Abordagem clínico-laboratorial no diagnóstico diferencial de hipercalcemia

Kayath, Marcia J.

doi:10.1590/s0004-27301999000600014

Cited by 7 publications

(4 citation statements)

References 64 publications

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“…It is known that osteoporosis in women is associated with a decrease of estrogen, which accelerates bone loss. There are other mechanisms that can lead to hypercalcemia, such as an increase in bone resorption and in intestinal calcium absorption and a decrease in the urinary excretion of calcium [37]. Studies performed with osteoblasts (MC3T3-E1) treated with calcium and fluoride in vitro showed that L-type calcium channels play an important role in this mineral homeostasis, because they affect the osteogenic expression of transcription factors such as activator protein 1, runt-related transcription factor 2, and osterix in These results suggest that the regulation of the expression or activity of the L-type calcium channels can regulate calcium signaling in bone cells and the modulation of these channels can influence bone remodeling in conditions of fluorosis [38].…”

Section: Discussionmentioning

confidence: 99%

Effect of Sodium Fluoride on Bone Biomechanical and Histomorphometric Parameters and on Insulin Signaling and Insulin Sensitivity in Ovariectomized Rats

Nunes

Chiba

Pereira

et al. 2016

Biol Trace Elem Res

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Osteoporosis is a systemic disease characterized by bone degradation and decreased bone mass that promotes increased bone fragility and eventual fracture risk. Studies have investigated the use of sodium fluoride (NaF) for the treatment of osteoporosis. However, fluoride can alter glucose homeostasis. The aim of this study was to evaluate the effects of NaF intake (50 mg/L) from water on the following parameters of ovariectomized (OVX) rats: (1) tyrosine phosphorylation status of insulin receptor substrate (pp185 (IRS-1/IRS-2)) in white adipose tissue; (2) insulin sensitivity; (3) plasma concentrations of glucose, insulin, total cholesterol, triglyceride, TNF-α, IL-6, osteocalcin, calcium, and fluoride; (4) bone density and biomechanical properties in the tibia; and (5) tibia histomorphometric analysis. Fifty-two Wistar rats (2 months old) were ovariectomized and distributed into two groups: control group (OVX-C) and NaF group (OVX-F), which was subjected to treatment with NaF (50 mg/L) administered in drinking water for 42 days. The chronic treatment with NaF promoted (1) a decrease in pp185 (IRS-1/IRS-2) tyrosine phosphorylation status after insulin infusion in white adipose tissue and in insulin sensitivity; (2) an increase in the plasma concentration of insulin, fluoride, osteocalcin, calcium, triglyceride, VLDL-cholesterol, TNF-α, and IL-6; (3) a reduction in the trabecular width, bone area, stiffness, maximum strength, and tenacity; (4) no changes in body weight, food and water intake, plasma glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, bone mineral content, and bone mineral density. It was concluded that chronic treatment with NaF (50 mg/L) in OVX rats causes a decrease in insulin sensitivity, insulin signaling transduction, and biochemical, biomechanical, and histomorphometric bone parameters.

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Section: Discussionmentioning

confidence: 99%

Effect of Sodium Fluoride on Bone Biomechanical and Histomorphometric Parameters and on Insulin Signaling and Insulin Sensitivity in Ovariectomized Rats

Nunes

Chiba

Pereira

et al. 2016

Biol Trace Elem Res

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“…O fato de o achado cirúrgico ter sido um adenoma também contraria a hipótese familiar, uma vez que nestes casos a hiperplasia é mais freqüente. Não há evidências para os distúrbios autossômico-dominantes neoplasia endócrina múltipla tipo I, na qual o hiperparatireoidismo está presente em 97% dos casos, nem tipo IIa, onde está presente em 20% dos casos (1,3,10). Uma outra síndrome associada ao hiperparatireoidismo seria a descrita por Jackson e cols.…”

Section: Discussionunclassified

Hiperparatireoidismo primário associado a epifisiólise de cabeça do fêmur em adolescente

Madeira

Machado

Maya

et al. 2005

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 49 nº 2 Abril 2005 314 RESUMOO hiperparatireoidismo primário (HPP) é uma doença incomum na infân-cia e na adolescência. A associação de HPP e epifisiólise de cabeça do fêmur é rara, tendo sido descritos apenas quatro casos na literatura. Relatamos um caso de HPP por adenoma de paratireóide, com dores e inúmeras deformidades ósseas, associado a epifisiólise de cabeça do fêmur em um jovem de 18 anos. A análise laboratorial mostrou cálcio de 13,7mg/dL, paratormônio de 1.524pg/mL e fosfatase alcalina de 3.449U/L. As deformidades foram decorrentes de diagnóstico tardio e possivelmente pelo fato de a doença ter ocorrido na fase de estirão puberal. A combinação de vários fatores metabólicos e mecânicos provavelmente contribuiu para esta associação. O paciente foi submetido à remoção cirúrgica do adenoma, que costuma ser acompanhada por resolução pronta da epifisiólise. Desta forma, foi optado por conduta expectante quanto à epifisiólise da cabeça do fêmur, em consonância com a literatura. Houve melhora das dores ósseas e normalização dos níveis de cálcio e de paratormônio. ABSTRACT Primary Hyperparathyroidism Associated to Slipped Capital Femoral Epiphysis in a Teenager.Primary hyperparathyroidism (PHP) is an uncommon disease in children and adolescents. The association between PHP and slipped capital femoral epiphysis is rare, and so far only four cases have been reported in the literature. Herein, we report a case of PHP due to a parathyroid adenoma, with several painful skeletal deformities and associated with slipped capital femoral epiphysis in an 18-year-old male patient. Laboratory evaluation showed: calcium of 13.6mg/dL, parathyroid hormone of 1,524pg/mL and alkaline phosphatase of 3,449U/L. Deformities were caused by late diagnosis during the growth spurt, and this association is the result of combinations between metabolic and mechanical factors. The patient underwent parathyroidectomy and, in agreement with the literature, since the removal of the adenoma is followed by prompt resolution of the slipped capital femoral epiphysis we decided for a conservative approach. We observed improvement of the pain and normalization of calcium and parathyroid hormone levels.

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“…Nesses indivíduos, tem sido aventada a coexistência de hiperparatireoidismo primário, de forma que a hipercalcemia poderia ser gerada por uma resposta da ação incontrolada do paratormônio sobre o osso. De toda forma, é importante investigar as paratireóides de pacientes hipertireóideos que apresentem hipercalcemia (99).…”

Section: Ribeiro Et Alunclassified

A osteoporose e os distúrbios endócrinos da tireóide e das gônadas

Ribeiro

Serákides

Nunes

et al. 2003

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 47 nº 3 Junho 2003 228 RESUMOApesar da dedicação incessante dos pesquisadores no estudo da osteoporose, muito ainda necessita ser elucidado. A deficiência dos esteróides sexuais, principalmente a de estrógeno, é considerada a principal causa de osteoporose, embora existam inúmeros outros fatores envolvidos. O hipertireoidismo, por exemplo, é considerado um dos fatores de risco para indução ou agravamento da osteoporose e tem despertado o interesse para o estudo dos efeitos de T3 e T4 sobre o metabolismo ósseo. Embora o hipotireoidismo e a afuncionalidade das gônadas seja uma associação freqüente na mulher, a hipofunção da tireóide não é considerada fator de risco para a osteoporose da menopausa. Assim, o estudo da inter-relação entre os distúrbios endócrinos, tão comuns na idade avançada, e a osteoporose é fundamental, pois deste conhecimento poderão advir meios de controle e tratamento adequados, bem como a definição da real natureza do distúrbio ósseo. O objetivo desta revisão é apresentar e discutir alguns aspectos da osteoporose e sua inter-relação com os distúrbios endócrinos da tireóide e das gônadas. ABSTRACT Osteoporosis and the Endocrine Disturbances of Thyroid and Gonads.Despite the incessant dedication of the researchers to the study of osteoporosis, a lot still needs to be elucidated. The deficiency of sexual steroids, mainly of estrogen, is considered the main cause of osteoporosis, although a number of other factors are involved. Hyperthyroidism, for instance, is considered a risk factor for induction or aggravation of osteoporosis and has risen the interest in the study of the effects of T3 and T4 on osseous metabolism. Although hypothyroidism and gonadic dysfunction are frequently associated in women, thyroid hypofunction is not considered as a risk factor for postmenopausal osteoporosis. Thus, the study of the inter-relationship between endocrine disturbances, so common in advanced age, and osteoporosis is fundamental. Adequate means of control and treatment may result from this knowledge, as well as a definition of the real nature of the bone disturbance. The aim of this review is to present and discuss some aspects of osteoporosis and its inter-relation with the endocrine dysfunctions of the thyroid and the gonads.

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Abordagem clínico-laboratorial no diagnóstico diferencial de hipercalcemia

Cited by 7 publications

References 64 publications

Effect of Sodium Fluoride on Bone Biomechanical and Histomorphometric Parameters and on Insulin Signaling and Insulin Sensitivity in Ovariectomized Rats

Effect of Sodium Fluoride on Bone Biomechanical and Histomorphometric Parameters and on Insulin Signaling and Insulin Sensitivity in Ovariectomized Rats

Hiperparatireoidismo primário associado a epifisiólise de cabeça do fêmur em adolescente

A osteoporose e os distúrbios endócrinos da tireóide e das gônadas

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