Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/3657 http://dx.doi.org/10.1590/S0100-879X2007000400010 |
Resumo: | Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93% of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97% of patients were cured, with increases in bone mineral density of 19.4% in the lumbar spine and 15.7% in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients. |
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Oliveira, Ulisses Eliseu Maia de [UNIFESP]Ohe, Monique Nakayama [UNIFESP]Santos, Rodrigo Oliveira [UNIFESP]Cervantes, Onivaldo [UNIFESP]Abrahão, Márcio [UNIFESP]Lazaretti-Castro, Marise [UNIFESP]Vieira, Jose Gilberto Henriques [UNIFESP]Hauache, Omar Magid [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Instituto Fleury2015-06-14T13:36:51Z2015-06-14T13:36:51Z2007-04-01Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 4, p. 519-526, 2007.0100-879Xhttp://repositorio.unifesp.br/handle/11600/3657http://dx.doi.org/10.1590/S0100-879X2007000400010S0100-879X2007000400010.pdfS0100-879X200700040001010.1590/S0100-879X2007000400010WOS:000245440000010Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93% of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97% of patients were cured, with increases in bone mineral density of 19.4% in the lumbar spine and 15.7% in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaInstituto FleuryUNIFESP, EPMSciELO519-526engAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological ResearchPrimary hyperparathyroidismHypercalcemiaClinical presentationParathyroidectomyBone mineral densityAnalysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidisminfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS0100-879X2007000400010.pdfapplication/pdf484804${dspace.ui.url}/bitstream/11600/3657/1/S0100-879X2007000400010.pdfb3aa51594d74f3754952bbba161c77d8MD51open accessTEXTS0100-879X2007000400010.pdf.txtS0100-879X2007000400010.pdf.txtExtracted texttext/plain29116${dspace.ui.url}/bitstream/11600/3657/2/S0100-879X2007000400010.pdf.txtd4af5cfe2d0ba9ba6cd2b20de33a46f1MD52open access11600/36572022-06-02 09:02:16.378open accessoai:repositorio.unifesp.br:11600/3657Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-06-02T12:02:16Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
title |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
spellingShingle |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism Oliveira, Ulisses Eliseu Maia de [UNIFESP] Primary hyperparathyroidism Hypercalcemia Clinical presentation Parathyroidectomy Bone mineral density |
title_short |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
title_full |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
title_fullStr |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
title_full_unstemmed |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
title_sort |
Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism |
author |
Oliveira, Ulisses Eliseu Maia de [UNIFESP] |
author_facet |
Oliveira, Ulisses Eliseu Maia de [UNIFESP] Ohe, Monique Nakayama [UNIFESP] Santos, Rodrigo Oliveira [UNIFESP] Cervantes, Onivaldo [UNIFESP] Abrahão, Márcio [UNIFESP] Lazaretti-Castro, Marise [UNIFESP] Vieira, Jose Gilberto Henriques [UNIFESP] Hauache, Omar Magid [UNIFESP] |
author_role |
author |
author2 |
Ohe, Monique Nakayama [UNIFESP] Santos, Rodrigo Oliveira [UNIFESP] Cervantes, Onivaldo [UNIFESP] Abrahão, Márcio [UNIFESP] Lazaretti-Castro, Marise [UNIFESP] Vieira, Jose Gilberto Henriques [UNIFESP] Hauache, Omar Magid [UNIFESP] |
author2_role |
author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Instituto Fleury |
dc.contributor.author.fl_str_mv |
Oliveira, Ulisses Eliseu Maia de [UNIFESP] Ohe, Monique Nakayama [UNIFESP] Santos, Rodrigo Oliveira [UNIFESP] Cervantes, Onivaldo [UNIFESP] Abrahão, Márcio [UNIFESP] Lazaretti-Castro, Marise [UNIFESP] Vieira, Jose Gilberto Henriques [UNIFESP] Hauache, Omar Magid [UNIFESP] |
dc.subject.eng.fl_str_mv |
Primary hyperparathyroidism Hypercalcemia Clinical presentation Parathyroidectomy Bone mineral density |
topic |
Primary hyperparathyroidism Hypercalcemia Clinical presentation Parathyroidectomy Bone mineral density |
description |
Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93% of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97% of patients were cured, with increases in bone mineral density of 19.4% in the lumbar spine and 15.7% in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients. |
publishDate |
2007 |
dc.date.issued.fl_str_mv |
2007-04-01 |
dc.date.accessioned.fl_str_mv |
2015-06-14T13:36:51Z |
dc.date.available.fl_str_mv |
2015-06-14T13:36:51Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 4, p. 519-526, 2007. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/3657 http://dx.doi.org/10.1590/S0100-879X2007000400010 |
dc.identifier.issn.none.fl_str_mv |
0100-879X |
dc.identifier.file.none.fl_str_mv |
S0100-879X2007000400010.pdf |
dc.identifier.scielo.none.fl_str_mv |
S0100-879X2007000400010 |
dc.identifier.doi.none.fl_str_mv |
10.1590/S0100-879X2007000400010 |
dc.identifier.wos.none.fl_str_mv |
WOS:000245440000010 |
identifier_str_mv |
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 4, p. 519-526, 2007. 0100-879X S0100-879X2007000400010.pdf S0100-879X2007000400010 10.1590/S0100-879X2007000400010 WOS:000245440000010 |
url |
http://repositorio.unifesp.br/handle/11600/3657 http://dx.doi.org/10.1590/S0100-879X2007000400010 |
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eng |
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Brazilian Journal of Medical and Biological Research |
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519-526 |
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Associação Brasileira de Divulgação Científica |
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Associação Brasileira de Divulgação Científica |
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