We summarize the clinical presentation and pathophysiology of pseudogout following parathyroidectomy. We present a case of a 71-year-old woman who developed pseudogout following removal of a parathyroid adenoma. [ncbi.nlm.nih.gov]

• Thyroid Nodule

  Mean thyroid nodule size was 2.01 ± 0.94 cm. All cases were completed successfully via a single retroauricular incision. There was no conversion to an open approach. [ncbi.nlm.nih.gov]

  Thyroid nodules are extremely common. Few are cancerous. They may secrete excess hormones, causing hyperthyroidism, or cause no problems. [webmd.com]

  Do remember that a huge parathyroid tumour may be mistaken for a thyroid nodule. 2. [endocrinesurgeon.co.uk]

  In addition, thyroid nodules are very common, and Ultrasonography prior to surgery will identify any thyroid disease that be evaluated prior to surgery, and if necessary removed at the time of parathyroidectomy. [ent.uci.edu]

  […] times the sestamibi scan Sestamibi scan - Nuclear medicine test where a small amount of radioactive material is injected into a vein and an X-ray is taken. incorrectly identifies a thyroid nodule as a parathyroid gland. [endocrinediseases.org]

• Aspiration

  ABBREVIATIONS: 4D-CT = four-dimensional computed tomography BNE = bilateral neck exploration FNA = fine-needle aspiration FNAB = fine-needle aspiration biopsy FP = focused parathyroidectomy IQR = 25 and 75% inter-quartile range PHPT = primary hyperparathyroidism [ncbi.nlm.nih.gov]

  In addition, IPM is useful in differential jugular venous sampling and ex vivo parathyroid aspiration (eAppendix in the Supplement ). [doi.org]

  Intraoperative parathyroid aspiration and parathyroid hormone assay as an alternative to frozen section for tissue identification. World J Surg 2000; 24: 1319-1322. - Chen H, et al. [revistas.unc.edu.ar]

  It highlights the difficulties that women have had in time, particularly in the last two centuries, trying to make their aspirations come true and their will in becoming surgeons. [giornalechirurgia.it]

• Abdominal Pain

  On presentation, she remained symptomatic with bone and joint pain, diffuse abdominal pain and fatigue. [ncbi.nlm.nih.gov]

  Gastrointestinal: Abdominal pain, vomiting, weight loss, peptic ulceration, pancreatitis IV. [clinicalpainadvisor.com]

  A 91 years-old man was admitted to Emergency Department reporting abdominal pain and vomit. [giornalechirurgia.it]

  pain Wheezing (from bronchospasm) Constipation Dysphagia Bone pain Voice changes (spasm of the larynx) Mental status changes Irritability, mental status changes Seizures and/or uncontrolled movements Table 1: Symptoms of severe hypercalcaemia and severe [omicsonline.org]

  At 16 years of age, the patient developed signs and symptoms of hypercalcemia including mild hypertension, abdominal pain, and frequent dysuria ( 19 ). [clinchem.aaccjnls.org]

• Dysphagia

  […] failure (reversible) Polyuria Perioral and/or finger tingling and numbness Dehydration Carpopedal spasm, Chvostek sign, Trusseau sign Nausea and/or vomiting Muscular cramps (back and lower limbs) Abdominal pain Wheezing (from bronchospasm) Constipation Dysphagia [omicsonline.org]

  Haematomas are potentially life‐threatening complications arising in 0.3% of all surgeries for PHPT, and may present with a variety of symptoms including neck pain, respiratory distress, dysphagia and wound drainage (Burkey 2001; Carty 2004). [cochranelibrary.com]

• Hypertension

  Introduction: Primary hyperparathyroidism (PHPT) is emerging as a cause of secondary hypertension. Between 20 and 50% of patients with PHPT have hypertension, this being directly proportional to the calcemia. [endocrine-abstracts.org]

  Elevated preoperative serum creatinine, alkaline phosphatase, and hypertension resulted in a higher rate of complications after PTX (P < .0001). [ncbi.nlm.nih.gov]

  Schiffl H, Lang SM: Hypertension Secondary to PHPT: Cause or Coincidence? Int J Endocrinol 2011;2011:974647. [karger.com]

  Cardiac: Hypertension, ECG changes (short QT, prolonged PR interval) III. Gastrointestinal: Abdominal pain, vomiting, weight loss, peptic ulceration, pancreatitis IV. [clinicalpainadvisor.com]

• Heart Disease

  This may suggest the possibility of under-diagnosis due to the high prevalence of asymptomatic disease. This may have clinical implications such as exacerbation of pre-existing coronary heart disease or precipitation of atrial arrhythmias ( 7 ). [edmcasereports.com]

  The most prevalent comorbidities were hypertension (78.9 %), diabetes mellitus (15.8 %), congestive heart failure (10.5 %) and coronary heart disease (10.5 %). [karger.com]

• Stroke

  Hospitalizations were significantly higher for stroke, acute myocardial infarction and dysrhythmia. For fractures, there was no difference. In addition, in subgroup analyses, older white men with comorbid conditions did worse (Figure 3). [nephjc.com]

  Risk of stroke in long-term dialysis patients compared with the general population. Am. J. Kidney Dis. 63, 604–611 (2014). 26. Kestenbaum, B. et al. Parathyroidectomy rates among United States dialysis patients: 1990-1999. [nature.com]

  Patients with pHPT may have higher rates of myocardial infarction, hypertension, stroke, congestive heart failure, diabetes, and mortality (eAppendix in the Supplement ). [doi.org]

We present a review of the literature and discuss elements of the history and physical examination suggestive of occult CVS, with additional workup proposed for appropriate cases. [ncbi.nlm.nih.gov]

Workup for hyperparathyroidism includes an intact PTH level with a serum calcium level, 24 hour urine calcium, sestimibi-parathyroid scan, and ultrasound of the thyroid and parathyroid. Dr. Alfred Simental and Dr. Paul D. [medical-center.lomalindahealth.org]

This results in a workup to exclude a multitude of other causes of Hypercalcemia, and ensure the diagnosis is correct. A thorough history is obtained to exclude drug induced Hypercalcemia, or other medical conditions causing Hypercalcemia. [ent.uci.edu]

In my pre-surgical workup, I weighed 102 lbs, pretty standard for me. The surgery was necessary and beneficial, but I now weigh 135 lbs. This is more than I weighed when I was pregnant and overdue! [steadyhealth.com]

• Soft Tissue Calcification

  We believe that this is due to a decreased PTH level and decreasing bone turnover which resulted in more circulating calcium facilitating vascular and soft tissue calcification. [ncbi.nlm.nih.gov]

  We also noted muscular weakness (18 patients, 62.1%), pruritus (12 patients, 41.4%), high blood pressure (12 patients, 41.4%), soft tissue calcification (4 patients, 13.8%). [cyberleninka.org]

  2008/19/5/854/42479 Calciphylaxis is a rare, but serious disorder characterized by systemic medial calcification of the arteries those results in ischemic necrosis of skin and soft tissues. [sjkdt.org]

• Calcium Decreased

  Patient 4 received oral alendronate, 140 mg/week for six weeks; her calcium decreased from 13.7 to 12.3 mg/dL and her CTX from 2,160 to 1,340 pg/mL. [ncbi.nlm.nih.gov]

  By negative feed back, raised serum ionised calcium decreases PTH secretion to maintain adequate serum calcium levels [ 3 ]. [omicsonline.org]

  These compounds decrease glandular parathyroid hormone (PTH) 1 secretion by binding the calcium-sensing receptor (CaSR) and decreasing the threshold for activation of the receptor by calcium ( 8 )( 9 ). [clinchem.aaccjnls.org]

The treatment of brown tumour is dependent on the treatment of the hyperparathyroidism. However, curettage should be considered if a large lesion is disturbing mastication. [ncbi.nlm.nih.gov]

Most microcarcinomas are slow growing and have a favorable prognosis. Lymph node metastasis caused by thyroid microcarcinoma is uncommon, and distant metastasis to lung or bone is even rarer. [ncbi.nlm.nih.gov]

The etiological factors and mechanisms underlying this condition, its consequences, and the possibility of treatment are the object of this study. [ncbi.nlm.nih.gov]

No associated variations were identified, and the diagnosis remained persistent primary hyperparathyroidism of unknown etiology. [clinchem.aaccjnls.org]

[…] controls matched for age, gender, and ethnic group) Neuromuscular symptoms: documented proximal weakness, atrophy, hyper-reflexia, and agait distubance Hereditary Hyperparathyroidism: Although cases of sporadic hyperparathyroidism are idiopathic and the etiology [medicine.uiowa.edu]

The effect of PTx on fractures has been evaluated in only one epidemiological study from the United States, which demonstrated a significant association of PTx and lower hip and combined fractures. [ncbi.nlm.nih.gov]

Immortal time bias in pharmaco-epidemiology. Am. J. Epidemiol. 167, 492–499 (2008). [nature.com]

Several recent studies have reported on the epidemiology of pHPT [ 1, 13 – 17 ], yet few reported on parathyroidectomy rates [ 14, 15 ]. [journals.plos.org]

Adami S, Marcocci C, Gatti D (2002) Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 17 Suppl 2: N18-23. Khan A, Bilezikian J (2000) Primary hyperparathyroidism: pathophysiology and impact on bone. CMAJ 163: 184-187. [omicsonline.org]

Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the GFR [ 10 ]. [karger.com]

We summarize the clinical presentation and pathophysiology of pseudogout following parathyroidectomy. We present a case of a 71-year-old woman who developed pseudogout following removal of a parathyroid adenoma. [ncbi.nlm.nih.gov]

Am J Kidney Dis 52:519–530 Article CAS PubMed Google Scholar Yerram P, Chaudhary K (2014) Calcific uremic arteriolopathy in end stage renal disease: pathophysiology and management. [link.springer.com]

Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):78–86. CrossRef PubMed 9. Li S, Chen YW, Peng Y, et al. [springermedizin.at]

Safe and effective parathyroidectomy requires mastery of the anatomical and pathophysiologic features of pHPT (eAppendix in the Supplement ). [doi.org]

Use of bisphosphonates to prevent HBS should be explored in future studies. [doi.org]

Careful consideration of postoperative care and electrolyte management is crucial to minimize preventable readmissions in this vulnerable population. [ncbi.nlm.nih.gov]

Calcium supplements are therefore often required to prevent symptoms of hypocalcemia and to restore lost bone mass. [en.wikipedia.org]