Surgical treatment of primary hyperparathyroidism in children: Report of 10 cases

Libánský, P; Astl, Jaromı́r; Adámek, S; Naňka, Ondřej; Pafko, Pavel; Špačková, Jana; Foltán, René; Šedý, Jiří

doi:10.1016/j.ijporl.2008.04.005

Cited by 24 publications

(23 citation statements)

References 14 publications

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“…The largest case series in children with PHPT from the Mayo Clinic [2] reported ultrasound to have a sensitivity of 86%, specificity of 67% and a positive predictive value of 95% in identifying adenomatous and hyperplastic glands. Other reports describing the use of ultrasound in children with PHPT reported a sensitivity of 55-90% [5,6] . In our hands, ultrasound predicted correct laterality of the abnormal glands in all older children, and its overall sensitivity and specificity were 93 and 98%, respectively.…”

Section: Investigationsmentioning

confidence: 98%

“…In children, MIBI scanning is used frequently and has a sensitivity of 60-90% [5,6,9] . Combined ultrasound and MIBI scanning has an overall sensitivity of 73% [3] and 95% [28,29] in detecting solitary adenomas.…”

Section: Investigationsmentioning

confidence: 99%

“…In adults it is a common condition and much is known about its epidemiology, clinical course, accuracy of imaging, and outcomes of surgical treatment. In contrast, PHPT in children is very rare, and such information is sparse as only about 200 cases have been described in the world literature [1][2][3][4][5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

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Aetiology, Diagnosis and Surgical Treatment of Primary Hyperparathyroidism in Children: New Trends

Alagaratnam

Kurzawinski²

2015

Horm Res Paediatr

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Primary hyperparathyroidism (PHPT) in children is a rare disorder with sharp contrasts in its presentation and aetiology compared with the disease process in adults. This review outlines the current literature, which is limited to about 200 cases, with reference to the aetiology, clinical features, outcomes of investigations, and surgery in children affected by PHPT. Familial conditions account for almost half of all cases of PHPT in children, suggesting that routine genetic testing would be appropriate. Neonatal severe hyperparathyroidism requires urgent medical attention, and performing total parathyroidectomies offers cure, though conservative management is successful in selected cases. Familial hyperparathyroidism in older children can be caused by conditions such as multiple endocrine neoplasia types 1 and 2a, hyperparathyroidism-jaw tumour syndrome and familial hyperparathyroidism. The role of surgery for this group is discussed. The use of ultrasound and MIBI (<sup>99m</sup>Tc-methoxyisobutylnitrile) scanning appears to accurately localise solitary adenomas in sporadic PHPT, thereby supporting the role of minimally invasive parathyroidectomy in children.

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Section: Investigationsmentioning

confidence: 98%

Section: Investigationsmentioning

confidence: 99%

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Aetiology, Diagnosis and Surgical Treatment of Primary Hyperparathyroidism in Children: New Trends

Alagaratnam

Kurzawinski²

2015

Horm Res Paediatr

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“…Preoperatively, maximum effort to localize particular parathyroid tissue, most often by sonography or scintigraphy, is necessary (Libánský et al, 2008). Surgical treatment, parathyroidectomy, is defi nitive, curative and relatively safe.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment, parathyroidectomy, is defi nitive, curative and relatively safe. During the operation, the main goal is to remove the proper pathologic parathyroid tissue (Libánský et al, 2008). The success of pathologic parathyroid gland removal is verifi ed by histology or, nowadays, more often by an intact parathormone (iPHT) level measurement (Schneider et al, 2014, Irvin et al, 2004.…”

Section: Introductionmentioning

confidence: 99%

Measurement of intact parathormone during operation for primary hyperparathyroidism

Libánský¹,

Adámek²,

Broulík³

et al. 2017

BLL

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In this prospective study, the role of the intact parathormone (iPHT) levels for the verifi cation of pathologic parathyroid tissue removal during parathyroidectomy, was analyzed in 441 patients diagnosed with primary hyperparathyroidism. The level of intact parathormone was obtained before the initial incision (baseline level) and 10 minutes after the pathologic parathyroid gland removal (control value). In 80 % of cases, the decrease of intact parathormone was more than 50 % of the baseline level. The comparison of preoperative and postoperative intact parathormone levels can also be used as marker of parathyroid hyperplasia or persistent hyperparathyroidism. This method is necessary mainly for performance of focused, miniinvasive approaches as well as in reoperations. This method is of signifi cant benefi t in cases of negative preoperative examination methods. The determination of intact parathormone level increases the success of parathyroidectomy (Ref. 26). Text in PDF www.elis.sk.

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Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism

Šedý¹

2009

Arch Surg

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implemented as a prelude to organ donation after an individual suffers unrecoverable injuries. In 1 study, substantial variations in do-not-resuscitate orders across hospitals in the national trauma registry were unexplained by patient characteristics but were associated with institutional differences in end-of-life ethos and perceptions of patients' ability to recover from life-threatening traumatic injuries. 4 To facilitate subsequent organ recovery, in-house procurement coordinators are linked with trauma professionals (Team Huddle Program) before the determination is made about the salvageability of patients with potentially unrecoverable conditions. 5 This early linkage in postinjury care combined with a lack of standard guidelines for declaring patients unrecoverable soon after trauma can misguide aggressive resuscitation toward preserving organs instead of saving lives. 6 Donor care that is necessary before death to recover transplantable organs can also influence timing and quality of end-of-life care for terminally ill patients. Institutions are then confronted with conflicting interests and roles: providing care in patients' best interests while also maximizing end-of-life organ recovery. 7 Acknowledging such conflicts is a first step toward establishing transparent guidelines for end-of-life care after traumatic injuries while maintaining public trust in the integrity of the medical profession.

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Surgical treatment of primary hyperparathyroidism in children: Report of 10 cases

Cited by 24 publications

References 14 publications

Aetiology, Diagnosis and Surgical Treatment of Primary Hyperparathyroidism in Children: New Trends

Aetiology, Diagnosis and Surgical Treatment of Primary Hyperparathyroidism in Children: New Trends

Measurement of intact parathormone during operation for primary hyperparathyroidism

Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism

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