Marked facial enlargement in secondary hyperparathyroidism

Benjelloun, M.C.; Tarrass, Faissal; Alaoui, Laila; Medkouri, G.; Hachim, Khadija; Gharbi, Mohamed Benghanem; Ramdani, B.

doi:10.1093/ndt/gfm473

Cited by 11 publications

(13 citation statements)

References 3 publications

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“…Dental treatment strategy should emphasize oral hygiene and patients should be reinforced frequently in hygiene performance. Symptomatic treatment should include oral antibiotics to prevent the future bacterial endocarditis and oral antifungals should be prescribed to prevent secondary candidal infection [10].…”

Section: Discussionmentioning

confidence: 99%

Oral Manifestations in a Renal Osteodystrophy Patient - A Case Report with Review of Literature

Nisha

A²,

P³

2014

JCDR

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Section: Discussionmentioning

confidence: 99%

Oral Manifestations in a Renal Osteodystrophy Patient - A Case Report with Review of Literature

Nisha

A²,

P³

2014

JCDR

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“…The most important factors to distinguish a renal osteodystrophy lesion from other bone lesions are the report of chronic kidney disease, hemodialysis (9) and secondary hyperparathyroidism, once the brown tumor is more likely to occur in primary hyperparathyroidism (12) and shows a faster growth (13). In 2007, Damm et al (4) stated that every expansive fibrous-osseous lesion in the maxillary bones of patients with CRI must be considered an osteodystrophic lesion until proven otherwise.…”

Section: Discussionmentioning

confidence: 99%

Facial lesions caused by renal osteodystrophy in a patient with chronic renal insufficiency: a case report

Karsburg¹,

Campos²,

Peres³

et al. 2012

Rev. odonto ciênc.

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Purpose: Chronic renal insufficiency (CRI) is the last stage of a chronic renal condition in which the kidney loses its filtration and endocrine functions. Chronic endocrine hypofunction causes generalized damage to the body known as Uremic Syndrome, which affects the central nervous system as well as the cardiovascular, hematologic, dermatologic, ophthalmic, endocrine, respiratory, gastrointestinal and skeletal systems. The present study reports the case of a female patient with CRI who presented facial osteodystrophy of the osteitis fibrosa type, and highlights the main features of this condition.Case Description: A 24-year old, female, Caucasian patient presented chronic glomerulonephritis recurrence and lost the transplanted kidney five years before, undergoing arteriovenous fistula hemodialysis three times a week. She presented swelling of the left masseter area with a hard consistency on palpation, covered by intact skin, swelling at the bottom of the left atrium, with a hard consistency on palpation, a mucosa-like color and absence of inflammation signs, suggesting expansive bone lesions on the face. These features were compatible with hyperparathyroidism brown tumor and/or osteodystrophy. The CT scan showed expansive bone lesions of heterogeneous appearance on the left jaw, maxilla/nasal floor, and right frontotemporal suture areas. The clinical and histopathological characteristics of the lesion, in association with PHT hormone high serum levels led to renal osteodystrophy diagnosis. The patient was referred to the nephrology services.Conclusion: Osteodystrophic bone alterations have a high prevalence in renal disease patients, and the dentist must take these alterations into consideration in bone lesion diagnosis for this specific group of patients.Key words: Chronic renal insufficiency; renal dialysis; renal osteodystrophy ResumoObjetivo: A Insuficiência Renal Crônica (IRC) é o último estágio da doença renal crônica, na qual o rim perde sua função de filtração e endócrina. A hipofunção endócrina renal ocasiona danos generalizados ao organismo, que no conjunto são conhecidos como Síndrome Urêmica, sendo composta por danos que comprometem o sistema nervoso central, assim como os sistemas cardiovasculares, hematológicos, dermatológicos, oftálmicos, endócrinos, respiratórios, gastrointestinais e ósseos. O presente estudo irá relatar o caso de uma paciente portadora de IRC apresentando osteodistrofia em face do tipo osteíte fibrosa, evidenciando as principais características dessa doença.Descrição do caso: Uma paciente de 24 anos, sexo feminino, caucasiana, apresentou glomerulonefrite recorrente após perda do rim transplantado, estando sob hemodiálise três vezes por semana. Apresentou inchaço da área do m. masseter esquerdo com consistência dura à palpação, coberto por pelo de aspecto normal, inchaço do átrio esquerdo, com consistência dura e ausência de sinais inflamatórios, sugerindo lesões ósseas na face. Estas características eram compatíveis com tumor marrom de hiperparatireoidismo e/ou osteod...

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“…A complete disappearance of the brown tumors has been observed after parathyroidectomy [4, 15]. However, regression of the brown tumors can be incomplete [3, 10]. Even if HPT is known to be the most important cause of brown tumors in ESRD, the lack of improvement in some patients after surgery suggests the contribution of other unknown factors in the development and growth of brown tumors [11].…”

Section: Discussionmentioning

confidence: 99%

“…These tumors represent a relatively rare (1.5–1.7%) but potentially severe complication of secondary HPT, notably because of the risk of bone fractures and compression of contiguous structures [4]. They are usually seen in severe forms of HPT [4] and are observed more frequently in the long bones [5, 6], ribs [7, 8, 9] and pelvis but may occur in any bone such as jaw [4, 10, 11, 12], or vertebra [2, 13]. …”

Section: Introductionmentioning

confidence: 99%

Sarcoma-Like Pyogenic Granuloma of the Thumb and Respiratory Restrictive Syndrome in a Non-Compliant Hemodialysis Patient

Simon

Gevenois²,

Marmol³

et al. 2012

Case Rep Nephrol Urol

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Pyogenic granuloma is a benign vascular tumor of the skin or mucosae usually observed after irritative processes. We report the case of a non-compliant hemodialysis patient with severe hyperparathyroidism who rapidly developed growing pyogenic granuloma of the distal part of the left thumb. This tumor mimicked sarcoma and caused recurrent bleeding during hemodialysis sessions. Hand radiograph revealed an osteolytic lesion compatible with a brown tumor. Among other brown tumors, several of those found in the ribs were responsible of a severe respiratory restrictive deficit. This report highlights the difficulty to choose the adequate treatment of severe hyperparathyroidism, and discusses the benefit/risk balance of performing parathyroidectomy.

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Marked facial enlargement in secondary hyperparathyroidism

Cited by 11 publications

References 3 publications

Oral Manifestations in a Renal Osteodystrophy Patient - A Case Report with Review of Literature

Oral Manifestations in a Renal Osteodystrophy Patient - A Case Report with Review of Literature

Facial lesions caused by renal osteodystrophy in a patient with chronic renal insufficiency: a case report

Sarcoma-Like Pyogenic Granuloma of the Thumb and Respiratory Restrictive Syndrome in a Non-Compliant Hemodialysis Patient

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