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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Inadequate PTH characterizes hypoparathyroidism, and presents as severe hypocalcemia. Symptoms during pregnancy are similar to the non-pregnant state, including weakness, fatigue, tetany (by Chvostek’s sign and Trousseau’s sign tests) and seizures. The etiology of hypoparathyroidism is usually idiopathic, autoimmune, or iatrogenic (surgical removal of parathyroid glands or compromised blood supply during thyroid surgery). In contrast, pseudohypoparathyroidism is caused by deficient end-organ response to the endogenous PTH.
Hypoparathyroidism in pediatric patients
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Andrew C. Calabria, Michael A. Levine
Hypoparathyroidism in children and adolescents may be isolated or part of a complex developmental or autoimmune syndrome. Depending on the severity of the defect in parathyroid development or function, hypoparathyroidism may present in the newborn period, may be transient or permanent, or may not manifest until the child is older. The causes of congenital hypoparathyroidism can be broadly classified into defects that impair formation of the parathyroid glands and those that interfere with normal function of the parathyroid glands; in both cases circulating levels of parathyroid hormone (PTH) will be frankly or inappropriately low in the context of hypocalcemia and hyperphosphatemia. By contrast, biochemical hypoparathyroidism can also be associated with elevated circulating concentration of PTH, particularly in patients with pseudohypoparathyroidism, a condition that is characterized by renal resistance to PTH and which is discussed separately in this edition. Delayed onset of hypoparathyroidism during infancy or childhood might represent an inability of a hypoplastic gland to secrete sufficient PTH to meet the increasing calcium requirements that occur during rapid skeletal growth or during an intercurrent illness. Alternatively, late-onset hypoparathyroidism might reflect accelerated apoptosis of parathyroid cells or development of an autoimmune disorder that leads to destruction of the parathyroid glands. Postsurgical hypoparathyroidism, constituting 75% of all cases in adults, is an unusual cause of hypoparathyroidism in pediatric patients.
The Endocrine System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Abnormally low activity of the parathyroid glands or hypoparathyroidism most commonly is caused by an adenoma or by surgical drainage or removal of the glands. Since parathormone affects calcium and associated phosphorus in bone, low serum calcium (hypocalcemia) and excessive serum phosphorus levels then result with increased muscular and nervous irritability, cramping, convulsions, and possible paralysis of the respiratory system, a condition known as tetany. Hyperparathyroidism is most commonly caused by an adenoma and can result in excessive elimination of mineral salts and weakening of bones with eventual kidney and circulatory collapse.
Radiofrequency ablation versus reoperation for benign thyroid nodules that developed after previous thyroid surgery
Published in International Journal of Hyperthermia, 2021
Lin Yan, Cuiai Deng, Qing Song, Nan Li, Ling Ren, HongYing He, Wen Li, Mingbo Zhang, Yukun Luo
The incidence rates of complications in the reoperation group and RFA group were 31.43% and 0%, respectively (p < 0.001). In the reoperation group, 24 patients (68.57%) had local pain after treatment, which resolved spontaneously before leaving the hospital. Two patients (5.71%) had transient hypoparathyroidism and recovered within one week. A total of seven patients had transient voice or swallowing change. Three of them only had voice change (3.57%) and refused laryngoscopy. They recovered spontaneously within one month. The other four patients (11.42%) had transient RLN injury diagnosed by laryngoscopy. They were treated with dexamethasone, and the injury resolved within three to six months. Meanwhile, two patients had permanent RLN injury by laryngoscopy (5.71%). No significant differences were found regarding complications in the two subgroups. In the RFA group, all patients tolerated the RFA procedure. Only seven patients (38.89%) experienced local pain after RFA treatment, which resolved spontaneously within two to three days.
Vitamin D deficiency and its relationship with cardiac iron and function in patients with transfusion-dependent thalassemia at Chiang Mai University Hospital
Published in Pediatric Hematology and Oncology, 2018
Prapai Dejkhamron, Karn Wejaphikul, Tuanjit Mahatumarat, Suchaya Silvilairat, Pimlak Charoenkwan, Suwit Saekho, Kevalee Unachak
Sixty-one (33M/28F) patients with Transfusion-dependent thalassemia were enrolled. The median (interquartile range) of age was 14.9 (11.7–18.1) years. All participants received iron chelation therapy. The median (interquartile range) of hemoglobin level was 7.8 (7.1–8.4) g/dL. The medians (interquartile ranges) of ferritin in the previous 12 and 60 months were 2,089 (1,299–2,566) and 2,485 (1,809–5,206) ng/mL, respectively. The prevalence of Vitamin D deficiency was 50.8% (31/61). Severe Vitamin D deficiency was observed in one patient (1.6%). All had normal calcium, phosphate, and ALP levels. None had elevated PTH level. Two patients had hypoparathyroidism. Six patients had cardiac iron overload. However, all were asymptomatic and had normal left ventricular (LV) function. Thirty-nine patients (63.93%) had liver iron overload. Table 1 summarizes the characteristics of the study participants.
A comparative study of short-term efficacy and safety for thyroid micropapillary carcinoma patients after microwave ablation or surgery
Published in International Journal of Hyperthermia, 2019
Jianming Li, Yujiang Liu, Jibin Liu, Peipei Yang, Xiangdong Hu, Linxue Qian
Transient hypoparathyroidism was recorded in 10 patients in the surgical group (7%). In contrast, no patients who underwent MWA developed permanent or transient hypoparathyroidism. Transient recurrent laryngeal nerve palsy was reported in 6 (4.2%) patients and permanent laryngeal nerve damage in 1 (0.7%) in the surgical group. The rates of transient and permanent recurrent laryngeal nerve injury in the MWA group were 3.6% and 0.6%, respectively. Hence, the complication rate was significantly lower after MWA than after surgery (p < .001). In addition, all patients in the surgical group required thyroid replacement therapy, whereas none of the patients in the MWA group did so (Table 3).