• Title/Summary/Keyword: hypoparathyroidism

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A Case of Idiopathic Hypoparathyroidism with Extensive Intracranial Calcification (광범위한 뇌 석회침착을 수반한 특발성 부갑상선 기능저하증 1례)

  • Kim, Wook-Nyeon;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.220-226
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    • 1997
  • Idiopathic hypoparathyroidism is frequently associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a case of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit $D_3$ therapy.

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A Case Report of a Thyroid Cancer Patient with Hypoparathyroidism after Total Thyroidectomy by a Combination of Korean-Western Medicine Treatment Including Insamyangyoung-tang (갑상선 전절제술 후 부갑상선기능저하증이 발생한 갑상선암 환자의 인삼양영탕을 활용한 한양방 복합 치료 증례 보고 1례)

  • Kim, Du-ri;Lee, Su-yeong;Lee, Hyun-seung;Moon, Byung-soon;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.814-821
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    • 2018
  • Thyroid cancer is one of the most common cancers in Korea, and thyroidectomy is the first-line treatment. Hypoparathyroidism is a common complication of thyroidectomy and can cause symptoms such as numbness, spasm, and anxiety, but these issues have seldom been reported in the Korean medical literature. The present case was a 53-year-old thyroid cancer patient who complained of numbness caused by hypoparathyroidism, general weakness, fatigue, and postoperative pain after total thyroidectomy. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion, and her changes in clinical symptoms were measured with a numeric rating scale (NRS), the Karnofsky performance status scale (KPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). After treatment, her clinical symptoms were improved, leading to an improvement in her quality of life. Therefore, Korean medicine may be effective in the treatment of thyroid cancer patients who experience numbness caused by hypoparathyroidism, general weakness and fatigue after total thyroidectomy.

Hypoparathyroidism in a diabetic dog (당뇨병 이환견에서 발생한 부갑상샘기능저하증 증례)

  • Lee, Hye-Jin;Lim, Soo-Jung;Lee, Sun-Hee;Song, Eun-Sik;Song, Kun-Ho
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.355-359
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    • 2009
  • A miniature schnauzer (8 years old, male castrated), diagnosed as diabetes mellitus 6 months ahead, were referred to the Veterinary Medical Teaching Hospital of our University with hindlimb stiffness, facial rubbing and tetany. Serum chemistry showed severe hypocalcemia, hypomagnesemia, and measured iPTH (intact pharathyroid hormone) concentration was low (< 3.0 pmol/L). Consistent rate injection of calcium gluconate (282 mg/kg over 30 min) resulted in prompt relief of the tetany. Then typical treatment for hypoparathyroidism (calcium gluconate and dihydrotachysterol per os) with magnesium administration could control the neuromuscular signs. Diabetes mellitus is being controlled by insulin therapy and prescription diet. Hypomagnesemia in diabetic dog may be induced hypoparathyrodism.

Safety and Prognostic Impact of Prophylactic Level VII Lymph Node Dissection for Papillary Thyroid Carcinoma

  • Fayek, Ihab Samy;Kamel, Ahmed Ahmed;Sidhom, Nevine FH
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8425-8430
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    • 2016
  • Purpose: To study the safety of prophylactic level VII nodal dissection regarding hypoparathyroidism (temporary and permanent) and vocal cord dysfunction (temporary and permanent) and its impact on disease free survival. Materials and Methods: This prospective study concerned 63 patients with papillary thyroid carcinoma with N0 neck node involvement (clinically and radiologically) in the period from December 2009 to May 2013. All patients underwent total thyroidectomy and prophylactic central neck dissection including levels VI and VII lymph nodes in group A (31 patients) and level VI only in group B (32 patients). The thyroid gland, level VI and level VII lymph nodes were each examined histopathologically separately for tumor size, multicentricity, bilaterality, extrathyroidal extension, number of dissected LNs and metastatic LNs. Follow-up of both groups, regarding hypoparathyroidism, vocal cord dysfunction and DFS, ranged from 6-61 months. Results: The mean age was 34.8 and 34.3, female predominance in both groups with F: M 24:7 and 27:5 in groups A and B, respectively. Mean tumor size was 12.6 and 14.7mm. No statistical differences were found between both groups regarding age, sex, bilaterality, multicentricity or extrathyroidal extension. The mean no. of dissected level VI LNs was 5.06 and 4.72 and mean no. of metastatic level VI was 1 and 0.84 in groups A and B, respectively. The mean no. of dissected level VII LNs was 2.16 and mean no. of metastatic LNs was 0.48. Postoperatively temporary hypoparathyroidism was detected in 10 and 7 patients and permanent hypoparathyroidism in 2 and 3 patients; temporary vocal cord dysfunction was detected in 4 patients and one patient, and permanent vocal cord dysfunction in one and 2 patients in groups A and B, respectively. No significant statistical differences were noted between the 2 groups regarding hypoparathyroidism (P=0.535) or vocal cord dysfunction (P=0.956). The number of dissected LNs at level VI only significantly affected the occurrence of hypoparathyroidism (<0.001) and vocal cord dysfunction (<0.001).The DFS was significantly affected by bilaterality, multicentricity and extrathyroidal extension. Conclusions: Level VII nodal dissection is a safe procedure complementary to level VI nodal dissection with prophylactic central neck dissection for papillary thyroid carcinoma.

Severe Intestinal Distension in a Dog with Primary Hypoparathyroidism (일차성 부갑상샘기능저하증에 이환된 개에서 장확장증 발생 증례)

  • Kim, Dong-In;Kim, Hye-Sun;Chang, Dongwoo;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.216-219
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    • 2014
  • An 1-year-old, female, mixed-breed dog weighing 17 kg was referred for abrupt collapse. She had remarkable hypocalcemia and hyperphosphatemia, and survey radiographs revealed a severe gas-filled intestine. Treatment with serial injections of calcium gluconate was initiated promptly and most of the gastrointestinal distension disappeared after 4 h. However, the clinical signs were not resolved completely. The serum intact parathyroid hormone concentration was not elevated in the context of hypocalcemia, which suggested primary hypoparathyroidism. The clinical signs and laboratory abnormalities in the patient were resolved completely 3 days after administration of calcium gluconate and calcitriol. This case describes the unique presentation of severe gastrointestinal distension in a dog diagnosed with primary hypoparathyroidism.

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

  • Kang, Jin Gu;Kim, Young Ah;Choi, Jung Eun;Lee, Soo Jung;Kang, Su Hwan
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.202-209
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    • 2020
  • Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Primary Hypoparathyroidism in a Miniature Schnauzer Dog (미니어처 슈나우저에서 발생한 원발성 부갑상선기능저하증)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.603-605
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    • 2009
  • A 7-year-old intact female, Miniature Schnauzer dog was presented with an acute seizure episode and tremors. Fever and panting were noted when presented. Physical examination revealed apparent forelimb muscle rigidity, fasciculations and stiff gait. Characteristic laboratory findings in this dog were severe hypocalcemia with hyperphosphatemia. The low serum concentration of intact parathyroid hormone and ionized calcium levels were consistent with the diagnosis of primary hypoparathyroidism. In addition, there were increased urinary excretion of calcium and decreased urinary excretion of phosphorus in this case. Urgent treatment was initiated with 10% calcium gluconate. The dog remained healthy with vitamin D analogue and oral calcium supplementation. A transient hyperphosphatemia was controlled well with sevelamer hydrochloride. To the author's knowledge, this is the first case report describing the clinical and laboratory characteristic features of canine primary hypoparathyroidism and its clinical outcome in Korea.

A DiGeorge Syndrome with both Basal Ganglia Calcification with 22q11.2 Deletion

  • Kim, Young Han;Choi, Joong Wan;Ryu, Hye Won;Bae, Eun Ju;Oh, Phil Soo;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.163-167
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    • 2014
  • DiGeorge syndrome is a disorder caused by microdeletion in chromosome 22q11.2 with various abnormalities including cardiac anomaly, facial dysmorphism, thymic and parathyroid hypoplasia, cleft palate and immune dysfunction. The frequency of hypocalcemia caused by hypoparathyroidism is known to be approximately 60% of DiGeorge syndrome. It is known that the disorder mostly occurs in the neonatal period and the symptoms are improved afterwards. Herein we report a case of DiGeorge syndrome only accompanied by hypocalcemia caused by hypoparathyroidism without other abnormalities. She was first diagnosed only at the age of 22 with basal ganglia calcification that had been discovered in brain CT (Computed tomography).

Complications in thyroid surgery (갑상선 절제술 후 합병증)

  • Tae, Kyung;Choi, Yong-Seung;Shim, Bong-Taek;Shin, Chang-Sik;Park, Chul-Won;Lee, Hyung-Seok
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.111-119
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    • 1996
  • The medical records of 87 patients with thyroid nodule treated from May 1992 to February 1996 were retrospectively reviewed to assess complication with age, sex, pathologic classification, location of lesions, and surgical procedures. The overall rate of complication were observed 10(11.5%) in thyroid surgery. The most common complication was transient hypoparathyroidism, which occurred in 6(6.9%) of 87 patients. The 2(2.3%) patients experienced Permanent hypoparathyroidism and each 1(1.1%) patient was reported in transient recurrent laryngeal nerve paralysis and hematoma.. Well-performed thyroid surgery usually produces few complications. More extensive resections, involving bilateral thyroidectomy are associated with a higher incidence of postoperative morbidity, in particular vocal cord paralysis and hypoparathyroidism, than procedures that consist essentially of unilateral thyroidectomy. Our experience suggests that the postoperative complication relates primarily to the surgical procedure. The low incidence of permanent complications in thyroid surgery suggests the feasibility of total thyroidectomy as the operation of choice when thyroid nodules were malignant and surgeons are familiar with the technique and indications.

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