Parathyroidectomy in the treatment of secondary hyperparathyroidism. Clinical and laboratory outcomes/ Paratiroidectomia în tratamentul hiperparatiroidismului secundar. Aspecte clinice şi de laborator

Neagoe, Radu Mircea; Sala, Daniela; Ionela, Pașcanu; Voidăzan, Septimiu; Moldovanu, R

doi:10.2478/rrlm-2014-0028

Romanian Review of Laboratory Medicine

2014

DOI: 10.2478/rrlm-2014-0028

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Parathyroidectomy in the treatment of secondary hyperparathyroidism. Clinical and laboratory outcomes/ Paratiroidectomia în tratamentul hiperparatiroidismului secundar. Aspecte clinice şi de laborator

Radu Mircea Neagoe¹,

Daniela Sala²,

Pașcanu Ionela³

et al.

Abstract: Background. Secondary hyperparathyroidism (sHPT) is frequently encountered in patients on hemodialysis (HD) for end stage renal disease (ESRD).

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Cited by 2 publications

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Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Mircea

Smaranda

et al. 2015

Acta Medica Marisiensis

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Backgrand. Lateralized periodic discharges (LPDs) are infrequent electroencephalograph (EEG) findings, and may present in ictal or interictal form. They are regarded as potential electrophysiologic signs of convulsive or nonconvulsive status epilepticus (NCSE). We report four patients who presented with NCSE and one who presented with convulsive status epilepticus in the postictal period, characterized by LPDs in EEG recordings in the first year after stroke. Material and methods. We prospectively evaluated patients who clinically presented with status epilepticus associated LPDs between March 2014 and March 2015. We investigated patients that presented with a new stroke occurrence. We excluded the other LPD etiologies. EEG studies of five patients (two men) who were admitted to our emergency unit with confusion, three of whom had visual symptoms; four were treated for NCSE as diagnosed with LPDs. The fifth patient had convulsive status epilepticus with LPD in the postictal period. Results and Discussion. None of the five patients, who were aged between 68 and 92 years, showed any etiologic factor other than a history of cerebrovascular disease (CVD). Magnetic resonance imaging studies of the patients revealed old infarcts and transitional diffusion restrictions. The clinical and EEG findings decreased substantially upon antiepileptic drug treatment. Herein, we illustrate the first patient who had confusion, visual hallucinations, and ictal and interictal LPD in her consecutive EEGs. Conclusions. CVDs may pave the way for LPDs in patients with a history of stroke because CVDs cause structural brain damage. Patients who present with a similar clinical profile and imaging signs of stroke should be checked for NCSE, particularly in the presence of LPDs in EEGs.

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Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Mircea

Smaranda

et al. 2015

Acta Medica Marisiensis

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"Hungry Bone" Syndrome after Parathyroidectomy: Up-To-Date

Sala¹,

Ţilea²,

Pantea³

et al. 2015

Surgery

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The hungry bone syndrome is considered in literature as being a complication following parathyroidectomy and it refers to the rapidly installed, severe, prolonged, and in most cases clinically manifested hypocalcaemia, which is sometimes accompanied by hypophosphatemia and hypomagnesemia. It appears due to the rapid demineralization of the dystrophic bone as a result of the sudden drop in the seric level of the parathyroid hormone. The prevalence of this complication is reported in literature with different variations, the number reported ranging from 4-95% depending on the type of affection-i.e. primary hyperparathyroidism or renal secondary hyperparathyroidism, but also on the geographical areas where the respective reports have been filled. The high preoperatory level of calcaemia, seric parathyroid hormone and alkalyne phophatase correlate statistically with the risk of postoperatory hungry bone syndrome appearance; the elderly patients present a higher risk for this complication, increasingly because this category of patients is oftenly associated with D hypovitaminosis and insufficient intake of nutritional calcium. The syndrome semiology is one of a hypocalcaemia and the curative treatment is initially a symptomatic one of fighting the severe postparathyroidectomy hypocalcaemia and only later a patogenic one, aiming to remineralize the distrofic bone. The purpose of this review is to describe the main epidemiologic, physiopathologic and clinical aspects of hungry bone syndrome but also of presenting prevention and treatment methods for this complication of parathyroidectomy.

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Parathyroidectomy in the treatment of secondary hyperparathyroidism. Clinical and laboratory outcomes/ Paratiroidectomia în tratamentul hiperparatiroidismului secundar. Aspecte clinice şi de laborator

Abstract: Background. Secondary hyperparathyroidism (sHPT) is frequently encountered in patients on hemodialysis (HD) for end stage renal disease (ESRD).

Cited by 2 publications

References 27 publications

Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

"Hungry Bone" Syndrome after Parathyroidectomy: Up-To-Date

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