Clinical features of primary hyperparathyroidism in patients with urolithiasis

2015 ◽  
Vol 15 (4) ◽  
pp. 37-43
Author(s):  
D Rogozin ◽  
S Sergiyko ◽  
A Rogozina
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Features

scholarly journals Presentation, diagnostic assessment and surgical outcomes in primary hyperparathyroidism: a single centre’s experience

2018 ◽  
Vol 7 (10) ◽  
pp. 1105-1115 ◽  
Author(s):  
Laura J Reid ◽  
Bala Muthukrishnan ◽  
Dilip Patel ◽  
Mike S Crane ◽  
Murat Akyol ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Imaging Modality ◽  
Evidence Base ◽  
University Hospital ◽  
Clearance Ratio ◽  
Curative Surgery ◽  
History Of ◽  
Surgical Failure

Objective Primary hyperparathyroidism (PHPT) is a common reason for referral to endocrinology but the evidence base guiding assessment is limited. We evaluated the clinical presentation, assessment and subsequent management in PHPT. Design Retrospective cohort study. Patients PHPT assessed between 2006 and 2014 (n = 611) in a university hospital. Measurements Symptoms, clinical features, biochemistry, neck radiology and surgical outcomes. Results Fatigue (23.8%), polyuria (15.6%) and polydipsia (14.9%) were associated with PHPT biochemistry. Bone fracture was present in 16.4% but was not associated with biochemistry. A history of nephrolithiasis (10.0%) was associated only with younger age (P = 0.006) and male gender (P = 0.037). Thiazide diuretic discontinuation was not associated with any subsequent change in calcium (P = 0.514). Urine calcium creatinine clearance ratio (CCCR) was <0.01 in 18.2% of patients with confirmed PHPT. Older age (P < 0.001) and lower PTH (P = 0.043) were associated with failure to locate an adenoma on ultrasound (44.0% of scans). When an adenoma was identified on ultrasound the lateralisation was correct in 94.5%. Non-curative surgery occurred in 8.2% and was greater in those requiring more than one neck imaging modality (OR 2.42, P = 0.035). Conclusions Clinical features associated with PHPT are not strongly related to biochemistry. Thiazide cessation does not appear to attenuate hypercalcaemia. PHPT remains the likeliest diagnosis in the presence of low CCCR. Ultrasound is highly discriminant when an adenoma is identified but surgical failure is more likely when more than one imaging modality is required.

Clinical features and management of primary hyperparathyroidism discovered by parathyroid incidentaloma

2020 ◽  
Author(s):  
Jaksic Vlatka Pandzic ◽  
Ana Majic ◽  
Jelena Andric ◽  
Berkovic Maja Cigrovski ◽  
Srecko Marusic
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Features

EFFECT OF PRIOR NECK RADIATION THERAPY ON CLINICAL FEATURES OF PRIMARY HYPERPARATHYROIDISM AND ASSOCIATED THYROID TUMORS

2003 ◽  
Vol 9 (5) ◽  
pp. 353-362 ◽  
Author(s):  
Behzad Kalaghchi, MD ◽  
Stephen A. Brietzke, MD, FACP, FACE ◽  
Almond J. Drake III, MD, FACP, FACE ◽  
K. M. Mohamed Shakir, MD, FACP, FRCP, FACE
Keyword(s):  
Radiation Therapy ◽  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Thyroid Tumors

scholarly journals Familial isolated hyperparathyroidism due to multiple adenomas associated with ossifying jaw fibroma and multiple uterine adenomyomatous polyps

1998 ◽  
pp. 557-561 ◽  
Author(s):  
M Fujikawa ◽  
K Okamura ◽  
K Sato ◽  
T Mizokami ◽  
K Tamaki ◽  
...  
Keyword(s):  
Young Adult ◽  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Multiple Endocrine Neoplasia ◽  
Adult Onset ◽  
Female Patients ◽  
Endocrine Neoplasia ◽  
Parathyroid Adenomas ◽  
Uterine Polyps ◽  
Familial Hyperparathyroidism

We describe three siblings with hyperparathyroidism due to multiple parathyroid adenomas without evidence of other endocrinological abnormalities. A 22-year-old woman had two parathyroid adenomas complicated by multiple ossifying jaw fibromas. Her sister, aged 29, also suffered from primary hyperparathyroidism associated with two parathyroid adenomas one of which was also suspected to be a carcinoma. These two female patients had unusual multiple small uterine polyps, which were diagnosed as adenomyomatous polyps. Their brother, aged 17, had two parathyroid adenomas complicated by urolithiasis. These three patients are characterized by young adult-onset familial isolated hyperparathyroidism due to multiple adenomas with various complications including ossifying jaw fibroma and uterine adenomyomatous polyps. These clinical features are different from those of familial hyperparathyroidism associated with multiple endocrine neoplasia.

scholarly journals Primary hyperparathyroidism clinical features on endocrinology in-patients clinic

2018 ◽  
Vol 90 (10) ◽  
pp. 51-54
Author(s):  
I E Sapozhnikova
Keyword(s):  
Retrospective Study ◽  
Hip Fracture ◽  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Pathological Fracture ◽  
Regional Hospital ◽  
Late Diagnosis ◽  
Ultra Sound ◽  
Blood Calcium

Aim. The analysis clinical features of primary hyperparathyroidism on endocrinology in-patients clinic. Materials and methods. Open retrospective study, included data of patients who were hospitalized at Kirov Regional Hospital with primary hyperparathyroidism from January 01, 2013 to December 31, 2016. Results and discussion. 23 patients were hospitalized. Their age is 24-78 years old (mediana 59 [52; 65] years old). There are 20 (87%) women, and 3 (13%) men. Manifest forms of primary hyperparathyroidism were detected in 18 (78.3%) patients, mild forms - in 5 (21.7%) patients. Pathological fracture had 7 (30.4%) patients including 3 (13%) vertebrae and hip fracture, urolithiasis had 10 (43.5%) persons. High blood calcium or parathyroma in ultra-sound were initially revealed in 8 (34.8%) patients 4 (50%) of them had manifest primary hyperparathyroidism. Period before diagnosis was 2 years and more in 10 (43.5%) patients. Conclusion. Clinical features of primary hyperparathyroidism are prevalence of manifest forms, late diagnosis, and high enough frequent of accidental reveal (including persons with representative symptoms).

Silent Renal Stones in Primary Hyperparathyroidism: Prevalence and Clinical Features

2014 ◽  
Vol 20 (11) ◽  
pp. 1137-1142 ◽  
Author(s):  
Sara Cassibba ◽  
Micaela Pellegrino ◽  
Laura Gianotti ◽  
Claudia Baffoni ◽  
Enrico Baralis ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Renal Stones

scholarly journals Symptomatic Hypercalcemia in Patients with Primary Hyperparathyroidism Is Associated with Severity of Disease, Polypharmacy, and Comorbidity

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
C. Aresta ◽  
E. Passeri ◽  
S. Corbetta
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Kidney Stones ◽  
Gastrointestinal Symptoms ◽  
Cardiovascular Comorbidities ◽  
Chronic Therapy ◽  
Serum Pth ◽  
Reduced Kidney Function

Current primary hyperparathyroidism (PHPT) clinical presentation is asymptomatic in more than 90% of patients, while symptoms concern osteoporosis and rarely kidney stones. Here, we retrospectively investigated the prevalence of PHPT patients presenting with hypercalcemic-related symptoms (HS-PHPT) as cognitive impairment, changes in sensorium, proximal muscle weakness, nausea and vomiting, constipation, and severe dehydration, in a single center equipped with an emergency department and described their clinical features and outcome in comparison with a series of asymptomatic PHPT out-patients (A-PHPT). From 2006 to 2016, 112 PHPT patients were consecutively diagnosed: 16% (n = 18, 3M/15F) presented with hypercalcemic-related symptoms. Gastrointestinal symptoms occurred in 66% of HS-PHPT patients and cognitive impairment in 44%; one woman experienced hypertensive heart failure. Two-thirds of HS-PHPT patients were hospitalized due to the severity of symptoms. Comparing the clinical features of HS-PHPT patients with A-PHPT patients, no gender differences were detected in the two groups, while HS-PHPT patients were older at diagnosis (71 (61–81) vs. 64 (56–74) years, P=0.04; median (IQR)). HS-PHPT patients presented higher albumin-corrected calcium levels (12.3 (11.3–13.7) vs. 10.6 (10.3–11.3) mg/dl, P<0.001); 4 HS-PHPT presented corrected calcium levels >14 mg/dl. Serum PTH levels and total alkaline phosphatase activity were higher in HS-PHPT. Reduced kidney function (eGFR < 45 ml/min) was prevalent in HS-PHPT patients (42% vs. 5%, P=0.05). No differences in kidney stones and osteoporosis were detected, as well as in the rates of cardiovascular comorbidities and main cardiovascular risk factors. HS-PHPT patients had an age-adjusted Charlson Comorbidity Index higher than that of the A-PHPT patients and were on chronic therapy with a greater number of medications than A-PHPT patients. In conclusion, hypercalcemic-related symptoms occurred in 16% of PHPT patients. Risk factors were severity of the parathyroid tumor function, multimorbidity, and polypharmacy.

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