Parathyroid Exploration: A Review of 125 Cases

Summers, Gordon W.

doi:10.1001/archotol.1991.01870230053007

Cited by 24 publications

(17 citation statements)

References 20 publications

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“…Another study from the USA identi¢ed only two cases of FBHH in a consecutive series of 181 operations for PHPT, by close investigation of ¢ve cases in which there was failure to restore normocalcaemia. 5 Two prospective studies of unselected patients referred for investigation of hypercalcaemia have been reported (see Table 1). 6,7 In each study, all new cases of hypercalcaemia were systematically investigated over a 3-year period.…”

Section: Epidemiologymentioning

confidence: 99%

Clinical and laboratory features of calcium-sensing receptor disorders: a systematic review

Gunn

Gaffney

2004

Ann Clin Biochem

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Mutations in the calcium-sensing receptor gene (CaSR) may result in disorders of calcium homeostasis manifesting as familial benign hypocalciuric hypercalcaemia (FBHH), neonatal severe hyperparathyroidism (NSHPT) or autosomal dominant hypocalcaemia with hypercalciuria (ADHH). FBHH may have a population prevalence as high as one in 16 000, and ADHH one in 70 000. NSHPT is very rare.The FBHH condition is usually asymptomatic. Parathyroidectomy does not result in normal serum calcium, and no active treatment is indicated. To differentiate FBHH from primary hyperparathyroidism (PHPT), a guideline which includes measurement of serum calcium, intact parathyroid hormone (PTH), magnesium and fasting urinary calcium excretion is proposed. Screening of family members for hypercalcaemia, and occasionally a search for mutations in the CaSR gene, may be required.The NSHPT condition may manifest with hypercalcaemia, (usually) very elevated serum PTH concentration, subperiosteal erosions and fractures. Milder cases may be managed medically, but respiratory failure, extreme hypercalcaemia and failure to thrive are indications for early parathyroidectomy.The ADHH condition may result in asymptomatic hypocalcaemia, but some affected family members have minor symptoms, and a minority experience seizures in infancy which can recur into adulthood. A significant proportion of cases previously reported as idiopathic hypoparathyroidism (IHP) may in fact be due to mutations in the CaSR gene. In a moderately hypocalcaemic patient with no other clearly discernible cause, an elevated urine calcium:creatinine ratio is suggestive of ADHH, as is the presence of a first-degree relative with hypocalcaemia. If treatment with vitamin D analogues is undertaken, serum and urine calcium should be monitored, advice which applies equally to ADHH and IHP.

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Section: Epidemiologymentioning

confidence: 99%

Clinical and laboratory features of calcium-sensing receptor disorders: a systematic review

Gunn

Gaffney

2004

Ann Clin Biochem

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“…PHPT is the most common cause of hypercalcemia in unselected patients. Although parathyroid disease is relatively uncommon, 80% of all cases of PHPT are caused by a single adenoma [1,3,6], while multiple gland hyperplasia occurs in 12-15%, double adenoma in 2-3% and carcinoma in about 1% [1,7].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Giant Mediastinal Parathyroid Adenomas Presented With Severe Hypercalcemia: Report of a Case

Bayraktar

2014

J Med Cases

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Primary hyperparathyroidism (PHPT) is a common disorder of parathyroid gland and mostly results from parathyroid adenoma with the excess production of parathyroid hormone, usually causing hypercalcemia. This is the most common reason for surgical removal of parathyroid glands. It is mostly seen as single gland adenoma and bilaterality is very rare. In this study, we report a case of bilateral giant parathyroid adenomas represented with severe hypercalcemia, representing to our knowledge the largest masses to have been documented in the literature.

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“…however, and these figures belong to the best units [16]. Difficulties arise in the frequent presence of poste rior thyroid nodules and cysts leading to false positives, while false negatives occur where pathology occurs in the 10-15% of parathyroid glands which are in regions inac cessible to ultrasonography being hidden behind air (pharynx and esophagus), or bone (sternum, clavicle) [ 14,17,18], Thallium-technetium scanning appears to be the most accurate technique for localising adenomas below the clavicles [13].…”

Section: Parathyroidmentioning

confidence: 99%

“…Sonographic evidence of multi ple gland enlargement should alert the surgeon to possible multiple endocrine neoplasia. Others argue that the most accurate means of localisation is an experienced parathy roid surgeon who would be expected to have a cure rate of 95% or more [18].…”

Section: Parathyroidmentioning

confidence: 99%

Ultrasonography of the Thyroid and Parathyroid Glands

McIvor

Freeman²,

Salem³

1993

ORL

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High-frequency ultrasonography is ideally suited to imaging of the thyroid and parathyroid glands by virtue of their superficial location in the neck. Ultrasonography of the thyroid is most commonly used in the evaluation of the solitary nodule. Ultrasonography of the parathyroid glands is usually performed to evaluate and localise parathyroid abnormalities in patients with hypercalcemia. The increased diagnostic acumen offered by this modality allows a realistic working diagnosis and leads to a rational management strategy.

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Parathyroid Exploration: A Review of 125 Cases

Cited by 24 publications

References 20 publications

Clinical and laboratory features of calcium-sensing receptor disorders: a systematic review

Clinical and laboratory features of calcium-sensing receptor disorders: a systematic review

Bilateral Giant Mediastinal Parathyroid Adenomas Presented With Severe Hypercalcemia: Report of a Case

Ultrasonography of the Thyroid and Parathyroid Glands

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