99mTc-MIBI SPECT in primary hyperparathyroidism

2008 ◽  
Vol 47 (01) ◽  
pp. 01-07 ◽  
Author(s):  
N. Thoma ◽  
M. Dietlein ◽  
D. Moka ◽  
W. Eschner ◽  
M. Faust ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Negative Influence ◽  
Normal Vitamin ◽  
Planar Images ◽  
99Mtc Mibi ◽  
Mibi Spect ◽  
Spect Images

SummaryAim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of 99mTc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: Between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a 99mTc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase 99mTc-MIBI protocol with SPECT were compared with histopathology. Results: In 54 pts with normal vitamin D values late SPECT images identified more lesions (n = 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a 99mTc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; 99mTc-MIBI SPECT: p = 0.1180. Conclusion: The likelihood of a pathological 99mTc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency.

scholarly journals Vitamin D levels in children with COVID-19: a report from Turkey

2021 ◽  
Vol 149 ◽  
Author(s):  
Aysegul Alpcan ◽  
Serkan Tursun ◽  
Yaşar Kandur
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Serum Vitamin ◽  
University Hospital ◽  
Control Group ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Normal Vitamin ◽  
The Mean

Abstract Several studies have demonstrated that higher levels of vitamin D are associated with better prognosis and outcomes in infectious diseases. We aimed to compare the vitamin D levels of paediatric patients with mild/moderate coronavirus disease 2019 (COVID-19) disease and a healthy control group. We retrospectively reviewed the medical records of patients who were hospitalised at our university hospital with the diagnosis of COVID-19 during the period between 25 May 2020 and 24 December 2020. The mean age of the COVID-19 patients was 10.7 ± 5.5 years (range 1–18 years); 43 (57.3%) COVID-19 patients were male. The mean serum vitamin D level was significantly lower in the COVID-19 group than the control group (21.5 ± 10.0 vs. 28.0 ± 11.0 IU, P < 0.001). The proportion of patients with vitamin D deficiency was significantly higher in the COVID-19 group than the control group (44% vs. 17.5%, P < 0.001). Patients with low vitamin D levels were older than the patients with normal vitamin D levels (11.6 ± 4.9 vs. 6.2 ± 1.8 years, P = 0.016). There was a significant male preponderance in the normal vitamin D group compared with the low vitamin D group (91.7% vs. 50.8%, P = 0.03). C-reactive protein level was higher in the low vitamin D group, although the difference did not reach statistical significance (9.6 ± 2.2 vs. 4.5 ± 1.6 mg/l, P = 0.074). Our study provides an insight into the relationship between vitamin D deficiency and COVID-19 for future studies. Empiric intervention with vitamin D can be justified by low serum vitamin D levels.

scholarly journals Role of Vitamin D Supplements in Prevention of Hungry Bone Syndrome after Successful Parathyroidectomy for Primary Hyperparathyroidism: A Prospective Study

2020 ◽  
pp. 145749692096260
Author(s):  
M. A. Salman ◽  
A. Rabiee ◽  
A. Salman ◽  
A. Youssef ◽  
H. E.-D. Shaaban ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Mineral Density ◽  
Hydroxyvitamin D ◽  
Group I ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

Background: We postulated that the preoperative correction of vitamin D levels can significantly reduce the incidence of hunger bone syndrome among patients undergoing parathyroidectomy for primary hyperparathyroidism. Methods: We performed a prospective, randomized, open-label study on 102 patients with primary hyperparathyroidism and coexisting vitamin D deficiency who were scheduled to undergo parathyroidectomy. Patients were divided into the following two groups: group I which included 52 patients who did not receive preoperative vitamin D supplementation; and group II which included 50 patients who received cholecalciferol 1000–2000 IU daily or 50000 IU weekly until they achieve vitamin D levels >20 ng/mL (group IIa = 25 patients) or vitamin D levels >30 ng/mL (group IIb = 25 patients). Results: The incidence of hunger bone syndrome in group IIb was lower than group I and group IIa (8% versus 16% versus 23%, respectively); however, this difference did not reach the level of statistical significance (p = 0.22). Patients with hunger bone syndrome were significantly younger and had higher serum phosphorus, alkaline phosphatase, magnesium, and bone mineral density at baseline than patients without hunger bone syndrome. On the other hand, patients with hunger bone syndrome had significantly lower 25-hydroxyvitamin D at baseline than patients without hunger bone syndrome (p = 0.001). The ROC curve showed that the baseline level of serum 25-hydroxyvitamin D was not an independent discriminator of hunger bone syndrome (area under curve = 0.21 (95% CI: 0.06–0.34); p = 0.011). Conclusion: Preoperative course of vitamin D supplements has no preventive role on the postoperative incidence of hunger bone syndrome among patients with primary hyperparathyroidism and coexisting vitamin D deficiency undergoing parathyroidectomy.

99mTc-MIBI-SPECT: Eine nicht invasive, sensitive Lokalisationsdiagnostik bei Verdacht auf Nebenschilddrüsenadenom

2018 ◽  
Vol 41 (02) ◽  
pp. 121-127
Author(s):  
Christina Schneider ◽  
Constanza Chiapponi ◽  
Monika Ortmann ◽  
Michael Faust ◽  
Markus Dietlein ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pet Ct ◽  
Ablative Verfahren ◽  
99Mtc Mibi ◽  
Met Pet ◽  
Mibi Spect

ZusammenfassungDie Aufgabe des Nuklearmediziners nach Diagnosestellung eines meist primären Hyperparathyreoidismus besteht in der erfolgreichen Lokalisation eines oder mehrerer Nebenschilddrüsenadenome. Die präoperative Lokalisation erlaubt die gezielte, heutzutage oft minimalinvasive Resektion. Hierzu ist 99 mTc-MIBI-SPECT eine klinisch fest etablierte Methode mit hoher Sensitivität. Wichtig ist die Kenntnis über Einflussfaktoren, die zu falsch-positiven oder falsch-negativen Ergebnissen führen. Eine wichtige Differenzialdiagnose für eine pathologische Anreicherung ist ein MIBI-positiver Schilddrüsenknoten. Häufigere Ursachen für negative Befunde sind kleinere hyperplastische Nebenschilddrüsen oder ein Vitamin-D-Mangel. In manchen Zentren ist als weiterführende Lokalisationsmethode C-11-MET PET/CT verfügbar. Ob sich neben der chirurgischen Therapie in Zukunft perkutan-ablative Verfahren etablieren können, was eine gezielte prätherapeutische Lokalisation voraussetzt, kann zum jetzigen Zeitpunkt noch nicht definitiv beantwortet werden.

scholarly journals Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Victoria Mendoza-Zubieta ◽  
Mauricio Carvallo-Venegas ◽  
Jorge Alberto Vargas-Castilla ◽  
Nicolás Ducoing-Sisto ◽  
Alfredo Alejandro Páramo-Lovera ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Bone Pain ◽  
Gamma Probe ◽  
Local Unit ◽  
Pathological Fractures ◽  
Severe Vitamin ◽  
Persistent Hyperparathyroidism ◽  
Skeletal Bone

Persistent primary hyperparathyroidism (PHPT) refers to the sustained hypercalcemia state detected within the first six months following parathyroidectomy. When it coexists with severe vitamin D deficiency, the effects on bone can be devastating. We report the case of a 56-year-old woman who was sent to this center because of persistent hyperparathyroidism. Her disease had over 3 years of evolution with nephrolithiasis and hip fracture. Parathyroidectomy was performed in her local unit; however, she continued with hypercalcemia, bone pain, and pathological fractures. On admission, the patient was bedridden with multiple deformations by fractures in thoracic and pelvic members. Blood pressure was 100/80, heart rate was 86 per minute, and body mass index was 19 kg/m2. Calcium was 14 mg/dL, parathormone 1648 pg/mL, phosphorus 2.3 mg/dL, creatinine 2.4 mg/dL, urea 59 mg/dL, alkaline phosphatase 1580 U/L, and vitamin D 4 ng/mL. She received parenteral treatment of hypercalcemia and replenishment of vitamin D. The second surgical exploration was radioguided by gamma probe. A retroesophageal adenoma of 4 cm was resected.Conclusion. Persistent hyperparathyroidism with severe vitamin D deficiency can cause catastrophic skeletal bone softening and fractures.

Severe Primary Hyperparathyroidism Masked by Profound Vitamin D Deficiency Presenting With an Atraumatic Fragility Fracture

2008 ◽  
Vol 18 (6) ◽  
pp. 300-303
Author(s):  
Susan M. Wang ◽  
Christine L. Twining ◽  
Jeffrey A. Guy ◽  
John B. Schenck ◽  
Juraj Osterman
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Fragility Fracture

scholarly journals Vitamin D Deficiency and Outcomes after Ankle Fusion

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0007
Author(s):  
Deepak Ramanathan ◽  
Mark J. Berkowitz ◽  
Alan Davis ◽  
Stephen J. Pinney ◽  
Sara Lyn Miniaci-Coxhead
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Reoperation Rate ◽  
Hardware Removal ◽  
Ankle Fusion ◽  
Vitamin D Levels ◽  
Normal Vitamin ◽  
Local Risk ◽  
The Impact

Category: Ankle Arthritis; Ankle; Basic Sciences/Biologics; Hindfoot Introduction/Purpose: Ankle fusions are associated with a complication profile including nonunion with associated poor functional outcomes, chronic pain, and need for reoperation. Local risk factors (bone and soft-tissue loss, infection, ankle and hindfoot deformity, and neuropathy) and systemic risk factors (advanced age, smoking, alcohol abuse, worker’s compensation, noncompliance, obesity, and systemic comorbidities such as diabetes and immunodeficiency) have been shown to be associated with the development of a nonunion following fusion procedures. Vitamin D has an important role in bone healing, and vitamin D deficiency has been proposed as a potential risk factor for the development of non-unions. The purpose of this study is to assess the impact of low vitamin D levels on reoperation rates and the development of nonunions following ankle fusion surgery. Methods: A retrospective chart review of all ankle fusions performed at a major health system from January 2010 to July 2019 was performed. In total, 240 ankle fusions were performed by seven surgeons. All patients who underwent primary fusion procedures were eligible for inclusion in this study. Exclusion criteria included: age less than 18 years; revision surgery; ankle fusion with the use of bulk allograft; ankle fusion performed as part of an oncologic reconstruction; and an absence of recorded vitamin D levels with 12 months of surgery. In total, 47 patients met inclusion criteria and formed the study group. In this group, 29/47 (61.7%) were female and 18/47 (38.3%) were male. Average age was 57.0 +- 12.3 years (range: 18.6 to 75.7). Patients were grouped according to their vitamin D levels as being deficient (<31 ng/ml) or normal (31-80 ng/ml). Results: Prevalence of vitamin D deficiency was 36.2% (17/47) at average of 35.7 ng/ml. In vitamin D deficient subgroup (n=17), average vitamin D level was 16.9 ng/ml. In normal vitamin D subgroup (n=30), average vitamin D was 46.4 ng/ml. Overall, reoperation rate was 21.3% (10/47). Reoperation rate was 35.3% (6/17) in vitamin D deficiency subgroup compared with 13.3% (4/30) reoperation rate in normal vitamin D subgroup (p<0.05). In vitamin D deficient subgroup, 5 procedures for nonunion included: dynamization (n=1), revision fusion (n=1), staged revision (n=2) and amputation (n=1) due to infected nonunion. There was also a symptomatic hardware removal. In normal vitamin D subgroup, reoperation indications included: malunion (n=1), elective dynamization before weightbearing (n=1), and symptomatic hardware removal (n=2). Normal vitamin D subgroup had zero nonunions. Conclusion: In patients undergoing ankle fusion, vitamin D deficiency (< 31 ng/ml) was associated with a reoperation rate over double that of patients with normal vitamin D levels. In the vitamin D deficient subgroup, nearly all reoperations were for nonunion as compared to zero nonunion incidence in those with normal vitamin D levels. These results suggest routine preoperative screening of vitamin D level is indicated as a key component of ankle fusion care. Vitamin D supplementation during the perioperative period may be indicated in regions with low sunlight to improve fusion rates and lower the risk of reoperation.

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