Classic phenotype primary hyperparathyroidism
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Aroca Martínez, G., Reyes Jaraba, C., Vergara Serpa, O., Pájaro Galvis, N., Hernández Agudelo, S., Atilano Vellojin, L., Castro Hernandez, C. ., León Diaz, M. P., Montes Sierra, D. A., & Rico Fontalvo, J. E. . (2021). Classic phenotype primary hyperparathyroidism. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 8(2).


Introduction: primary hyperparathyroidism is characterized by hypercalcemia and high levels of parathyroid hormone; It can manifest as three clinical phenotypes: classic, asymptomatic, and normocalcemic.

Purpose: to present a case of classical phenotype of Primary hyperparathyroidism, discuss its pathophysiology, approach and treatment.

Case presentation: 36-year-old woman who consulted for three simultaneous pathological fractures and a decrease in bone mineral density, associated with the in-hospital finding of nephrocalcinosis, renal failure, hypercalcemia and increased levels of parathyroid hormone. Given these findings, a diagnosis was made of primary hyperparathyroidism with a classic phenotype, secondary to a left parathyroid adenoma, and that she received surgical treatment.

Discussion and conclusion: classic phenotype primary hyperparathyroidism is a rare pathological entity, it is related to serious skeletal and kidney complications; there are few cases described in the literature, so more studies are required in oír environment to define the epidemiological characteristics of the patients, thus avoiding cases with clinical manifestations in advanced stages of the disease.
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Cope O. The study of hyperparathyroidism at the Massachusetts General Hospital. N Engl J Med. 1966 my. 26;274(21):1174-82.

Schulte KM, Talat N. Diagnosis and management of parathyroid cancer. Nat Rev Endocrinol. 2012 oct.;8(10):612-22.

Liu JM, Cusano NE, Silva BC, Zhao L, He XY, Tao B, et al. Primary Hyperparathyroidism: A tale of two cities revisited - New York and Shanghai. Bone Res. 2013 jun. 28;1(2):162-9.

Yeh MW, Ituarte PH, Zhou HC, Nishimoto S, Liu IL, Harari A, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013 mzo.;98(3):1122-9.

Silva BC, Cusano NE, Bilezikian JP. Primary hyperparathyroidism. Best Pract Res Clin Endocrinol Metab. 2018 oct.;32(5):593-607.

Eufrazino C, Veras A, Bandeira F. Epidemiology of primary hyperparathyroidism and its non-classical manifestations in the city of Recife, Brazil. Clin Med Insights Endocrinol Diabetes. 2013 dic. 4;6:69-74.

Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. Lancet. 2018 en. 13;391(10116):168-78.

Bandeira F, Cusano NE, Silva BC, Cassibba S, Almeida CB, Machado VC, et al. Bone disease in primary hyperparathyroidism. Arq Bras Endocrinol Metabol. 2014 jul.;58(5):553-61.

Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018 febr.;14(2):115-25.

Silverberg SJ, Bilezikian JP. The diagnosis and management of asymptomatic primary hyperparathyroidism. Nat Clin Pract Endocrinol Metab. 2006 sept.;2(9):494-503.

Centeno PP, Herberger A, Mun HC, Tu C, Nemeth EF, Chang W, et al. Phosphate acts directly on the calcium-sensing receptor to stimulate parathyroid hormone secretion. Nat Commun. 2019 oct. 16;10(1):4693.

Hwang S, Jeong JJ, Kim SH, Chung YJ, Song SY, Lee YJ, et al. Differential expression of miRNA199b-5p as a novel biomarker for sporadic and hereditary parathyroid tumors. Sci Rep. 2018 ag. 13;8(1):12016.

Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018 febr.;14(2):115-25.

DeLellis RA. Parathyroid tumors and related disorders. Mod Pathol. 2011 abr.;24(supl. 2):S78-93.

Newey PJ, Nesbit MA, Rimmer AJ, Attar M, Head RT, Christie PT, et al. Whole-exome sequencing studies of nonhereditary (sporadic) parathyroid adenomas. J Clin Endocrinol Metab. 2012 oct.;97(10):E1995-2005.

Marx SJ, Simonds WF, Agarwal SK, Burns AL, Weinstein LS, Cochran C, et al. Hyperparathyroidism in hereditary syndromes: special expressions and special managements. J Bone Miner Res. 2002 nov.;17(supl. 2):N37-43.

Verdelli C, Avagliano L, Guarnieri V, Cetani F, Ferrero S, Vicentini L, et al. Expression, function, and regulation of the embryonic transcription factor TBX1 in parathyroid tumors. Lab Invest. 2017 dic.;97(12):1488-99.

Heppner C, Kester MB, Agarwal SK, Debelenko LV, Emmert-Buck MR, Guru SC, et al. Somatic mutation of the MEN1 gene in parathyroid tumours. Nat Genet. 1997 ag.;16(4):375-8.

García-Maldonado G, Castro-García RJ. Endocrinological Disorders related to the medical use of Lithium. A narrative review. Rev Colomb Psiquiatr (Engl ed.). 2019 en.-mzo.;48(1):35-43.

Rao SD, Frame B, Miller MJ, Kleerekoper M, Block MA, Parfitt AM. Hyperparathyroidism following head and neck irradiation. Arch Intern Med. 1980 febr.;140(2):205-7.

Vaidya A, Curhan GC, Paik JM, Kronenberg H, Taylor EN. Hypertension, Antihypertensive Medications, and Risk of Incident Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2015 jun.;100(6):2396-404.

Fraser WD. Hyperparathyroidism. Lancet. 2009 jul. 11;374(9684):145-58.

Tfelt-Hansen J, Brown EM. The calcium-sensing receptor in normal physiology and pathophysiology: a review. Crit Rev Clin Lab Sci. 2005;42(1):35-70.

Hamdy NA. A patient with persistent primary hyperparathyroidism due to a second ectopic adenoma. Nat Clin Pract Endocrinol Metab. 2007 mzo.;3(3):311-5.

Shibamoto A, Ogawa T, Duyck J, Vandamme K, Naert I, Sasaki K. Effect of high-frequency loading and parathyroid hormone administration on peri-implant bone healing and osseointegration. Int J Oral Sci. 2018 mzo. 13;10(1):6.

Ott SM. Therapy for patients with CKD and low bone mineral density. Nat Rev Nephrol. 2013 nov.;9(11):681-92.

Kawakami K, Takeshita A, Furushima K, Miyajima M, Hatamura I, Kuro-O M, et al. Persistent fibroblast growth factor 23 signalling in the parathyroid glands for secondary hyperparathyroidism in mice with chronic kidney disease. Sci Rep. 2017 en. 17;7:40534.

Takeshita A, Kawakami K, Furushima K, Miyajima M, Sakaguchi K. Central role of the proximal tubular ?Klotho/FGF receptor complex in FGF23-regulated phosphate and vitamin D metabolism. Sci Rep. 2018 my. 2;8(1):6917.

Eastell R, Brandi ML, Costa AG, D'Amour P, Shoback DM, Thakker RV. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab. 2014 oct.;99(10):3570-9.

Rosário PW. Primary Hyperparathyroidism with normal calcium and PTH. World J Surg. 2017 jun.;41(6):1649-50.

Starup-Linde J, Waldhauer E, Rolighed L, Mosekilde L, Vestergaard P. Renal stones and calcifications in patients with primary hyperparathyroidism: associations with biochemical variables. Eur J Endocrinol. 2012 jun.;166(6):1093-100.

Vignali E, Viccica G, Diacinti D, Cetani F, Cianferotti L, Ambrogini E, et al. Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab. 2009 jul.;94(7):2306-12.

Diniz ET, Bandeira F, Lins OG, Cavalcanti ÉN, de Arruda TM, Januário AM, et al. Primary hyperparathyroidism is associated with subclinical peripheral neural alterations. Endocr Pract. 2013 mzo.-abr.;19(2):219-25.

Bess MA, Edis AJ, van Heerden JA. Hyperparathyroidism and pancreatitis. Chance or a causal association? JAMA. 1980 en. 18;243(3):246-7.

D'Amour P, Brossard JH, Rousseau L, Roy L, Gao P, Cantor T. Amino-terminal form of parathyroid hormone (PTH) with immunologic similarities to hPTH(1-84) is overproduced in primary and secondary hyperparathyroidism. Clin Chem. 2003 dic.;49(12):2037-44.

Ambrogini E, Cetani F, Cianferotti L, Vignali E, Banti C, Viccica G, et al. Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial. J Clin Endocrinol Metab. 2007 ag.;92(8):3114-21.

Lundstam K, Heck A, Godang K, Mollerup C, Baranowski M, Pernow Y, et al. Effect of surgery versus observation: skeletal 5-year outcomes in a randomized trial of patients with primary HPT (the SIPH Study). J Bone Miner Res. 2017 sept.;32(9):1907-14.

Stavrakis AI, Ituarte PH, Ko CY, Yeh MW. Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery. Surgery. 2007 dic.;142(6):887-99.

Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY, et al. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg. 2016 oct. 1;151(10):959-68.

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