Surgical Approach in Hereditary Hyperparathyroidism

Tonelli, Francesco; Marcucci, Tommaso; Giudici, Francesco; Falchetti, Alberto; Brandi, Maria Luisa

doi:10.1507/endocrj.k09e-204

Cited by 40 publications

(34 citation statements)

References 76 publications

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“…In general, in pHPT associated with MEN 1, total parathyroidectomy (TPTX) and autologous graft of the parathyroid tissue or subtotal parathyroidectomy are recommended because of the high recurrence rate of pHPT after removing only enlarged parathyroid gland(s) (2,3). In the present case, we chose TPTX to avoid the recurrence of pHPT.…”

Section: Discussionmentioning

confidence: 97%

“…Technetium-99 m MIBI scintigraphy did not show any suspicion of an enlarged parathyroid gland. In addition, her lumbar bone mineral density (L2-4) was 0.485 g/ cm 2 , and T-score and Z-score of her lumbar spine were -4.7 and -3.1, respectively. Her distal radius bone mineral density was 0.260 g/cm 2 , and T-score and Z-score of her distal radius bone were -7.43 and -4.63, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Severe Hypocalcemia Complicated by Postsurgical Hypoparathyroidism and Hungry Bone Syndrome in a Patient with Primary Hyperparathyroidism, Graves' Disease, and Acromegaly

et al. 2012

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We herein report a case of severe postsurgical hypocalcemia associated with primary hyperparathyroidism (pHPT), Graves' disease (GD) and acromegaly (AC). A 54-year-old woman was referred to our clinic for treatment of pHPT and GD. She also had active AC and was clinically diagnosed as multiple endocrine neoplasm type 1 because of pHPT and AC. Two enlarged parathyroid glands were detected by preoperative examinations. We performed total parathyroidectomy and thyroidectomy. After the operation, she showed severe hypocalcemia induced by postsurgical hypoparathyroidism and hungry bone syndrome. This is a rare case of postsurgical severe hypocalcemia associated with pHPT, GD and AC.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Severe Hypocalcemia Complicated by Postsurgical Hypoparathyroidism and Hungry Bone Syndrome in a Patient with Primary Hyperparathyroidism, Graves' Disease, and Acromegaly

et al. 2012

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“…Однако во-прос об объеме оперативного вмешательства (про-ведение субтотальной ПТЭ с удалением 3,5 ОЩЖ или тотальной ПТЭ), а также о времени проведения оперативного вмешательства (в ранние сроки после постановки диагноза или отсроченно), остается дискутабельным. Субтотальная ПТЭ ассоциирована с риском развития рецидива ПГПТ у 40-60% в сро-ки 10-12 лет после операции [95][96][97][98]. Также реци-див возможен в 50% случаев при тотальной ПТЭ с аутотрансплантацией фрагмента ОЩЖ в предпле-чье, при этом удаление аутотрансплантата не всегда приводит к ремиссии [97].…”

Section: 2unclassified

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Dedov

Иванович²,

Мельниченко

et al. 2017

Probl Endokrinol (Mosk)

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Primary hyperparathyroidism (PHT) is the third most common endocrine disorder in men and women after diabetes mellitus and thyroid disease and one of the most frequent causes of osteoporosis and fractures among the secondary osteopathy. PHT refers to socially significant problems in connection with involvement in the pathological process of the majority of organs and system In recent years, the conception of epidemiology, clinic and tactics of management of patients with PHT has changed due to significant increase of morbidity at the expense of identification of mild forms of disease. The modern management concept tactics depends on clinical manifestations. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of PHT based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on PHT.

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“…The most common hereditary variants are part of syndromes where the pHPT is The paper was presented at the 6th Workshop of the European Society of Endocrine Surgeons (ESES) entitled "Hyperparathyroidism due to multiple gland disease: An evidence-based perspective", May 28-30, 2015, Varna, Bulgaria. associated with other endocrine and non-endocrine neoplasms: multiple endocrine neoplasia (MEN) type 1, 2A or 4 and hyperparathyroidism-jaw tumour syndrome (HPT-JT). Less frequently, it may be found without any syndromic association including familial isolated hyperparathyroidism (FIHPT), familial hypocalciuric hypercalcaemia (FHH), neonatal severe hyperparathyroidism (NSHPT) and autosomal dominant moderate hyperparathyroidism (ADMH) (Tables 1 and 2) [1].…”

Section: Introductionmentioning

confidence: 99%

Hereditary hyperparathyroidism—a consensus report of the European Society of Endocrine Surgeons (ESES)

Iacobone

Carnaille

Palazzo

et al. 2015

Langenbecks Arch Surg

114

126

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Hereditary hyperparathyroidism typically presents at an earlier age than the sporadic variants. Gene penetrance and expressivity varies. Parathyroid multiple gland involvement is common, but in some variants, it may occur metachronously often with long disease-free intervals, simulating a single-gland involvement. Bilateral neck exploration with subtotal parathyroidectomy or total parathyroidectomy + autotransplantation should be performed, especially in MEN 1, in order to decrease the persistent and recurrent hyperparathyroidism rates; in some variants (MEN 2A, HPT-JT), limited parathyroidectomy can achieve long-term normocalcemia. In FHH, surgery is contraindicated; in NSHPT, urgent total parathyroidectomy is required. In FIHPT, MEN 4 and ADMH, a tailored case-specific approach is recommended.

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Surgical Approach in Hereditary Hyperparathyroidism

Cited by 40 publications

References 76 publications

Severe Hypocalcemia Complicated by Postsurgical Hypoparathyroidism and Hungry Bone Syndrome in a Patient with Primary Hyperparathyroidism, Graves' Disease, and Acromegaly

Severe Hypocalcemia Complicated by Postsurgical Hypoparathyroidism and Hungry Bone Syndrome in a Patient with Primary Hyperparathyroidism, Graves' Disease, and Acromegaly

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Hereditary hyperparathyroidism—a consensus report of the European Society of Endocrine Surgeons (ESES)

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