The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting...The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra-sonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of asso-ciated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.展开更多
HYPOPARATHYROIDISM is characterized by hypocalcemia, hyperphosphatemia and low or inappropriately normal levels of parathyroid hormone （PTH）. PTH is a key calcium regulatinghormone essential for calcium homeostasis,...HYPOPARATHYROIDISM is characterized by hypocalcemia, hyperphosphatemia and low or inappropriately normal levels of parathyroid hormone （PTH）. PTH is a key calcium regulatinghormone essential for calcium homeostasis, vitamin D-dependent calcium absorption, renal calcium reabsorption and renal phosphate clearance. Hypoparathyroidism may be due to congenital or acquired disorders. Causes include autoimmune diseases, genetic abnormalities, destruction or infiltrative disorders of the parathyroid glands.展开更多
Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours...Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients.展开更多
What the liver organized examining to the diagnosis of liver disease, course of disease alive is appraised and treated and taught fruits by stages, judge respects such as the prognosis, etc. play an important role. In...What the liver organized examining to the diagnosis of liver disease, course of disease alive is appraised and treated and taught fruits by stages, judge respects such as the prognosis, etc. play an important role. In recent years, supersound lead down, examine marksmanship walk liver puncture the technology that examines living to employ at clinic extensively becoming while being living. In order to appraise its application effect, specially carry on reviewing summary analysis.展开更多
基金Project (No. 2007C34001) supported by the Science and TechnologyResearch Foundation of Zhejiang Province, China
文摘The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra-sonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of asso-ciated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.
文摘HYPOPARATHYROIDISM is characterized by hypocalcemia, hyperphosphatemia and low or inappropriately normal levels of parathyroid hormone （PTH）. PTH is a key calcium regulatinghormone essential for calcium homeostasis, vitamin D-dependent calcium absorption, renal calcium reabsorption and renal phosphate clearance. Hypoparathyroidism may be due to congenital or acquired disorders. Causes include autoimmune diseases, genetic abnormalities, destruction or infiltrative disorders of the parathyroid glands.
文摘Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients.
文摘What the liver organized examining to the diagnosis of liver disease, course of disease alive is appraised and treated and taught fruits by stages, judge respects such as the prognosis, etc. play an important role. In recent years, supersound lead down, examine marksmanship walk liver puncture the technology that examines living to employ at clinic extensively becoming while being living. In order to appraise its application effect, specially carry on reviewing summary analysis.
