Clinical profile of primary hyperparathyroidism from western India

Gopal, RA; Acharya, SV; Bandgar, Tushar; Menon, P. S. N.; An, Dalvi; Shah, Nehal

doi:10.4103/0022-3859.65279

Cited by 62 publications

(63 citation statements)

References 16 publications

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“…Recent case series from Asia reported much higher prevalence rates of 24-87% (31,32,33,34), whereas a case series from Saudi Arabia documented a prevalence rate of only 4% (35).…”

Section: Prevalence Of Hbs After Parathyroidectomymentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

Witteveen

Thiel

Romijn

et al. 2013

European Journal of Endocrinology

285

220

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Hungry bone syndrome (HBS) refers to the rapid, profound, and prolonged hypocalcaemia associated with hypophosphataemia and hypomagnesaemia, and is exacerbated by suppressed parathyroid hormone (PTH) levels, which follows parathyroidectomy in patients with severe primary hyperparathyroidism (PHPT) and preoperative high bone turnover. It is a relatively uncommon, but serious adverse effect of parathyroidectomy. We conducted a literature search of all available studies reporting a 'hungry bone syndrome' in patients who had a parathyroidectomy for PHPT, to identify patients at risk and address the pitfalls in their management. The severe hypocalcaemia is believed to be due to increased influx of calcium into bone, due to the sudden removal of the effect of high circulating levels of PTH on osteoclastic resorption, leading to a decrease in the activation frequency of new remodelling sites and to a decrease in remodelling space, although there is no good documentation for this. Various risk factors have been suggested for the development of HBS, including older age, weight/volume of the resected parathyroid glands, radiological evidence of bone disease and vitamin D deficiency. The syndrome is reported in 25-90% of patients with radiological evidence of hyperparathyroid bone disease vs only 0-6% of patients without skeletal involvement. There is insufficient data-based evidence on the best means to treat, minimise or prevent this severe complication of parathyroidectomy. Treatment is aimed at replenishing the severe calcium deficit by using high doses of calcium supplemented by high doses of active metabolites of vitamin D. Adequate correction of magnesium deficiency and normalisation of bone turnover are required for resolution of the hypocalcaemia which may last for a number of months after successful surgery. Preoperative treatment with bisphosphonates has been suggested to reduce post-operative hypocalcaemia, but there are to date no prospective studies addressing this issue. European Journal of Endocrinology 168 R45-R53

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“…Recent case series from Asia reported much higher prevalence rates of 24-87% (31,32,33,34), whereas a case series from Saudi Arabia documented a prevalence rate of only 4% (35).…”

Section: Prevalence Of Hbs After Parathyroidectomymentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

Witteveen

Thiel

Romijn

et al. 2013

European Journal of Endocrinology

285

220

View full text Add to dashboard Cite

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“…In a study of 39 patients of PHPT by Priya et al , 78% of the patients had neuromuscular weakness and 28% had concomitant vitamin D deficiency 3. Similarly in a recent single centre study of 79 patients by Gopal et al , the prevalence of neuromuscular weakness was 45.5% 4. The same trend was shown in a recent review of multi-centre data 5.…”

Section: Discussionmentioning

confidence: 69%

A unique ca(u)se of quadriparesis

Kamalanathan

Balachandran²,

Halanaik³

et al. 2012

Case Reports

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“…In a systematic review on PHPT, in India, reported by various tertiary care institutes (344 PHPT cases) across the country showed the rate of renal disease in 36% cases (9). Gopal et al reported renal calculi including nephrocalcinosis in 40.5% of the PHPT patients (10). Renal stone disease was present in 78% cases of symptomatic and in 35.5% asymptomatic PHPT patients has reported in another study by Cipriani et al (11).…”

Section: Discussionmentioning

confidence: 93%

Renal Manifestation in Patients with Primary Hyperparathyroidism: a Retrospective Analysis in a Tertiary Institute

Begum

Sultana

Parveen

et al. 2018

Bangladesh J. Nuclear Med.

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Objectives:The classical renal manifestations of primary hyperparathyroidism (PHPT) are nephrolithiasis and nephrocalcinosis. The presence of renal stone categorizes PHPT as symptomatic variant. The clinical profile of PHPT has changed in past few decades with decreased prevalence of renal stone disease with the introduction of widespread routine biochemical screening in normal subjects. In developing countries, PHPT is still a late diagnosed disorder and most of the patients are symptomatic at presentation. Presence of renal stone in PHPT patients is an absolute indication of parathyroidectomy, hence it is important to identify renal involvement in PHPT. The objective of the study is to determine the rate of renal manifestations in patients of biochemically primary hyperparathyroidism and compared to control group. This retrospective review was performed to determine whether the rate of nephrolithiasis and nephrocalcinosis is still high in the patients who underwent dual phase 99mTc sestamibi scan for PHPT at National Institute of Nuclear Medicine and Allied Sciences (NINMAS) compared to those not affected by the disorder.

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Clinical profile of primary hyperparathyroidism from western India

Abstract: PHPT in western India is symptomatic disorder with skeletal and renal manifestations at a much younger age. Clinical profile of PHPT in children is similar to that of adults.

Cited by 62 publications

References 16 publications

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

A unique ca(u)se of quadriparesis

Renal Manifestation in Patients with Primary Hyperparathyroidism: a Retrospective Analysis in a Tertiary Institute

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