, except for one SHPT patient. By the end of follow-up, serum iPTH levels had decreased from 2400.26 ± 844.26 pg/mL to 429.39 ± 407.93 pg/mL (p 
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research

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Myocardial calcifications are often discovered incidentally and result from dystrophic or metastatic deposition of calcium1. Dystrophic calcification represents the sequalae of local tissue damage with necrosis, most commonly from myocardial ischemia. Unlike the prior, metastatic calcification is the result of abnormal calcium homeostasis; including renal failure, hyperparathyroidism, and vitamin D deficiency. Myocardial calcifications are not entirely a benign finding, since they can lead to heart failure, arrhythmias and sudden cardiac death2.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
AbstractSummaryThe receptor activator of nuclear factor-kappa B ligand (RANKL)/RANK/osteoprotegerin system is dysregulated in hyperparathyroid bone diseases. The introduction of denosumab preceding elective surgery as an alternative option when surgery is not possible immediately.IntroductionThe effects of denosumab on vascular calcification in patients with chronic renal failure and low bone mass have been a subject of interest. Therefore, this investigation aimed to determine the short-term changes in vascular calcification after denosumab treatment using a serial electrocardiography-gated computed tomography (CT) to mea...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
​The wrist is not commonly aspirated in the emergency department, but emergent arthrocentesis may be indicated for extreme or concerning cases, and tapping the wrist to determine the underlying pathology or relieve pain may be of great value. The synovial fluid from the joint space can be analyzed for crystals, infection, and blood. This information may help determine the overall plan and aid in decision-making and consultation. The ultimate treatment plan may include admission, intravenous antibiotics, multiple aspirations, and even surgical washout.A swollen, painful wrist that is hot to the touch is concerning for sep...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
We report two cases of adolescent PHPT presenting with generalized tonic-clonic seizures and altered sensorium. On evaluation, both had hypertension, severe hypercalcemia (serum calcium 14.1 mg/dl and 14.5 mg/dl, respectively) and elevated parathyroid hormone levels. Magnetic resonance imaging revealed T2/FLAIR hyperintensities located predominantly in the parieto-occipital regions, suggestive of PRES. Localization and excision of parathyroid adenoma led to restoration of normocalcemia. Neurological symptoms and MRI changes improved subsequently. Extensive literature search revealed only four cases of PHPT-associated PRES;...
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Tags: J Clin Res Pediatr Endocrinol Source Type: research
Conclusion: Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels. PMID: 31909044 [PubMed]
Source: Annals of Surgical Treatment and Research - Category: Surgery Tags: Ann Surg Treat Res Source Type: research
A 28-year-old woman sought care due to an increase in mandible volume lasting approximately 1 year. The patient had chronic kidney disease caused by Berger disease in childhood, and underwent hemodialysis 3 times a week. An intraoral clinical examination revealed an expansive lesion on the left side of the mandible, causing mobility of the adjacent teeth. The radiographic examination showed a lesion of imprecise borders in the region of the right mandible of approximately 2 cm in size. An incisional biopsy and histologic examination revealed a giant cell lesion.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
ConclusionIn patients with CRF it’s difficult to diagnose parathyroid carcinoma, because its presentation mimics the most common secondary hyperparathyroidism; the concomitant presence of metastases should lead us to suspect malignant parathyroid lesions.Surgery is the only effective therapy and therefore should be always performed.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusion: PTX is a safe and effective therapy for treating SHPT that is refractory to medical therapies and accompanied by related signs and symptoms in dialysis patients. All three operative techniques were effective in controlling SHPT. PMID: 31573378 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Authors: Wang J, Zhao X, Shi H, Zhu L, Tao X Abstract Uremic leontiasis ossea (ULO), which occurs in the craniomaxillofacial region, is a sign of terminal stage osteitis fibrosa cystica or brown tumors and primarily caused by secondary hyperparathyroidism induced by renal failure. Pathophysiological changes include osteoclasts or osteoblasts proliferation, bone resorption, bone decalcification, and connective tissue proliferation. In this paper, we report a case of a 24-year-old female patient, who was diagnosed with ULO and presented with multiple facial swellings. Imaging features included zonal patterns with alt...
Source: Dentomaxillofacial Radiology - Category: Radiology Tags: Dentomaxillofac Radiol Source Type: research
Conclusions: 99mTc-MIBI SPECT/CT can increase the sensitivity and consistency of preoperative localization of eutopic parathyroid glands, and it can accurately locate ectopic parathyroid without sensitivity improvement. PMID: 31537128 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
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