Hypothesis: the case for quaternary hyperparathyroidism

Brain, H; Sharma, Anup; Nussey, Stephen

doi:10.1016/j.mehy.2003.10.023

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Finally, quaternary HP is defined as the presence of parathyroid cell hyperfunction in association with a parathyroid adenoma. 5,6 Parathyroid ultrasonography is a lowcost, non-invasive means of evaluating the cause of high serum PTH concentration. Indeed, this simple technique permits the differentiation of the different forms of HP, such that the most appropriate therapeutic approach can be selected.…”

Section: Discussionmentioning

confidence: 99%

Bilio-pancreatic diversion: report of a case involving bone metabolism complications

et al. 2020

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Prolonged vitamin D deficiency may result in lower calcium absorption and osteoporosis, leading to pathologic fractures. We report the case of a young woman with severe, complicated osteoporosis, which developed several years after biliopancreatic diversion that was performed to treat morbid obesity. Chronic low vitamin D levels provided a continuous stimulus for parathormone secretion, which resulted in parathyroid hyperplasia/adenoma and autonomous production of the hormone.

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Section: Discussionmentioning

confidence: 99%

Bilio-pancreatic diversion: report of a case involving bone metabolism complications

et al. 2020

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“…Brain et al reported the case of ay oung women with hyperparathyroidism due to a large parathyroid adenomaa ssociatedw ith severe vitamin Dd eficiencya nd speculated that it is possible that ap roportiono fc ases represent the coincidence of pHPT with vitamin Dd eficiencya st he pathogenesiso f parathyroid adenomaformationinvitamin D deficiency remainsu nclear ( 8).B rain et al hypothesized that in their casedescribed that autonomousf our gland hyperplasia or tertiaryh yperparathyroidism maya lternatively progress to adenoma formation and this should be termed quaternaryh yperparathyroidism (8). Concerningo ur patients with pHPT and vitamin Ddeficiencywecouldnot confirmt he hypothetical concept of quaternaryh yperparathyroidism as histopathological results couldnot confirmfour gland adenomaformationinany of thepatients.…”

Section: Discussionmentioning

confidence: 99%

99mTc-MIBI SPECT in primary hyperparathyroidism

Schmidt¹,

Thoma²,

Dietlein³

et al. 2008

Nuklearmedizin

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SummaryAim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of 99mTc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: Between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a 99mTc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase 99mTc-MIBI protocol with SPECT were compared with histopathology. Results: In 54 pts with normal vitamin D values late SPECT images identified more lesions (n = 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a 99mTc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; 99mTc-MIBI SPECT: p = 0.1180. Conclusion: The likelihood of a pathological 99mTc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency.

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“…The tertiary type, first described in 1963, is the rarest form and affects patients with long‐lasting secondary hyperparathyroidism, who because of renal insufficiency develop autonomous functioning of the parathyroid with PTH hypersecretion . Some authors also defend the existence of a quaternary type, where the autonomous 4‐gland hyperplasia of tertiary hyperparathyroidism progresses to adenoma formation …”

Section: Brown Tumor Of Hyperparathyroidismmentioning

confidence: 99%

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report

Santos

Koth

Figueiredo

et al. 2018

Special Care in Dentistry

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Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant-cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand-wrist, pelvis, and femur. We present here a brief literature review focusing on the clinical and radiographic features, diagnostic criteria and treatment of brown tumor and also report a case of the disease affecting the jaw.

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Hypothesis: the case for quaternary hyperparathyroidism

Cited by 5 publications

References 16 publications

Bilio-pancreatic diversion: report of a case involving bone metabolism complications

Bilio-pancreatic diversion: report of a case involving bone metabolism complications

99mTc-MIBI SPECT in primary hyperparathyroidism

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report

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