scholarly journals Primary Hyperparathyroidism with Multiple Fractures and Brown Tumors in a 14-year-old Girl: Case Report & Review of Literature

2021 ◽  
Vol 22 (2) ◽  
pp. 130-136
Author(s):  
Nasim Khan ◽  
Nazmun Nahar ◽  
Rawshan Ara ◽  
Fahima Akter Dowel ◽  
Shakila Zaman Rima ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Tumor Resection ◽  
Good Health ◽  
Vitamin D Insufficiency ◽  
Multiple Fractures ◽  
Brown Tumors ◽  
Variable Presentation

Primary hyperparathyroidism (PHPT) presenting as pathological fractures with brown tumors is very rare in children. The rarity and variable presentation of PHPT can make its diagnosis a challenge – especially in the developing countries where malnutrition may mask hypercalcemia. We report a case of a 14–year-old girl who presented with muscle pain, multiple fractures and bone pain. Laboratory tests revealed normocalcemia with vitamin D insufficiency. Subsequent biochemical, radiographic and scintigraphic findings were consistent with primary hyperparathyroidism due to a parathyroid adenoma. Tumor resection was done in a local hospital and histopathology confirmed parathyroid adenoma. Following parathyroidectomy, fractures were treated conservatively with supplementation of calcium and vitamin D. We found her quite capable of self-care and walking in good health at 1 year follow up. Though rare, PHPT-causing brown tumors related skeletal fractures is an important differential diagnosis in the evaluation of patients presenting with multiple foci of radiotracer uptake in bone scintigraphy. Bangladesh J. Nuclear Med. 22(2): 130-136, Jul 2019

scholarly journals Assessing Biomarkers of Breast Cancer Risk in Underserved Women in a Midwestern County

2021 ◽  
Vol 12 ◽  
pp. 215013272110177
Author(s):  
Marla A. DeWitt ◽  
Ivana T. Croghan ◽  
Celine M. Vachon ◽  
Thomas D. Thacher ◽  
Marcia R. Venegas Pont ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mammographic Density ◽  
Small Sample Size ◽  
Vitamin D Insufficiency ◽  
Screening Mammography ◽  
Small Sample ◽  
Vitamin D Status ◽  
Small Pilot Study ◽  
Unexpected Findings

Objective: The primary aim of this study was to evaluate the feasibility of collecting risk factor information and accessing digitized mammographic data in a medically marginalized population. A secondary aim was to examine the association between vitamin D status and mammographic density. Methods: Breast-screening examinations were provided for age-appropriate patients, and a referral for no-cost screening mammography was offered. Study participants were asked to undergo 25-hydroxyvitamin D testing at mammography and 1-year follow-up. Results: Of 62 women approached, 35 (56%) consented to participate. Of 32 participants who had baseline mammography, the median mammographic density measured by VolparaDensity (Volpara Solutions Limited) was 5.7%. After 1 year, 9 women obtained follow-up mammograms, with a median density of 5.7%. Vitamin D status was measured for 31 participants at baseline and 13 participants in the following year. Insufficient vitamin D status (<30 ng/mL) was noted in 77% at each time point. Mammographic density was not significantly correlated with vitamin D status ( P = .06). Conclusions: On the basis of this small pilot study, vitamin D insufficiency is common in this study population. Owing to the small sample size, an association between vitamin D insufficiency and breast density was not clear. Additional unexpected findings included substantial barriers in initial access to care and longitudinal follow-up in this population. Further study of these issues is needed.

scholarly journals Overlap of Pseudohypoparathyroidism and Primary Hyperparathyroidism in a Patient: Just a Coincidence?

2011 ◽  
Vol 3 (3) ◽  
pp. 128-130
Author(s):  
Ana Karena Neukirch ◽  
Christian Heckmann ◽  
Norbert Weyerbrock ◽  
Silke Günther ◽  
Cornelia Dotzenrath
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Female Patient ◽  
Oral Calcium ◽  
Albright’S Hereditary Osteodystrophy ◽  
Lower Position ◽  
The Right ◽  
Inactivating Mutation ◽  
Gnas1 Gene

ABSTRACT A 56-year-old female patient with the phenotype of Albright's hereditary osteodystrophy (AHO) and pseudohypoparathyroidism 1a (PHP) diagnosed in 1987 was shown to have a heterozygote inactivating mutation on the GNAS1 gene. The patient has been treated with oral calcium and vitamin D since diagnosis of PHP 1a and developed primary hyperparathyroidism (pHPT) in 2009. Ultrasound as well as 99Tcsestamibi could demonstrate a lesion in the right lower position. Intraoperatively, a solitary parathyroid adenoma was found and resected leading to a ‘normalization’ of PTH and calcium. This case highlight is the rare coincidence of PHP, AHO and pHPT.

scholarly journals Replantation of Spinous Process-lamina Complex in the Treatment of Cervical Spine Tumor : Two Cases Report and Literature Review

2021 ◽  
Author(s):  
Xu Jiahui ◽  
Ma Bin ◽  
Wang Chenggang
Keyword(s):  
Spinous Process ◽  
Tumor Resection ◽  
Good Health ◽  
Structure And Function ◽  
Anatomical Structure ◽  
Spine Tumor ◽  
Posterior Element ◽  
Cervical Spine Tumor ◽  
And Function

Abstract Purpose: The primary aim of our study was to prove that the replantation of spinous process-lamina complex is beneficial to restore the anatomical structure and function of the spine, and to find if it can reduce postoperative complications.Methods: We report two cases of cervical intraspinal tumor, whose postoperative pathological diagnosis, Respectively, are Neurilemmoma and meningioma. They all underwent the resection and replantation of spinous process-lamina complex, in which the resected spinous process-lamina complex was replanted at the end of the procedure, allowing a complete reconstruction of the posterior element of the spinal canal. Results：After the surgery, the symptoms were relieved, and no dysfunction of upper limbs and sphincter was observed. The tumors were benign pathologically and were diagnosed as Neurilemmoma and meningioma. The patient recovered and at 6-month follow-up had no complaints and in good health.Conclusion: After tumor resection, the replantation of spinous process-lamina complex is beneficial to restore the anatomical structure and function of the spine.

Does vitamin D status predict weight gain or increase in waist circumference? Results from the longitudinal Health 2000/2011 Survey

2020 ◽  
Vol 23 (7) ◽  
pp. 1266-1272 ◽  
Author(s):  
Tuija Jääskeläinen ◽  
Satu Männistö ◽  
Tommi Härkänen ◽  
Katri Sääksjärvi ◽  
Seppo Koskinen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Weight Gain ◽  
Waist Circumference ◽  
Healthy Lifestyle ◽  
Adult Population ◽  
Population Based ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status

AbstractObjective:To investigate whether vitamin D status predicts weight gain or increase in waist circumference during the 11-year follow-up in general adult population.Design:A population-based longitudinal study.Setting:The study was conducted using data from the nationally representative Health 2000/2011 Survey. The analyses were based on regression models adjusted for sociodemographic and lifestyle factors.Participants:Weight, waist circumference and vitamin D status (serum 25-hydroxyvitamin D concentration analysed with radioimmunoassay) were measured from 2924 participants aged 30–64 years at baseline.Results:In men, low vitamin D status at baseline predicted ≥10 % increase in waist circumference during the follow-up when adjusted for age only (OR for sufficient v. deficient S-25(OH)D 0·41; 95 % CI 0·25, 0·67; P for trend <0·01), but the association with weight gain was only borderline significant. After adjustment for potential confounders, low vitamin D status remained a significant predictor of increase in waist circumference, but the association with weight gain was further attenuated. In women, vitamin D status at baseline did not predict weight gain or increase in waist circumference.Conclusions:Our results suggest that vitamin D insufficiency may be a risk factor of abdominal obesity among men but not among women. In men, it may also increase the risk of weight gain. Further studies are required to confirm these findings and examine potential mechanisms behind them. There is also a possibility that vitamin D is a biomarker of healthy lifestyle rather than an independent risk factor for obesity.

SAT0297 Prognosis of Vitamin D Insufficiency: A 3-Year Follow-Up of the Road Study

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 765.3-765
Author(s):  
N. Yoshimura ◽  
S. Muraki ◽  
H. Oka ◽  
S. Tanaka ◽  
H. Kawaguchi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Insufficiency ◽  
The Road ◽  
Road Study

scholarly journals Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study

2015 ◽  
Vol 172 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Viveca Åberg ◽  
Sophie Norenstedt ◽  
Jan Zedenius ◽  
Maria Sääf ◽  
Jörgen Nordenström ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Study Medication ◽  
Double Blind ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

ObjectiveVitamin D insufficiency is common in primary hyperparathyroidism (pHPT). Patients with pHPT frequently have a reduced health-related quality of life (HRQoL). Our objectives were to evaluate whether HRQoL in pHPT is associated with vitamin D insufficiency and whether vitamin D supplementation after parathyroidectomy (PTX) could improve HRQoL.DesignA randomized, double-blind study (ClinicalTrials.gov identifier: NCT00982722).MethodsThe study included 150 pHPT patients randomized, 6 weeks after PTX, to daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg (D+) or calcium carbonate alone (D−). HRQoL was estimated with SF-36 before and after PTX and after 12 months of study medication.ResultsThree-quarters (77%) of the pHPT patients had vitamin D insufficiency, defined as 25OHD <50 nmol/l. The pHPT patients scored lower than a reference population in all domains of SF-36. A total of 135 patients completed the entire study period. Improvements in nearly all domains were registered at the follow-up 6 weeks after PTX. At the end of the study medication period, the D+ group had a significantly higher median serum (s-) 25OHD concentration (76 (65; 93) (lower; upper interquartile ranges) vs 48 (40; 62) nmol/l, P<0.001) and a lower plasma (p-) parathyroid hormone concentration (40 (34; 52) vs 49 (38; 66) ng/l, P=0.01) than the D− group. The improvements in HRQoL remained unchanged at the follow-up 1 year after PTX. Postoperative vitamin D supplementation had no obvious effect on HRQoL.ConclusionPTX resulted in significant improvements in HRQoL. Despite a high prevalence of vitamin D insufficiency, 1 year of postoperative vitamin D supplementation had no obvious beneficial effect on HRQoL.

The effects of vitamin D insufficiency in patients with primary hyperparathyroidism

1999 ◽  
Vol 107 (6) ◽  
pp. 561-567 ◽  
Author(s):  
Shonni J Silverberg ◽  
Elizabeth Shane ◽  
David W Dempster ◽  
John P Bilezikian
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Insufficiency

scholarly journals Vitamin D Repletion in Patients with Primary Hyperparathyroidism and Coexistent Vitamin D Insufficiency

2005 ◽  
Vol 90 (4) ◽  
pp. 2122-2126 ◽  
Author(s):  
Andrew Grey ◽  
Jenny Lucas ◽  
Anne Horne ◽  
Greg Gamble ◽  
James S. Davidson ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Serum Alkaline Phosphatase ◽  
Vitamin D Insufficiency ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Total Serum ◽  
Calcium Excretion ◽  
Intact Pth

Abstract Vitamin D insufficiency is common in patients with primary hyperparathyroidism (PHPT) and may be associated with more severe and progressive disease. Uncertainty exists, however, as to whether repletion of vitamin D should be undertaken in patients with PHPT. Here we report the effects of vitamin D repletion on biochemical outcomes over 1 yr in a group of 21 patients with mild PHPT [serum calcium &lt;12 mg/dl (3 mmol/liter)] and coexistent vitamin D insufficiency [serum 25 hydroxyvitamin D [25(OH)D] &lt;20 μg/liter (50 nmol/liter)]. In response to vitamin D repletion to a serum 25(OH)D level greater than 20 μg/liter (50 nmol/liter), mean levels of serum calcium and phosphate did not change, and serum calcium did not exceed 12 mg/dl (3 mmol/liter) in any patient. Levels of intact PTH fell by 24% at 6 months (P &lt; 0.01) and 26% at 12 months (P &lt; 0.01). There was an inverse relationship between the change in serum 25(OH)D and that in intact PTH (r = −0.43, P = 0.056). At 12 months, total serum alkaline phosphatase was significantly lower, and urine N-telopeptides tended to be lower than baseline values (P = 0.02 and 0.13, respectively). In two patients, 24-h urinary calcium excretion rose to exceed 400 mg/d, but the group mean 24-h urinary calcium excretion did not change. These preliminary data suggest that vitamin D repletion in patients with PHPT does not exacerbate hypercalcemia and may decrease levels of PTH and bone turnover. Some patients with PHPT may experience an increase in urinary calcium excretion after vitamin D repletion.

Metabolic inactivation of vitamin D is enhanced in primary hyperparathyroidism

1987 ◽  
Vol 73 (6) ◽  
pp. 659-664 ◽  
Author(s):  
M. R. Clements ◽  
M. Davies ◽  
D. R. Fraser ◽  
G. A. Lumb ◽  
E. Barbara Mawer ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Vitamin D Deficiency ◽  
Metabolic Clearance ◽  
Half Time ◽  
Hydroxyvitamin D ◽  
Elimination Half ◽  
Before And After ◽  
25 Hydroxyvitamin D

1. The elimination half-time of 25-hydroxyvitamin D in plasma was estimated after intravenous injection of the radioactively labelled metabolite in seven patients with primary hyperparathyroidism before and after excision of a parathyroid adenoma. 2. The elimination half-time of 25-hydroxyvitamin D was significantly shortened in primary hyperparathyroidism and reverted towards normal after parathyroidectomy. 3. The increased metabolic clearance of 25-hydroxyvitamin D in primary hyperparathyroidism was accounted for by an increased excretion of vitamin D-derived inactivation products in the faeces. 4. Enhanced hepatic inactivation of 25-hydroxyvitamin D may be important in the development of vitamin D deficiency in primary hyperparathyroidism.

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