جستجوی مقالات مرتبط با کلیدواژه "hypoparathyroidism" در نشریات گروه "پزشکی"

Hypocalcemia is the most frequent complication of thyroid surgeries. Hypocalcemia is the most common complication following thyroid surgeries and is crucial in managing patients with thyroid cancer.

This study aimed to describe hypocalcemia after thyroidectomy and evaluate the factors associated with postoperative hypocalcemia.

A cross-sectional study was conducted on 91 patients with thyroid cancer at Hanoi Medical University Hospital. Hypocalcemia was defined as serum calcium levels lower than 2.1 mmol/L, measured 24 hours after surgery.

In the postoperative period, 27.5% of the patients exhibited hypocalcemia, with distinct prevalence rates observed between the total thyroidectomy group (47.6%) and the thyroid lobectomy group (10.2%). Concurrently, hypoparathyroidism manifested in 15.4% of the cases. Various factors were identified as contributors to postoperative hypocalcemia, including lymph node metastasis (odds ratio [OR] = 2.6; P < 0.05), total thyroidectomy (OR = 8.0; P < 0.01), diminished parathyroid hormone (PTH) levels (OR = 12.6; P < 0.001), and reduced 25-hydroxyvitamin D3 (25[OH]D3) levels (P < 0.01). Furthermore, multivariate analyses revealed that free thyroxine (FT4) (P = 0.04), 25(OH)D3 (P = 0.037), surgical procedure (P < 0.001), and cancer stage (P < 0.001) independently predicted postoperative hypocalcemia. Notably, our findings underscored a substantial correlation between total thyroidectomy (OR = 21.5, P < 0.001), diminished PTH levels (P < 0.001), and the occurrence of postoperative hypoparathyroidism.

The identification of lymph node metastasis, total thyroid surgery, decreased PTH and 25(OH)D3 levels, and albumin concentration are crucial factors in guiding the surgical team to prevent the onset of hypocalcemia.

Iron overload can adversely affect thyroid and parathyroid function in patients with transfusion-dependent thalassemia. Iron deposition in both glands or the pituitary gland, which controls thyroid function, can lead to their destruction and dysfunction. Hypothyroidism can cause symptoms such as fatigue, weight gain, and depression, while hypoparathyroidism can cause symptoms such as numbness and tingling in the hands and feet, muscle cramps, and seizures. Regular thyroid and parathyroid function monitoring is essential in thalassemia patients to detect any dysfunction early and provide appropriate treatment. Treatment may include medications to replace thyroid hormone or calcium and vitamin D supplements to manage hypoparathyroidism. A comprehensive approach to managing endocrine complications in thalassemia patients can improve outcomes and quality of life for these individuals. To provide professional healthcare members with clear and concise recommendations for diagnosing and treating hypothyroidism and hypoparathyroidism in transfusion dependent thalassemia patients, a practical national guideline should be developed.

One of the most common surgeries performed worldwide is thyroidectomy, the most common of which ishypoparathyroidism. Hypoparathyroidism can be transient or permanent. Parathyroid Hormone (PTH) is a major factor inregulating calcium, and small changes in PTH levels alter calcium levels within minutes. Therefore, hypocalcemia may occur after thyroidectomy. This study looked at the predictive factors of hypoparathyroidism after thyroidectomy.

In the present systematic review study, all quantitative articles related to the purposes of the study and published from 2015 to 2019 were reviewed. Searches of PubMed, Google Scholar, and Science Direct databases were performed using keywords for predictive factors, hypoparathyroidism, and thyroidectomy and their synonyms. In total, 3811 titles were initially identified with the described search strategy. From among these articles, 20 articles were selected, and by removing poor quality articles, eight articles were finally studied in terms of content.

Hypoparathyroidism is common after thyroidectomy. The main role of PTHs is in the regulation of calcium. Calcium deficiency at the blood level is threatening and can lead to chronic kidney disease, kidney stones and myocardial dysfunction.Therefore, measuring serum PTH immediately after thyroidectomy and the identification of patients at risk can reduce the risk of hypocalcemia by prescribing calcium and active vitamin D.

predictive factors of hypoparathyroidism after thyroidectomy are important because of the role of PTHs. According to findings, measuring serum calcium, iPTH, and phosphorus the day after surgery, reducing the duration of surgery and female gender are among the predictive factors of hypoparathyroidism after thyroidectomy.

Hypoparathyroidism is an endocrine disorder that can be congenital or acquired. Generally, hypoparathyroidism is characterized by hypocalcemia, hyperphosphatemia, and low or abnormal levels of Parathyroid Hormone (PTH). It can be asymptomatic or symptomatic. The symptoms include seizures, paresthesia, depression, psychosis, extrapyramidal manifestations, and increased intracranial pressure. In this case study, we reported a 40-year- old male patient who was admitted to the emergency department with generalized tonic- clonic movements and urine incontinency. Laboratory investigations revealed hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels and in paraclinical studies, including Electroencephalography (EEG) and brain CT-scan, despite normal EEG, extensive intracranial calcification involving the basal ganglia, thalamus, white matter of the cerebral hemispheres, and subcortical area of the frontal and parietal lobes were observed on CT-scan.

Cerebral venous sinus thrombosis is a rare and infrequent condition in pregnant women. Hemorrhagic infarction can occur in early stages of cerebral venous thrombosis. This article reports a rare case of cerebral transverse sinus thrombosis presenting in pregnant women with unidentified secondary hypoparathyroidism, highlighting the difficulties in identifying this rare case from common diagnosis like preeclampsia. According to the differential diagnoses for this case, it can be a good exercise to strengthen clinical reasoning in students and medical teachers to improve the quality of clinical education.

The prevalence of hypoparathyroidism in the USA is 37 out of 100,000. Hypoparathyroidism is divided into primary and acquired. It occurs when there is inadequate secretion of PTH leading to the decrease of calcium as well as the increase of phosphate level. Coexistence of any cases of hypoparathyroidism, Graves’ disease and papillary thyroid carcinoma (PTC) has never been reported in the literature before. The rare case introduced here is a 42 years old woman with the history of primary hypoparathyroidism since 18 years ago that developed Graves’ disease about 14 years after the onset of the disorder and underwent a thyroid surgery due to PTC 2 years later.

  This study aimed to investigate whether pre-operative dexamethasone could ameliorate transient hypoparathyroidism outcome through total thyroidectomy.

This randomized clinical trial study was conducted on 128 patients underwent total thyroidectomy from March 2014 to April 2015. Patients were randomly assigned to two groups of experimental receiving 8 mg IV of intravenous dexamethasone (n=45) 45 min before skin incision treatment and control (n=83). After the surgery, all patients were evaluated for clinical and laboratory hypocalcaemia.

Post-operative transient biochemical hypoparathyroidism and hypocalcaemia did not occur more often in the control group, compared to the dexamethasone group while controlling for the baseline variables. However, there was a significant difference in phosphorus level between the dexamethasone and control groups (P=0.028). A total of 50 (39.1%) patients developed hypocalcaemia after surgery. Moreover, post-operative symptomatic hypocalcemia occurred more frequently in the control group (68%) compared to the dexamethasone group (32%); however, this difference was not statistically significant (P=0.54).

The pre-operative administration of dexamethasone reduced post-operative hypocalcemia rate. It is essential to conduct future studies with validated means for better results.

Barakat syndrome is a rare autosomal dominant disorder characterized by hypoparathyroidism, sensorineural deafness, and renal disease, collectively known as HDR syndrome. This disease is caused by the mutation of GATA3 gene located on chromosome 10p15. GATA3 is involved in the embryonic development of kidneys, inner ears, parathyroid glands, and central nervous systems.
Case report: Herein, we presented a 20-month-old female with seizure and microcephaly, congenital left kidney dysplasia, hypoparathyroidism, and bilateral sensorineural deafness. Her laboratory tests were consistent with hypoparathyroidism, and the chromosomal study revealed a deletion in chromosome 10. The patient was diagnosed as a case of Barakat syndrome based on her clinical and laboratory tests. The microarray-based comparative genomic hybridization study of the patient was compatible with the monosomy of 10p15.3p13 and trisomy of 12p13.33p13.33.
It is important to be aware of rare inherited conditions like Barakat syndrome (HDR syndrome) in a patient with abnormal presentations, such as seizure, neurodevelopmental delay, kidney defects associated with hearing loss, and clinical abnormalities associated with hypoparathyroidism.

Hypothyroidism (HT) and hypoparathyroidism (HPT) are common endocrine complications in thalassemia major (TM) patients.
In the present study, we assessed the frequency of HT and HPT in a population of TM patients in Southeast of Iran.
This cross sectional study was performed on 194 TM patients in Zabol, Sistan and Baluchestan Province, Iran, during February - July 2016. The demographic, clinical, and laboratory data were collected via interviews and history - taking. For hormone measurements, specific ELISA kits were used. Statistical analysis was performed in SPSS version 16.
A total of 103 (53.1%) and 91 (46.9%) females and males were recruited in this study, respectively. The mean age of the patients was 15 ± 7.5 years. HT and HPT showed overall frequencies of 8.2% (18/194) and 18% (35/194), respectively. Subclinical and overt HT were observed in 13 (6.7%) and 5 (2.6%) patients, respectively. There was no significant association between HT and age, while patients with HPT were significantly older than those without HPT (20.1 ± 5.8 vs. 13.9 ± 6.2 years; P In patients with TM, HT was a complication with a relatively low frequency, while HPT was more common. Based on the findings, HPT was more frequent in older patients receiving regular blood transfusions, thereby necessitating close monitoring of these patients.

Autoimmune polyendocrine syndrome (APS) is an autoimmune disorder defined by multiple endocrinopathies and the presence of other systemic or organ-specific autoimmunities. This case study, reports on a 46-year-old woman with confirmed idiopathic hyperparathyroidism, who was referred for inflammatory back pain. HLA-B27 positivity, recurrent anterior uveitis and radiologic findings led to ankylosing spondylitis (AS) diagnosis. By further investigations, a subclinical atrophic autoimmune thyroid disease (AITD) was also diagnosed for her in addition to a history of premature ovarian failure. According to the absence of adrenal insufficiency in addition to an AITD and systemic autoimmune disorder, APS type IIIC was the most probable diagnosis. To the best of our knowledge, this is the first case report of APS type III associated with AS.

Background and Importance: Hypoparathyroidism is due to parathyroid hormone deficiency and categorized as an endocrine disorder. Acute clinical presentations of hypoparathyroidism are muscle cramps and spasms, tetany, weakness, paresthesia and seizure. Hypoparathyroidism may be accompanied with psychosis, depressio n, seizures and extrapyramidal manifestations in chronic condit ion.
The present case reported about a 37-year-old man who presented with the history of several episodes of seizures, slurred speech, progressive limbs and trunk stiffness and increa sed muscle tone and rigidity.
Paraclinical investigations revealed hypocalcemia and very low parathyroid hormone levels with extensive intracranial calcification involving bilateral basal ganglia, cerebellum and subcortical white matters on brain CT scan.

Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very atypical and rare circumstance, which is usually intractable to conventional therapy for cardiac failure, but responds satisfactorily to restoration of normocalcemia. We describe a young woman who developed clinical signs of hypocalcemia due to hypoparathyroidism, reduced left ventricular ejection fraction and polymorphic ventricular tachycardia as consequences of hypocalcemia. This case underscores the importance of biochemical abnormalities like hypocalcemia as a rare cause of secondary cardiomyopathy and emphasizes on the need for effective and immediate treatment of hypocalcemia and its related causes.

The present study aimed to determine the prevalence of hypothyroidism, hypoparathyroidism and the frequency of regular chelation therapy in patients with thalassemia major in Iran. Searching process was performed by two independent researchers using valid keywords in the national and international database, including: Magiran, Iranmedex, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library and google scholar search engine. All studies were searched until 2016 with no time limit. All articles met inclusion criteria were evaluated and the data were analyzed by using SATA Software Ver.11.1. Twenty-seven studies about hypothyroidism (sample size of 4851, the mean age of 16.36±5.5) and 19 studies related to hypoparathyroidism (sample size of 3219, the mean age of 17.44±6.5) were examined. The prevalence of hypothyroidism was calculated 5.7% (95% CI: 4.7-6.8) in patients with thalassemia major in Iran (P=0.000; I2 index=93.9%). The prevalence of overt and subclinical hypothyroidism was estimated 3.1% (95% CI: 1-4.7) and 6.7% (95% CI: 3.3-10), respectively. The prevalence of hypoparathyroidism was calculated 10% (95% CI: 7-12) in patients with thalassemia major in Iran. In reviewing 5 studies, the frequency of regular chelation therapy was estimated 54.6% (95% CI: 28-81.2) in these patients. The prevalence of hypothyroidism and hypoparathyroidism is high in patients with thalassemia major in Iran. Thus, new planning and supervising seem to be essential to minimize endocrine complications in these patients. There is no connection between serum ferritin level and developing hypoparathyroidism. A high percent of Iranian patients with thalassemia major perform the chelation therapy irregularly. It's been recommended to adopt the necessary measures such as educating and enhancing awareness of the patients about its complications.

Muscles and bones are interconnected. Recent studies suggest that undercarboxylated osteocalcin from bone may affect muscle mass and strength. There are, however, no prospective human data on this relationship.
We previously treated patients with hypoparathyroidism with intact Parathyroid Hormone (PTH) or placebo in a six-month randomized, placebo-controlled trial and demonstrated a marked increase in undercarboxylated osteocalcin (ucOC) in the PTH-treated group. We therefore investigated if this increase correlated with changes in muscle mass, strength or function. Primarily, the muscle mass using Dual energy X-ray Absorptiometry (DXA) was measured and the maximal voluntary isometric muscle strength at the upper and lower extremities, using dynamometry, was assessed. Furthermore, repeated chair stands test, Timed Up and Go test were performed and postural stability using a stadiometer was assessed. Finally, the relationship between change in ucOC or the ratio of the changes in ucOC and total OC (ucOC%/OC%) and different measures of muscle function were analyzed, using regression analyses.
The findings indicated that ucOC%/OC% was positively and significantly associated with percentage change in max force production during elbow extension (β = 0.28, P = 0.034), however, all other associations were non-significant.
Given the number of statistical tests that were carried out, our one significant finding may represent a false positive. Thus the results do not support the role of ucOC in muscle function in humans with hypoparathyroidism. Our results are inconsistent with previous data from a human cross-sectional study; however, cross-sectional studies, do not allow for inference of causality. The analyses should be repeated in larger, randomized trials including healthy individuals.

Hypoparathyroidism might cause various musculoskeletal findings, resembling Spondyloarthropathies. We described a 52-year-old woman, diagnosed as a case of undifferentiated spondyloarthropathy for ten years, who was unresponsive to classic anti-inflammatory therapies. She developed anterior ischemic optic neuropathy and had elevated muscle enzymes during the course of disease. On a routine checkup, marked hypocalcemia and suppressed parathyroid hormone levels were found. Calcium and calcitriol therapy led to clinical and laboratory improvement. This case emphasizes the importance of recognizing rheumatic manifestations of hypoparathyroidism to preclude unnecessary treatments. Serum calcium should be included in the diagnostic workup of these patients.

This paper presents a 54-year-old female with lupus whom severe anaemia due to pure red cell aplasia (PRCA) was the first manifestation. There was seven years interval between PRCA onset and diagnosis of lupus. Thymectomy due to thymoma had been carried out six years before but anaemia sustained. Hypothyroidism and hypoparathyroidism were other associated diseases. Severe anaemia and the need for monthly blood infusions were resolved following treatment with Prednisolone, Hydroxychloroquine and Levothyroxine.

To report a rare case of a patient with hypoparathyroidism presenting with bilateral disc swelling and near mature cataract as her first clinical manifestation Case report: A 23-year-old woman presented with complaint of worsening vision since one year ago and a history of refractory seizures and headache for several years, being under treatment with Lamotrigine 50 mg/daily. Slit-lamp examination revealed significant cataracts on both sides. Red reflex was dull in the right eye and absent in the left side. The intraocular pressure (IOP) measurement was normal in both eyes (16 mmHg). Her fundus examination revealed disc swelling in her right eye and hazy media that obscured fundus examination due to dense cataract in the left eye. The combination of bilateral disc swelling and dense cataracts raised suspicion to hypoparathyroidism. Subsequently, neuroimaging and intracranial pressure (ICP) monitoring was requested along with neuro-ophthalmalogy consultation. The diagnosis was Psedotumor Cerebri. Due to increased ICP, she underwent multiple lumber punctures. Computed tomography (CT) scan showed abnormal signal density in basal ganglia suggestive for presence of calcium depositions, making the diagnosis of hypoparathyroidism more probable. Ensuing laboratory result made the definite diagnosis of hypoparathyroidism. Meanwhile the cataract progressed and the visual acuity (VA) decreased to HM in her both eyes. She underwent cataract extraction and PCIOL implantation. Papilledema resolved and the vision restored to 20/20. Ocular complaints happens very rare in the course of hypoparathyroidism but still it seems rational that this occasionally fatal condition be ruled out by hormonal evaluation for cases of unexplained cataracts, particularly if it is accompanied by disc swelling.