Fig. 13.1 Multiple cervical scars in a patient with persistent primary hyperparathyroidism MEN1-related, after three previous failed operations due to incorrect diagnosis and inadequate surgical approach Moreover, both negative preoperative…
Corrected total calcium or ionized calcium Both elevated or only free calcium Second or third PTH generation assays High or inappropriately normal 25-OH-vitamin D The deficit should be corrected to…
© Springer-Verlag Italia 2016Guido Gasparri, Nicola Palestini and Michele Camandona (eds.)Primary, Secondary and Tertiary HyperparathyroidismUpdates in Surgery10.1007/978-88-470-5758-6_19 19. Patient Information for Surgery in Primary and Secondary Hyperparathyroidism Pier Giorgio Nasi and Lodovico Rosato1 (1) Department of Surgery, ASL4, Ivrea…
Fig. 2.1 Embryologic origin of the parathyroid glands, thyroid, and thymus (Source: Ferrari CC et al. Surgical strategy for primary hyperparathyreoidism with thyroid hemiagenesis. Langenbecks Arch Surg 2014;399:1077–1081. Springer) The…
Drug Form Calcium content High cost Aluminum hydroxide liquid, capsule, tablet No No (not recommended) Calcium acetate capsule, tablet Yes No Calcium carbonate liquid, capsule, tablet, gum Yes No Magnesium…
Cardiovascular Congestive heart failure Prolonged QT interval at ECG Cardiomyopathy Neuromuscular inability Chvostek’s and Trusseau’s sign Paresthesia Muscle cramps and paresthesia Laryngeal and bronchial spasms Tetany Seizures Tremor Neurological signs…
Some diseases, such as myeloma with hypergammaglobulinemia or hyper-albuminemia due to severe dehydration, can cause an elevation in the serum total calcium level without any rise in serum ionized calcium…
Fig. 11.1 Algorithm for surgical treatment in patients with/without contraindication to imaging studies other than ultrasound (see text). BNE, bilateral neck exploration; CT, computed tomography; ioPTH, intraoperative parathyroid hormone; MIBI,…
Fig. 10.1 a A case of intrathyroidal parathyroid adenoma (hematoxilin and eosin, original magnification 40×). b Negative for thyroglobulin (immunoperoxidase, original magnification 40×). c Positive for chromogranin A and GATA-3…
If a reliable measurement of ionized serum calcium (iCa) is available, this measurement may be useful especially in selected patients (with hyper- or hypoalbuminemia, thrombocytosis, Waldenström macroglobulinemia and myeloma); moreover,…
