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Ann Nucl Med 2020 May 20. Epub 2020 May 20.

Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Objectives: Currently, neck ultrasound is the preferred preoperative imaging in patients with secondary/tertiary hyperparathyroidism, and the use of Tc-99m sestamibi scan is limited in these patients. We conducted this study to compare the diagnostic utilities of F-18 fluorocholine PET/CT, Tc-99m sestamibi scintigraphy, and neck ultrasound for localizing hyperfunctioning parathyroid glands in secondary/tertiary hyperparathyroidism.

Methods: We prospectively enrolled 30 dialysis patients with a diagnosis of secondary/tertiary hyperparathyroidism; of these, 27 participants underwent all three imaging modalities, including dual-phase F-18 fluorocholine PET/CT (PET acquired 5 and 60 min after tracer injection), dual-phase Tc-99 m sestamibi SPECT/CT, and neck ultrasound. Read More

Am J Surg 2020 Apr 29. Epub 2020 Apr 29.

Department of General Surgery, Changzheng Hospital, Naval medical university, Shanghai, 200003, China. Electronic address:

Background: Intraoperative imaging is used to address the challenges of parathyroidectomy, but no standard modality has been established. This study aimed to assess whether carbon nanoparticle injection is useful in localizing parathyroid glands (PGs) during parathyroidectomy.

Methods: Patients who underwent total parathyroidectomy (TPTX) between September 2015 and November 2018 were included. Read More

Gland Surg 2020 Apr;9(2):401-408

Department of Thyroid and Breast Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University & Lishui Hospital of Zhejiang University & Lishui Central Hospital, Lishui 323000, China.

Background: Drug-refractory secondary hyperparathyroidism (SHPT) is the most common complication in patients with chronic renal failure (CRF). Although surgery is the most effective and safe method for drug-refractory SHPT, the condition may persist or recur after the primary surgery, and reoperation is often required in these patients. The purpose of our current study was to evaluate the safety and effectiveness of reoperation for drug-refractory SHPT. Read More

Medicine (Baltimore) 2020 May;99(19):e19989

Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine.

This study aimed to establish an optimal protocol for Tc-sestamibi parathyroid imaging for lesion localization in patients with hyperparathyroidism (HPT).We retrospectively enrolled 35 consecutive patients who underwent dual-phase (at 10 minutes and 120 minutes) Tc-sestamibi parathyroid scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT). Twenty seven patients had primary HPT, and 8 had secondary or tertiary HPT. Read More

Sisli Etfal Hastan Tip Bul 2019 27;53(3):201-214. Epub 2019 Aug 27.

Department of General Surgery, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Primary hyperparathyroidism (pHPT) is characterized by an increase in the levels of PTH and Ca, or one of these (Ca, PTH) as a result of a dysregulation of calcium (Ca) metabolism due to inappropriate excess parathyroid hormone (PTH) autonomously produced from one or more than one parathyroid glands. Ninety to 95% of pHPT is a sporadic type, which is not associated with the familial history and other endocrine organ tumors, and 5-10% of it is hereditary. While 80-85% of pHPT arises from a single parathyroid adenoma, 4-5% is caused by a double adenoma, 10-15% by multigland hyperplasia and less than 1% by parathyroid cancer. Read More

BMC Endocr Disord 2020 Apr 20;20(1):53. Epub 2020 Apr 20.

Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany.

Background: Primary hyperparathyroidism is a rare condition of disease which can seldomly present as giant retrotrhyroideal cysts, complicating the localization of the adenoma to resect.

Case Presentation: A 56-year old female presented with hypercalcaemia of 3.38 mmol/L (2. Read More

Eur Arch Otorhinolaryngol 2020 Apr 11. Epub 2020 Apr 11.

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.

Purpose: Spontaneous neck hematoma is a rare yet potentially fatal complication of primary hyperparathyroidism (PHPT). Here we aim to describe novel presentations of neck hematomas secondary to PHPT, discussing tools and signs that facilitate diagnosis.

Methods: Case series data were extracted by retrospective chart reviews of our institution's electronic medical records, including all neck hematoma cases from parathyroid origin between 2005 and 2020. Read More

Ann R Coll Surg Engl 2020 Apr 1:e1-e4. Epub 2020 Apr 1.

United Lincolnshire Hospitals NHS Trust, UK.

Introduction: Bilateral giant parathyroid adenoma in the absence of multiple endocrine neoplasia (MEN) type 1 is extremely rare and literature on this subject is limited.

Case History: A 79-year-old man presented with acute kidney injury secondary to hypercalcaemia. Blood test results indicated primary hyperparathyroidism. Read More

Cureus 2020 Jan 31;12(1):e6830. Epub 2020 Jan 31.

Internal Medicine, Ocala Regional Medical Center/ University of Central Florida College of Medicine, Ocala, USA.

The two types of parathyroid cysts are functional and non-functional cysts. Cystic parathyroid lesions are a rare cause of hypercalcemia and often pose a diagnostic challenge due to the reduced detection on preoperative imaging studies. We, herein, present a rare case of an elderly female presenting to the emergency department with altered mental status associated with hypercalcemic crisis and a negative sestamibi scan. Read More

J Clin Res Pediatr Endocrinol 2020 Mar 4. Epub 2020 Mar 4.

Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity characterized by subcortical vasogenic edema presenting with acute neurological symptoms. Common precipitating causes include renal failure, pre-eclampsia/eclampsia, post-organ transplant and cytotoxic drugs. Hypercalcemia is a rare cause of PRES; most cases occur in the setting of severe hypercalcemia secondary to malignancy or iatrogenic vitamin D/calcium overdose. Read More

Medicina (B Aires) 2020 ;80(1):39-47

Cirugía de cabeza y cuello, Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Argentina.

The ectopic parathyroid tissue is a frequent cause of recurrent hyperparathyroidism (HPT), accounting 16% in primary HPT and 14% in secondary cases. Although intrathoracic ectopic glands represent 25-35% of all ectopic cases, only 2% requires thoracic surgery. The aim of this study is to report a case series of patients with ectopic mediastinal HPT treated by thoracic approach in a private institution in Argentina. Read More

AACE Clin Case Rep 2019 Jul-Aug;5(4):e230-e232. Epub 2019 Mar 13.

Objective: Brown tumors develop as skeletal manifestations of hyperparathyroidism. Increased osteoclast activity leads to accumulation of highly active giant cells and to excess cortical bone resorption, producing fibrous cysts. Though most often reported in patients with parathyroid adenomas, brown tumors secondary to parathyroid carcinoma create a clinical dilemma. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019 Dec;54(12):924-927

Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022.

To investigate the etiology, characteristics and prevention of severe facial deformity in patients with uremia entering the dialysis stage. Four cases with uremia in the dialysis stage who presented with severe facial deformity between October 2011 and November 2018 were reviewed, including 3 males and 1 female. The ages were 31, 15, 51 and 61, respectively. Read More

In Vivo 2020 Jan-Feb;34(1):23-32

Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", National and Kapodistrian University of Athens Medical School, Athens, Greece.

Background/aim: Recently, indocyanine green (ICG) fluorescence imaging has been used for the identification of the parathyroid glands (PG) during thyroid and parathyroid surgery. However, an overall consensus on the optimal technique, the dosage, the timing of the ICG administration and finally its interpretation and clinical usefulness is still lacking evidence. The aim of this review is to investigate the use of ICG angiography during thyroidectomy and/or parathyroidectomy for identification as well as for the perfusion integrity of the parathyroid glands. Read More

Clin Hemorheol Microcirc 2019 Dec 19. Epub 2019 Dec 19.

The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Objective: The aim of our study was to evaluate the role of preoperative US, CEUS, and 99mTc-MIBI scanning with SPECT/CT in localizing diseased parathyroid glands in cases of refractory secondary hyperparathyroidism (SHPT).

Material And Methods: Using pathological results as the gold standard, we compared the operative findings with the preoperative localization of each modality in 73 nodules and evaluated the accuracy, and sensitivity of each modality and combinations of the four modalities.

Results: The sensitivity of US, CEUS, 99mTc-MIBI and SPECT/CT was 98. Read More

Probl Radiac Med Radiobiol 2019 Dec;24:380-394

State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine.

Objective: Study of the status of parathyroid glands in individuals exposed to ionizing radiation as a result of the ChNPP accident and comparison with the general population of Ukraine.

Materials And Methods: Subjects exposed as a result of the ChNPP accident (n = 1,348) and people from the general population of Ukraine (n=655) were examined. Diagnostic ultrasound scan of thyroid and parathyroid glands (PTG) was conducted in all study subjects. Read More

Swiss Med Wkly 2019 12 4;149:w20160. Epub 2019 Dec 4.

Department of General and Visceral Surgery, University Hospital Basel, Switzerland.

Background: Secondary hyperparathyroidism (sHPTH) is common in patients with end-stage chronic kidney disease. If drug therapy fails, total parathyroidectomy with autotransplantation of parathyroid tissue into the forearm (PTX-AT) is the most widely used procedure. High recurrence rates of sHPTH following PTX-AT are reported in the literature. Read More

Int J Endocrinol 2019 3;2019:9035407. Epub 2019 Nov 3.

Department of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

Context: Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia.

Objective: To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected.

Design And Participants: Case-control study of patients with benign adrenocortical tumors (cases;  = 400) and normal adrenal glands (controls;  = 400), who underwent repeated abdominal cross-sectional imaging. Read More

Vet Clin North Am Exot Anim Pract 2020 Jan;23(1):131-149

Clinica per Animali Esotici, Roma, Italy.

Reptiles can develop various diseases of the urinary tract, including, but not exclusively, urolithiasis, gout, acute and chronic kidney injury, and secondary renal hyperparathyroidism. Diagnostic imaging is instrumental in differentiating and diagnosing these ailments. This article describes the current diagnostic imaging approaches used in reptile medicine for evaluation of urinary tract disease. Read More

BMC Nephrol 2019 11 21;20(1):425. Epub 2019 Nov 21.

Department of Internal Medicine III, Academic Teaching Hospital Feldkirch, Carinagasse 47, Feldkirch, Austria.

Background: Pregnancy is rare in women on hemodialysis. Recommendations for the treatment of secondary hyperparathyroidism (sHPT) and preservation of bone health in pregnant dialysis patients are lacking.

Case Presentation: We present the case of a young woman with end-stage kidney disease (ESKD) due to lupus nephritis, who developed multiple brown tumors while on hemodialysis during her second pregnancy. Read More

Int J Hyperthermia 2019 ;36(1):1129-1136

Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

Tertiary hyperparathyroidism (THPT) is very common in hemodialysis patients with secondary hyperparathyroidism. However, a medical treatment is not indicated for THPT. To investigate the feasibility, safety and efficacy of microwave ablation (MWA) in treating THPT. Read More

Mayo Clin Proc 2019 11;94(11):2358-2359

MedStar Health, Washington, DC.

Chirurgia (Bucur) 2019 Sept-Oct;114(5):541-549

It is estimated that up to 90% of patients with chronic kidney disease develop secondary hyperparathyroidism (sHPT). Although the disease has multiple manifestations, the most important pathological feature, from the point of view of increased mortality, is represented by the ectopic arterial, myocardial and cardiac valvular calcifications. The calcifications are progressive and lead to high blood pressure, left ventricular hypertrophy, atrio-ventricular blocks, angina and myocardial infarction. Read More

Trials 2019 Oct 24;20(1):601. Epub 2019 Oct 24.

Department of Nephrology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.

Background: Fibroblast growth factor 23 (FGF23) is associated with left ventricular hypertrophy (LVH) in patients with chronic kidney disease, and calcimimetic therapy reduces plasma concentrations of FGF23. It remains unknown whether treatment with the calcimimetic etelcalcetide (ETL) reduces LVH in patients on hemodialysis.

Methods/design: This single-blinded randomized trial of 12 months duration will test the effects of ETL compared with alfacalcidol on LVH and cardiac fibrosis in maintenance hemodialysis patients with secondary hyperparathyroidism. Read More

Sci Rep 2019 10 10;9(1):14634. Epub 2019 Oct 10.

Nagoya Daini Red Cross Hospital, Department of Transplant and Endocrine Surgery, 466-8650, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, Japan.

Complete parathyroidectomy (PTx) is essential during total PTx for secondary hyperparathyroidism (SHPT) to prevent recurrent and persistent hyperparathyroidism. Pre-operative imaging evaluations, including computed tomography (CT), ultrasonography (US), and Tc-99m sestamibi (MIBI) scans, are commonly performed. Between June 2009 and January 2016, 291 patients underwent PTx for SHPT after pre-operative evaluations involving CT, US, and MIBI scans, and the diagnostic accuracies of these imaging modalities for identifying the parathyroid glands were evaluated in 177 patients whose intact parathyroid hormone (PTH) levels were <9 pg/mL after the initial PTx. Read More

Surgery 2020 01 30;167(1):144-148. Epub 2019 Sep 30.

Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA.

Background: Parathyroidectomy (PTX) increases bone mineral density and decreases fracture risk in patients with primary hyperparathyroidism. This study examined the effect of adding bisphosphonates either before or after PTX on skeletal outcomes.

Methods: A retrospective cohort study of bisphosphonate-naïve patients (1995-2016) with osteoporosis and primary hyperparathyroidism (calcium >10. Read More

Dentomaxillofac Radiol 2020 Jan 27;49(1):20190253. Epub 2019 Sep 27.

Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine.

Uremic leontiasis ossea (ULO), which occurs in the craniomaxillofacial region, is a sign of terminal stage osteitis fibrosa cystica or brown tumors and primarily caused by secondary hyperparathyroidism induced by renal failure. Pathophysiological changes include osteoclasts or osteoblasts proliferation, bone resorption, bone decalcification, and connective tissue proliferation. In this paper, we report a case of a 24-year-old female patient, who was diagnosed with ULO and presented with multiple facial swellings. Read More

Scand J Surg 2019 Sep 25:1457496919877581. Epub 2019 Sep 25.

Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Background And Aims: Intraoperative localization of pathologic parathyroid glands is of major importance for the hyperparathyroidism treatment. Based on the small size and the anatomic variability, the localization can be very challenging. The current practice is to compare preoperative ultrasonography with Technetium-99m sestamibi scintigraphy (MIBI) and plan the resection accordingly. Read More

BMJ Case Rep 2019 Sep 24;12(9). Epub 2019 Sep 24.

Oral and Maxillofacial Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Brown tumours are rare osteolytic lesions that occur secondary to hyperparathyroidism (HPT). In 2% of all cases, the craniofacial bones are affected, most frequently the mandible. HPT is classified according to aetiology into three types, of which tertiary HPT is the rarest. Read More

Ren Fail 2019 Nov;41(1):885-892

Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital , Nanjing , China.

Accurate preoperative parathyroid localization is important for successful parathyroidectomy (PTX). The aim of our study was to investigate whether SPECT/CT has enhanced effect in preoperative localization of parathyroids. In our retrospective cohort study, we evaluated the effects of technetium-99m methoxyisobutylisonitrile-single-photon emission computed tomography/computed tomography (Tc-MIBI SPECT/CT) on preoperative parathyroid localization for 645 secondary hyperparathyroidism (SHPT) patients. Read More

Ann R Coll Surg Engl 2019 Nov 11;101(8):e178-e183. Epub 2019 Sep 11.

Department of General Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

Parathyromatosis is a rare entity and usually appears as a consequence of the seeding on previous parathyroid surgery which was applied for the secondary hyperparathyroidism. A 63-year-old woman presented with a history of subtotal thyroidectomy 20 years ago and parathyroidectomy due to primary hyperparathyroidism (PHPT) four years ago. Imaging methods revealed multiple parathyromatosis foci on subcutaneous tissue of the neck. Read More

Clin Nephrol Case Stud 2019 9;7:54-59. Epub 2019 Sep 9.

Department of Medicine.

Non-adherence to medical therapy in patients with end-stage kidney disease (ESKD) can lead to severe metabolic derangements rarely seen in the current medical era. Such complications may take the form of secondary hyperparathyroidism (HPT) leading to rare manifestations of bone mineral disease, and profound vitamin C deficiency from poor nutrition combined with removal of water-soluble vitamins during dialysis. Secondary HPT causes renal osteodystrophy which can lead to diffuse enlargement of the facial skeleton and morphological changes suggestive of leontiasis ossea. Read More

BMJ Case Rep 2019 Sep 5;12(9). Epub 2019 Sep 5.

Department of ENT Surgery, University Hospital Lewisham, London, UK.

Parathyroid carcinoma is the rarest endocrine malignancy. Definitive diagnosis is challenging as it is difficult to distinguish malignant from benign disease. A 71-year-old man presented with weight loss and hypercalcaemia. Read More

Insights Imaging 2019 Jul 29;10(1):75. Epub 2019 Jul 29.

Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospital Foundation Trust, Windmill Road, Headington, Oxford, OX3 7HE, UK.

Brown tumours do not represent neoplastic process, but they are focal bony lesions due to bone remodelling from either primary or secondary hyperparathyroidism. Their incidence is also low. The current literature on brown tumour is mainly in the form of case reports that focus on single affected sites. Read More

Clin Transplant 2019 10 16;33(10):e13671. Epub 2019 Aug 16.

Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore City, Singapore.

The evolution of trabecular bone score (TBS) and bone mineral density (BMD) over the first 5 years after renal transplantation was prospectively evaluated in 164 patients. Dual energy X-ray absorptiometry (DXA) scans were performed at 0, 6, 12, 24, and 60 months. Cumulative steroid dose, serum 25(OH)D, calcium, parathyroid hormone, and total ALP levels at these time points were checked. Read More

BMC Surg 2019 Jul 16;19(1):94. Epub 2019 Jul 16.

Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania.

Background: The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). Read More

J Surg Res 2019 11 2;243:380-383. Epub 2019 Jul 2.

Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address:

Background: Parathyroidectomy for patients with secondary hyperparathyroidism (sHPT) generally requires a four-gland exploration. Some groups have strongly recommended routine preoperative Tc-99m-sestamibi scans; others practice scanning for only selected patients. To determine the utility of sestamibi scans in this patient population, we reviewed our experience. Read More

Medicine (Baltimore) 2019 Jun;98(24):e16077

Rationale: Secondary hyperparathyroidism (SHPT) is often complicated with chronic renal failure. Though the total parathyroidectomy (TPTX) with forearm autotransplantation (FAT) has been commonly used to treatment refractory renal SHPT, the recurrence of SHPT is not infrequent, resulting from hyperplastic autograft, remnant parathyroid tissues, and supernumerary parathyroid gland (SPG).

Patient Concerns: A 67-year-old man undergoing TPTX+FAT 4 years previously for renal SHPT, who received regular hemodialysis with active vitamin D supplements of Rocaltrol treatment postoperatively, was admitted to our hospital with progressively elevated serum intact parathyroid hormone (iPTH) from 176 to 1266 pg/mL for 8 months and bilateral ankle joints pain for 1 month. Read More

J Musculoskelet Neuronal Interact 2019 06;19(2):196-206

Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria.

Objectives: Little is known about bone mineralization and osteocyte lacunae properties in chronic kidney disease mineral bone disorder (CKD-MBD).

Methods: In this retrospective study, we measured the bone mineralization density distribution (BMDD) and osteocyte lacunar section (OLS) 2D-characteristics by quantitative backscatter electron imaging in Straumann drill biopsy samples from n=58 patients with CKD-MBD. Outcomes were studied in relation to serum parathyroid hormone (PTH), alkaline phosphatase (APH), histomorphometric bone turnover and treatment with cinacalcet or phosphate binders. Read More

Endocrine 2019 09 7;65(3):707-709. Epub 2019 Jun 7.

Department of Clinical Medicine, Division of Endocrinology, Federal University of Espírito Santo, Vitória, ES, Brazil.

Radiographics 2019 Jul-Aug;39(4):1036-1055. Epub 2019 Jun 7.

From the Department of Radiology, Saint Louis University Hospital, St Louis, Mo (M.A.S., E.I.A.); Department of Radiology and Imaging, Medical College of Georgia, Augusta, Ga (P.K.M.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (B.P.L.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (F.H.M.); Department of Radiology, University of Kansas School of Medicine, Wichita, Kan (K.A.); Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India (S.S.); and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (C.C.M.).

Hypertension is a common problem; if left untreated, it can result in significant complications, including those involving the cardiovascular system and end organs. Approximately 10% of patients with hypertension are classified as having , defined as hypertension attributable to a specific and potentially remediable cause. The evaluation for secondary hypertension typically begins with acquiring the patient history and performing a physical examination and screening laboratory tests. Read More

Perm J 2019 17;23. Epub 2019 May 17.

Department of Internal Medicine, Montefiore Hospital and Medical Center, Bronx, NY.

JAMA Otolaryngol Head Neck Surg 2019 May 30. Epub 2019 May 30.

Department of Head and Neck Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Importance: Identifying parathyroid glands correctly before a surgical procedure is essential to perform minimally invasive surgery. First-line tests with discordant or negative results underscore the need for more accurate imaging tests, thus decreasing the requirement for bilateral neck exploration or reintervention.

Objective: To review the available evidence to determine positive predictive value, negative predictive value, sensitivity, and specificity in clinical cases in which 18F-fluorocholine positron emission tomography-computed tomography (PET/CT) could be useful as a method to locate the lesions, and the benefits and controversial aspects of the method. Read More

CEN Case Rep 2019 11 14;8(4):227-232. Epub 2019 May 14.

Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey.

Secondary and tertiary hyperparathyroidism is an important problem of chronic kidney disease. Brown tumor is a benign, unusual, reactive lesion as a result of disturbed bone remodeling, from long-standing increase in parathyroid hormone level. Brown tumors may cause morbidity due to pressure symptoms on neural structures and spontaneous bone fractures. Read More

Eur J Endocrinol 2019 Apr 1. Epub 2019 Apr 1.

I Chiodini, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

An underlying disease affecting bone health is present in up to 40% and 60% of osteoporotic post-menopausal women and men respectively. Among the disorders leading to a secondary form of osteoporosis, the endocrine diseases are highly represented. A frequent finding in patients affected with an endocrine-related forms of bone disease is that the skeletal fragility is partially independent of the bone density, since the fracture risk in these patients is related more to a reduction of bone quality than to a decrease of bone mass. Read More

J Pak Med Assoc 2019 Apr;69(4):600

Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.

Metastatic calcification relates to abnormal calcification resulting from hypercalcaemia in otherwise normal tissues. Hypercalcaemia can occur secondary to chronic renal failure, hyperparathyroidism, hypervitaminosis D, and metastatic neoplasms. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Read More

Clin Kidney J 2019 Apr 20;12(2):269-280. Epub 2018 Jul 20.

Division of Nephrology, Ambroise Paré University Medical Center, APHP, University of Paris Ouest (UVSQ), Boulogne Billancourt/Paris, France.

Chronic kidney disease (CKD) is often associated with a mineral and bone disorder globally described as CKD-Mineral and Bone Disease (MBD), including renal osteodystrophy, the latter ranging from high bone turnover, as in case of secondary hyperparathyroidism (SHPT), to low bone turnover. The present article summarizes the important subjects that were covered during 'The Parathyroid Day in Chronic Kidney Disease' CME course organized in Paris in September 2017. It includes the latest insights on parathyroid gland growth, parathyroid hormone (PTH) synthesis, secretion and regulation by the calcium-sensing receptor, vitamin D receptor and fibroblast growth factor 23 (FGF23)-Klotho axis, as well as on parathyroid glands imaging. Read More

Otolaryngol Head Neck Surg 2019 08 9;161(2):251-256. Epub 2019 Apr 9.

4 Department of Radiology, Naval Medical Center San Diego, San Diego, CA.

Objectives: To describe parathyroid computed tomography angiography (PCTA), determine its accuracy, and, as a secondary objective, calculate its mean radiation dosimetry.

Study Design: Retrospective chart review of patients who underwent parathyroidectomy for primary hyperparathyroidism from 2007 to 2015.

Setting: Single-center tertiary care academic military hospital. Read More

Cureus 2019 Jan 26;11(1):e3966. Epub 2019 Jan 26.

Internal Medicine, Louis Stokes Cleveland VA Medical Center, Cleveland, USA.

Primary hyperparathyroidism is the third most commonly encountered endocrine disorder after diabetes and thyroid diseases. There has been a constant debate between medical and surgical management of the disorder. Guidelines clearly indicate surgical management over medical management in symptomatic patients and asymptomatic patients below 50 years of age. Read More