Primer hiperparatiroidizmde preoperatif lokalizasyon çalişmalari

Uludağ, Mehmet

doi:10.14744/semb.2019.78476

Cited by 6 publications

(2 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common imaging methods for the detection of hyperfunctional parathyroid lesions are parathyroid ultrasonography (US) and technetium-99m methoxy isobutyl isonitrile (Tc-99m MIBI) parathyroid scintigraphy [4,5]. When Tc-99m MIBI is used together with single photon emission computed tomography (SPECT), its sensitivity in determining parathyroid lesion increases [6].…”

Section: Introductionmentioning

confidence: 99%

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Korkmaz

2021

Acta Medica Alanya

View full text Add to dashboard Cite

Amaç: Hiperfonksiyon gösteren paratiroid lezyonlarının preoperatif lokalizasyonun-da ince iğne aspirasyonu (İİA) yıkama sıvısında parathormon (PTH) ölçümünün du-yarlılık ve pozitif prediktif değer (PPD)'ini belirlemek. Yöntem: 2016-2020 yılları arasında kliniğimizde primer hiperparatiroidi (PHPT) tanısı alan hastaların tıbbi kayıtları retrospektif olarak inceledik. Operasyon öncesi İİA-PTH yıkama prosedürü uygulanan 36 PHPT hastası çalışmaya alındı. İİA-PTH yıkama, sadece teknesyum-99m metoksi-isobutil-isonitril / tek foton emisyonlu bilgisayarlı to-mografi (Tc-99m MIBI/SPECT) negatif hastalarda yapıldı. Serum PTH seviyesinden daha yüksek PTH yıkama seviyeleri, pozitif kesme değeri olarak tanımlandı. İİA-PTH yıkama prosedürünün duyarlılık, PPD, yanlış pozitif, yanlış negatif ve tanısal doğruluk değerleri hesaplandı. Bulgular: PTH yıkama 2 olguda yanlış pozitif, 1 olguda yanlış negatif ve 33 olguda gerçek pozitifti. Gerçek paratiroid lezyonların ayırt edilmesinde PTH yıkamanın du-yarlılığı %97.05, pozitif prediktif değeri %94.29 ve tanısal doğruluğu %91.67 olarak hesaplandı. PTH yıkanma seviyeleri, serum PTH ve paratiroid lezyon hacmi ile pozitif koreleydi (sırasıyla, r= 0.347, p= 0.041 ve r=0.356, p= 0.036). Tüm hastalar İİA-PTH yıkama işlemini iyi tolere etti ve sonrasında herhangi bir komplikasyon gelişmedi. Sonuç: İİA-PTH yıkaması, Tc-99m MIBI/SPECT negatif PHPT hastalarında paratiroid lezyonlarını lokalize etmek için güvenli ve kullanışlı bir yöntemdir.

show abstract

Section: Introductionmentioning

confidence: 99%

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Korkmaz

2021

Acta Medica Alanya

View full text Add to dashboard Cite

show abstract

“…In this process, pre-operative localization possibilities, whether there are risk factors for multiple gland disease in the patient, and the facilities of the surgical center, such as peroperative frozen or rapid serum parathormone testing, should be considered. [ 7 , 8 ] High cure rate can be achieved in the first surgery by minimizing the risk of complications in PHPT surgery. [ 9 - 12 ] However, secondary surgical procedures may be required with the diagnosis of persistent or recurrent PHPT after parathyroid surgery, even in centers experienced in endocrine surgery.…”

mentioning

confidence: 99%

Parathyroidectomy results in primary hyperparathyroidism: analysis of the results from a single center

et al. 2021

View full text Add to dashboard Cite

Objectives: The curative treatment of primary hyperparathyroidism (PHPT) is surgery. Persistent and recurrent disease may develop after surgical treatment. In this study, we aimed to evaluate the surgical cure rate in patients who underwent surgery for PHPT in our clinic. Methods: The data of patients who underwent parathyroidectomy for PHPT by two experienced surgeons between 2000 and 2015 in our clinic were retrospectively evaluated. Patients who were followed for at least 6 months after their first parathyroidectomy were included in the study. Surgical cure and persistent and recurrent disease rates were evaluated in patients. Results: During this period, 368 interventions were performed in 357 patients (293 F and 64 M) who were operated for PHPT in our clinic, with a mean age of 54.9±13.1 years. In the first surgery, 116 patients (32.5%) had bilateral neck exploration, 251 patients (67.5%) had unilateral neck exploration (UNE) or focused parathyroid surgery (FPS). In the first operation, 343 patients (96.1%) had cure, 14 patients (13 F and 1 M) remained persistent. Secondary surgical intervention was performed in 11 patients. UNE or FPS was performed to 10 patients (90.9%); partial sternotomy was performed to one patient. Ten of the patients had cure. Three of these patients had a solitary parathyroid adenoma that was not removed in the first surgery, and seven patients had a second adenoma. Four patients remained persistent (1.1%). Recurrent disease developed in four patients during follow-up (1.1%). Total cure rate was 97.8%. Conclusion: The only definitive treatment for PHPT is surgery. High surgical cure can be achieved by pre-operative evaluation and appropriate surgical planning. However, persistent PHPT may develop, especially due to double adenoma or ectopic location. Patients with persistent PHPT can be evaluated with repeat imaging methods and with appropriate surgical planning, a high cure rate can be obtained in secondary surgery, which can increase the total surgical cure rate. Recurrence rate is rare.

show abstract

Unravelling a hidden pathology of a vertebral fracture in a teenage girl

Sivageethan,

Gnanathayalan,

Fernando

et al. 2024

BMC Endocr Disord

View full text Add to dashboard Cite

Background Although the skeleton remains a common target of primary hyperparathyroidism, the classic bone disease “osteitis fibrosa cystica” is currently rare due to early diagnosis. This case represents severe classic bone manifestations of primary hyperparathyroidism due to delayed diagnosis and delayed medical attention. Case presentation A 19-year-old young female was symptomatically managed for chronic back pain and nonspecific bone pain in the small joints of both hands over 2 months by a general practitioner. The patient had delayed seeking for treatment for 3 months. Later, she was evaluated for tuberculosis, hematological malignancies and rheumatic disorders following a fractured T12 vertebra and underwent pedicle screw fixation. However, clinical examination and investigations, including biochemistry, imaging and histology, ruled out the above conditions. Unfortunately, serum calcium level was not performed at the initial presentation. Later, primary hyperparathyroidism was diagnosed on the basis of moderate hypercalcaemia and elevated intact PTH levels (2064 pg/ml). She had sufficient vitamin D levels and normal kidney function. Her DXA scan revealed severe secondary osteoporosis with the lowest Z score of -8 at the total lumbar spine. Ultrasonography of the thyroid revealed a hypo echoic mass in the left lower neck, and localization studies with technetium-99 m sestamibi and 4D-CT revealed a left inferior parathyroid adenoma (1.6 × 1.5 × 1.6 cm). CT scan also revealed brown tumors in the mandible and vertebrae and diffuse bony changes in the skull, sternum, humerus and vertebrae. Her radiographs revealed subperiosteal bone resorption on the radial aspects of the middle and distal phalanges and brown tumors in both the ulna and fibula. We excluded MEN and other hereditary syndromes in our patient with a personal and family history and with a normal pituitary hormone profile because of poor resources for genetic testing. She underwent parathyroid adenoma excision, and the postoperative period was complicated with hungry bone syndrome, requiring high doses of calcium and active vitamin D supplements. These supplements were gradually weaned off over 6 months, and she recovered with normal biochemical investigations. Histology revealed parathyroid adenoma without malignant features. Conclusion In developing countries where routine calcium screening is not available, clinicians should be aware of various manifestations of primary hyperparathyroidism to allow diagnosis as soon as possible without delay to prevent further progression, as it is a treatable condition.

show abstract

Primer hiperparatiroidizmde preoperatif lokalizasyon çalişmalari

Cited by 6 publications

References 62 publications

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Parathyroidectomy results in primary hyperparathyroidism: analysis of the results from a single center

Unravelling a hidden pathology of a vertebral fracture in a teenage girl

Contact Info

Product

Resources

About