Musculoskeletal manifestations of primary hyperparathyroidism

Pappu, R.; Jabbour, Serge; Reginato, Anthony M.; Reginato, Antonio J.

doi:10.1007/s10067-016-3450-3

Cited by 44 publications

(40 citation statements)

References 42 publications

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Section: Introductionunclassified

“…Нарушения со стороны опорно-двигательного аппарата не ограничиваются только костными нарушениями и включают в себя широ-кий спектр патологических изменений в суставах и мышцах. В ряде случаев мышечно-суставные проявления могут выступать в качестве единственных и доминирующих симптомов заболевания [2,3].Несмотря на сравнительно длительный период наблюдения пациентов с ПГПТ, истинная распространенность мышечно-суставной патологии у данной категории больных остается неизвестной. По результатам исследований частота нервно-мышечного синдрома при ПГПТ может варьировать в пределах 13-93% [3].…”

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“…В ряде случаев мышечно-суставные проявления могут выступать в качестве единственных и доминирующих симптомов заболевания [2,3].Несмотря на сравнительно длительный период наблюдения пациентов с ПГПТ, истинная распространенность мышечно-суставной патологии у данной категории больных остается неизвестной. По результатам исследований частота нервно-мышечного синдрома при ПГПТ может варьировать в пределах 13-93% [3]. Частота суставной патологии, в частности хондрокальциноза, колеблется в широком диапазоне от 9 до 40% случаев [3][4][5][6].…”

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“…По результатам исследований частота нервно-мышечного синдрома при ПГПТ может варьировать в пределах 13-93% [3]. Частота суставной патологии, в частности хондрокальциноза, колеблется в широком диапазоне от 9 до 40% случаев [3][4][5][6]. Вариабельность в распространенности мышечно-суставных нарушений при ПГПТ может быть обусловлена как разнообразием неспецифических симптомов, предъ-ПАТОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ В СУСТАВАХ И МЫШЦАХ ПРИ ПЕРВИЧНОМ ГИПЕРПАРАТИРЕОЗЕ © Н.Г.…”

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“…Поражение костно-суставной и мышечной систем при ПГПТ может быть следствием нескольких патогенетических механизмов. К основным из них относят отложение кристаллов пирофосфата кальция (ПФК) в синовиальной жидкости, ассоциированное с острым или хроническим артритом, синовитом, остеоартрозом; острый подагрический артрит или хроническая тофусная подагра, а также развитие деформации суставных поверхностей костей и «бурых опухолей» при тяжелом фиброзно-кистозном остеите [3]. Фундаментальные исследования, посвященные патогенетическим аспектам и динамике развития мышечно-суставной патологии при ПГПТ, ограничены.…”

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Joint and muscle involvement in primary hyperparathyroidism

et al. 2019

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In addition to the classical symptoms such as osteoporosis, renal stones and gastric ulcers primary hyperparathyroidism (PHPT) could be presented with “non-classical” manifestations, including muscle and joint pathology. Moreover, in some cases the articular and neuromuscular impairment might be the main signs of the disease. Despite the long research history the true prevalence of these PHPT complications remains unknown. Discrepancies in studies results may be due the non-specific and different symptoms that patients complain about, various study design, uncorrected comorbid conditions, the different PHPT populations, a wide methods variety in the assessment of neuromuscular and articular involvement. However, the underestimated muscle dysfunction and joint damage can lead to decreased quality of life and disability, primarily from fragility fractures. In the majority of the studies parathyroidectomy improved muscle strength, but there is no clear results for articular manifestations. Basic research and large randomized control trials are limited. The main goal of this review is to summarize currently available data on muscle and joint involvement in patients with PHPT.

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Section: Introductionunclassified

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Joint and muscle involvement in primary hyperparathyroidism

et al. 2019

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Frailty, malnutrition, and the endocrine system impact outcome in patients undergoing aortic valve replacement

Al‐Kassou

Shamekhi

Weber

et al. 2021

Cathet Cardio Intervent

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Background: Frailty is a multidimensional syndrome that affects mortality after aortic valve replacement (AVR). Malnutrition is often associated with the development of frailty.However, data regarding the association of frailty with nutritional status and underlying endocrinological dysregulation in patients with severe aortic valve stenosis are limited.Objectives: We aimed to systematically screen for frailty and malnutrition, to evaluate for underlying endocrinological disorders and inflammation, and to assess the ability of these parameters to predict outcomes after AVR.Methods: Our study included 373 patients undergoing transcatheter and surgical AVR. Frailty was assessed using the Fried Frailty Phenotype (FFP), Essential Frailty Toolset, Lawton-Brody, and Katz Index. Malnutrition was measured using the Mini Nutritional Assessment (MNA-LF) and Controlling Nutritional Status. Outcomes of interest were 30-day and one-year mortality. Results:The prevalence of frailty ranged from 6.4% to 65.7% and malnutrition from 5.9% to 10.5%, depending on the evaluation tool. Both parameters were associated with higher levels of cortisol and parathormone as well as lower levels of IGF-1, testosterone, DHEAS, and c-reactive protein. Malnutrition was associated with increased 30-day mortality, and both frailty and malnutrition with increased oneyear mortality. In a multivariate analysis, malnutrition measured by the MNA-LF (OR: 2.32 [95%CI: 1.19-4.53], p = 0.01) and frailty as assessed by the FFP (OR:1.42 [95%CI: 1.02-1.96], p = 0.03) were independent predictors of one-year mortality.Baravan Al-Kassou and Jasmin Shamekhi are contributed equally to the manuscript

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Classical and Nonclassical Manifestations of Primary Hyperparathyroidism

Fuleihan

Chakhtoura

Cipriani

et al. 2020

Journal of Bone and Mineral Research

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This narrative review summarizes data on classical and nonclassical manifestations of primary hyperparathyroidism (PHPT). It is based on a rigorous literature search, inclusive of a Medline search for systematic reviews from 1940 to December 2020, coupled with a targeted search for original publications, covering four databases, from January 2013-December 2020, and relevant articles from authors' libraries. We present the most recent information, identify knowledge gaps, and suggest a research agenda. The shift in the presentation of PHPT from a predominantly symptomatic to an asymptomatic disease, with its varied manifestations, has presented several challenges. Subclinical nephrolithiasis and vertebral fractures are common in patients with asymptomatic disease. The natural history of asymptomatic PHPT with no end organ damage at diagnosis is unclear. Some observational and cross-sectional studies continue to show associations between PHPT and cardiovascular and neuropsychological abnormalities, among the different disease phenotypes. Their causal relationship is uncertain. Limited new data are available on the natural history of skeletal, renal, cardiovascular, neuropsychological, and neuromuscular manifestations and quality of life. Normocalcemic PHPT (NPHPT) is often diagnosed without the fulfillment of rigorous criteria. Randomized clinical trials have not demonstrated a consistent long-term benefit of parathyroidectomy (PTX) versus observation on nonclassical manifestations. We propose further refining the definition of asymptomatic disease, into two phenotypes: one without and one with evidence of target organ involvement, upon the standard evaluation detailed in our recommendations. Each of these phenotypes can present with or without non-classical manifestations. We propose multiple albumin-adjusted serum calcium determinations (albumin-adjusted and ionized) and exclusion of all secondary causes of high parathyroid hormone (PTH) when establishing the diagnosis of NPHPT. Refining the definition of asymptomatic disease into the phenotypes proposed will afford insights into their natural history and response to interventions. This would also pave the

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Musculoskeletal manifestations of primary hyperparathyroidism

Cited by 44 publications

References 42 publications

Joint and muscle involvement in primary hyperparathyroidism

Joint and muscle involvement in primary hyperparathyroidism

Frailty, malnutrition, and the endocrine system impact outcome in patients undergoing aortic valve replacement

Classical and Nonclassical Manifestations of Primary Hyperparathyroidism

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