• 제목/요약/키워드: Secondary hyperparathyroidism

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Regulation of Calcium Concentration in Primary and Secondary Hyperparathyroidism

  • Kim, Yong-baek
    • 한국수의병리학회:학술대회논문집
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    • 한국수의병리학회 2003년도 추계학술대회초록집
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    • pp.35-38
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    • 2003
  • The parathyroid gland is probably the simplest endocrine organ in the body. The only cells of clinical significance are the parathyroid or chief cells. The primary signal that these cells listen to is calcium. Primary hyperparathyroidism is due to a parathyroid adenoma. The most common cause of hypercalcemia in veterinary medicine is hypercalcemia of malignancy associated with variety of neoplasms. Secondary hyperparathyroidism is due to a disease process, most commonly associated with renal and nutritional hyperparathyroidism. Primary and secondary hyperparathyroidism are markedly different in their clinical, laboratory, and pathogenic mechanism.

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Brown Tumor of the Thoracic Spine : First Manifestation of Primary Hyperparathyroidism

  • Sonmez, Erkin;Tezcaner, Tugan;Coven, Ilker;Terzi, Aysen
    • Journal of Korean Neurosurgical Society
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    • 제58권4호
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    • pp.389-392
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    • 2015
  • Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

새끼 고양이에서의 영양학적 원인에 의한 부갑상선 기능항진증 증례 (A Case of a Kitten with Nutritional Secondary Hyperparathyroidism)

  • 박우대;김휘율;배춘식;김희정;윤화중;장경진
    • 한국임상수의학회지
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    • 제14권1호
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    • pp.131-135
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    • 1997
  • Nutritional secondary hyperparathyroidism in a seven-month old male kitten showing signs of paraparesis (ataxia, dragging the pelvic limbs), abdominal distention, aconuresis was diagnosed with clinical signs, radiographs and serum biochemical tests. In radiographs, bones were abnormally radiolucent and cortices were thin. Serum biochemical tests were performed, but had normal values. The treatment was directed at the suspected dietary calcium and phosphorus imbalance. Oral calcium supplement and a commercial cat food were introduced. On clinical evaluation 3 months later, this case showed no clinical signs.

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Hyperplastic Autotransplanted Parathyroid Tissue Migrating into Fatty Tumor after Total Parathyroidectomy

  • Reza, Joseph Arturo;Wiese, Georg Kristof;Portoghese, Joseph Dominic
    • Journal of Endocrine Surgery
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    • 제18권4호
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    • pp.236-239
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    • 2018
  • Secondary hyperparathyroidism (SHPTH) occurs commonly in patients with end-stage renal disease (ESRD). Uncontrolled SHPTH is associated with complications of calcium deposition including calciphylaxis and elevated rates of cardiovascular morbidity. Current treatment recommendations for medically refractory disease include total parathyroidectomy, often with autotransplantation (TPTH+AT) of minced parathyroid gland. Surgical intervention is associated with a reduction in cardiovascular mortality. We report a case of a 56-year-old man with ESRD who developed SHPTH and underwent TPTH+AT of parathyroid tissue into the right brachioradialis muscle. Over the course of 7 years he developed a mass at the site of the autotransplanted gland as well as recurrent refractory hyperparathyroidism with increased forearm uptake noted on sestamibi scan. After excision of this mass, pathology demonstrated hyperplasia of the minced gland fragments which were embedded within a mass of fibroadipose tissue rather than the muscle tissue it was originally transplanted in.

투석환자의 이차성 부갑상선 기능 항진증 치료에서 cinacalcet의 유효성과 안전성 및 사용 적정성 평가 (Efficacy and Safety of Cinacalcet for Secondary Hyperparathyroidism in Dialysis Patients and Drug Use Evaluation)

  • 서희남
    • 한국임상약학회지
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    • 제23권2호
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    • pp.142-150
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    • 2013
  • Background: Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease, affecting most of those who are receiving dialysis. Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower PTH levels in dialysis patients. Objective: This study aimed to assess efficacy, safety and appropriateness of use of cinacalcet in dialysis patients. Method: This retrospective study was performed on total 24 cases with identified intact parathyroid hormone (iPTH), serum calcium and phosphorus levels before and 4 weeks after cinacalcet initiation at a teaching hospital from July 1st, 2011 to October 31st, 2012. Results: Cinacalcet decreased iPTH by 19% from baseline after 4weeks treatment and it was statistically significant (p<0.001). Cinacalcet also significantly decreased iPTH levels regardless of dialysis modality (hemodialysis group versus peritoneal dialysis group) and severity of SHPT (iPTH 300-800 pg/ml group versus iPTH >800 pg/ml group). Serum calcium, phosphorus and Ca x P levels were decreased without statistical significance. Gastrointestinal events, headache and hypocalcemia were the most common side effects. Monitoring for iPTH and serum calcium was not performed appropriately. 43.7% patients initiated cinacalcet therapy at serum calcium level< 9.0 mg/dl. Conclusion: In conclusion, cinacalcet lowers parathyroid hormone levels with no serious side effects. However, it is required to avoid cinacalcet treatment in patients with low serum calcium levels and monitor iPTH and serum calcium levels during cinacalcet administration.

속발성 부갑상선 기능항진증을 동반한 말기 신부전의 치료를 위한 신장이식 (Kidney Transplantation in End-Stage of Renal Failure with Secondary Hyperparathyroidism)

  • 곽호현;남현숙;김윤태;박인철;한정희;우흥명
    • 한국임상수의학회지
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    • 제24권4호
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    • pp.522-528
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    • 2007
  • A 3-year-old male Maltese dog(weighing 2.5 kg) was referred with an excessive movement of mandible and depression. Comprehensive diagnostic investigation revealed an end-stage of renal disease with secondary hyperparathyroidism. The renal allograft was performed after the condition of dog was stabilized by hemodialysis and medical treatment. After transplantation, the renal function of this dog was returned to normal. thereafter, the dog died suddenly without apparent clinical signs. The subsequent pathological studies revealed the actual etiology of death was not clearly identified However acute pancreatitis caused by abrupt introduction of food after prolonged luting might be involved in the etiology. This case study showed the necessity of pancreatic function test in postoperative management after renal transplantation.

이차성 부갑상선 기능항진증과 동반된 갑상선내 부갑상선암 1예 (A Case of Intrathyroidal Parathyroid Carcinoma Associated with Secondary Hyperparathyroidism)

  • 권민수;장항석;김호근;정웅윤;임승길;박정수
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.235-238
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    • 1999
  • Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with primary hyperparathyroidism. In the patients with chronic renal failure, the incidence is extremely low. Only 13 cases of parathyroid carcinoma with chronic renal failure have been described in the world literature. We report a case of parathyroid carcinoma in a 43-year-old man who has been suffered from chronic renal failure for 19 years. To our knowledge, this is the first case of parathyroid carcinoma occurring in the thyroid gland associated with secondary hyperparathyroidism.

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Orofacial Manifestations of Hyperparathyroidism: A Dental Perspective

  • Jo-Eun Park
    • Journal of Oral Medicine and Pain
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    • 제49권2호
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    • pp.40-42
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    • 2024
  • Hyperparathyroidism (HPT) is a significant condition marked by the overproduction of parathyroid hormones, affecting both systemic health and orofacial regions. Predominantly, secondary HPT associated with chronic kidney disease (CKD) is critical because of its link to widespread conditions such as diabetes and hypertension. This short article highlights the vital role of dental professionals in identifying HPT through panoramic radiography, which can reveal critical orofacial signs such as brown tumors, altered dental development, and specific bone changes. With the CKD prevalence expected to increase alongside an aging population, the importance of early detection of HPT and its manifestations in dental settings cannot be overstated. Dental practitioners play a crucial role in the early detection of HPT, emphasizing the importance of being knowledgeable about its orofacial manifestations.

만성신부전증에 의한 이차성 부갑상선기능항진증 환자에서 양쪽 대퇴사두건 동시 파열: 증례 보고 (Simultaneous Bilateral Quadriceps Tendon Rupture in Patient with Secondary Hyperparathyroidism due to Chronic Renal Failure: A Case Report)

  • 심종준;심재찬;하정구;이경은;이기재;김호균;서정호
    • Investigative Magnetic Resonance Imaging
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    • 제16권2호
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    • pp.169-172
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    • 2012
  • 양측 대퇴사두건의 동시성 파열은 매우 드물며 몇 개의 증례만이 문헌에 보고되어 있다. 정확한 병인은 아직까지 알려지지 않았다. 그러나 만성신부전에 의한 이차성 부갑상선기능항진증과 같은 만성 대사성 질환을 앓고 있는 환자들에게 드물게 발생한다. 저자들은 만성신부전에 의한 이차성부갑상선기능항진증 환자에서 대퇴사두건이 양측 동시 파열된 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

A case of mucolipidosis II presenting with prenatal skeletal dysplasia and severe secondary hyperparathyroidism at birth

  • Heo, Ju Sun;Choi, Ka Young;Sohn, Se Hyoung;Kim, Curie;Kim, Yoon Joo;Shin, Seung Han;Lee, Jae Myung;Lee, Juyoung;Sohn, Jin A;Lim, Byung Chan;Lee, Jin A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • 제55권11호
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    • pp.438-444
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    • 2012
  • Mucolipidosis II (ML II) or inclusion cell disease (I-cell disease) is a rarely occurring autosomal recessive lysosomal enzyme-targeting disease. This disease is usually found to occur in individuals aged between 6 and 12 months, with a clinical phenotype resembling that of Hurler syndrome and radiological findings resembling those of dysostosis multiplex. However, we encountered a rare case of an infant with ML II who presented with prenatal skeletal dysplasia and typical clinical features of severe secondary hyperparathyroidism at birth. A female infant was born at $37^{+1}$ weeks of gestation with a birth weight of 1,690 g (<3rd percentile). Prenatal ultrasonographic findings revealed intrauterine growth retardation and skeletal dysplasia. At birth, the patient had characteristic features of ML II, and skeletal radiographs revealed dysostosis multiplex, similar to rickets. In addition, the patient had high levels of alkaline phosphatase and parathyroid hormone, consistent with severe secondary neonatal hyperparathyroidism. The activities of ${\beta}$-D-hexosaminidase and ${\alpha}$-N-acetylglucosaminidase were moderately decreased in the leukocytes but were 5- to 10-fold higher in the plasma. Examination of a placental biopsy specimen showed foamy vacuolar changes in trophoblasts and syncytiotrophoblasts. The diagnosis of ML II was confirmed via GNPTAB genetic testing, which revealed compound heterozygosity of c.3091C>T (p.Arg1031X) and c.3456_3459dupCAAC (p.Ile1154GlnfsX3), the latter being a novel mutation. The infant was treated with vitamin D supplements but expired because of asphyxia at the age of 2 months.