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Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

BACKGROUND: Tumoral calcinosis (TC) is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). However, parathyroidectomy (PTX) seems to be ineffective at relieving TC in some patients. In this study, we investigated the relationship between PTX and TC shrinkage. METHODS: We retrosp...

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Autores principales: Wang, Jing, Zeng, Ming, Yang, Guang, Huang, Yaoyu, Wu, Buyun, Guo, Jing, Wang, Ningning, Xing, Changying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6740033/
https://www.ncbi.nlm.nih.gov/pubmed/31510980
http://dx.doi.org/10.1186/s12893-019-0603-8
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author Wang, Jing
Zeng, Ming
Yang, Guang
Huang, Yaoyu
Wu, Buyun
Guo, Jing
Wang, Ningning
Xing, Changying
author_facet Wang, Jing
Zeng, Ming
Yang, Guang
Huang, Yaoyu
Wu, Buyun
Guo, Jing
Wang, Ningning
Xing, Changying
author_sort Wang, Jing
collection PubMed
description BACKGROUND: Tumoral calcinosis (TC) is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). However, parathyroidectomy (PTX) seems to be ineffective at relieving TC in some patients. In this study, we investigated the relationship between PTX and TC shrinkage. METHODS: We retrospectively followed up nine TC patients who underwent PTX, dividing them into two groups: those with TC size reduced by > 80% were in the “effective group” (group A), and the rest in the “ineffective group” (group B). RESULTS: We enrolled nine patients (7 men; mean age 38.6 ± 10.9 years) with SHPT-related TC. One patient with calciphylaxis was excluded due to sudden death. The efficiency of PTX in causing TC regression was 62.5% (5 patients in group A). Group A had a shorter overall duration of TC (6 [5.5, 6.0] vs. 9 [8.0, 10.0] months; P = 0.02) and higher serum levels of alkaline phosphatase (ALP; 408.0 [217.9, 1101.7] vs. 90.8 [71.0, 102.1] pg/ml; P = 0.03) and high-sensitivity C-reactive protein (hs-CRP; 82.7 [55.0, 112.4] vs. 3.1 [3.1, 4.5] mg/l; P = 0.02). Average calcium supplementation within 1 week of surgery was significantly greater in group A than in group B (96.8 [64.1, 105.3] vs. 20.1 [13.1, 32.7] g; P = 0.04). Patients in both the groups demonstrated similar serum phosphate levels before PTX, but these levels were higher in group B than in group A at follow-up times (3 months, P = 0.03; 6 months, P = 0.03). CONCLUSIONS: The shorter duration of pre-existing TC and higher ALP levels before PTX, as well as lower serum phosphate levels after PTX, were correlated with effective SHPT-TC shrinkage.
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spelling pubmed-67400332019-09-16 Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism Wang, Jing Zeng, Ming Yang, Guang Huang, Yaoyu Wu, Buyun Guo, Jing Wang, Ningning Xing, Changying BMC Surg Research Article BACKGROUND: Tumoral calcinosis (TC) is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). However, parathyroidectomy (PTX) seems to be ineffective at relieving TC in some patients. In this study, we investigated the relationship between PTX and TC shrinkage. METHODS: We retrospectively followed up nine TC patients who underwent PTX, dividing them into two groups: those with TC size reduced by > 80% were in the “effective group” (group A), and the rest in the “ineffective group” (group B). RESULTS: We enrolled nine patients (7 men; mean age 38.6 ± 10.9 years) with SHPT-related TC. One patient with calciphylaxis was excluded due to sudden death. The efficiency of PTX in causing TC regression was 62.5% (5 patients in group A). Group A had a shorter overall duration of TC (6 [5.5, 6.0] vs. 9 [8.0, 10.0] months; P = 0.02) and higher serum levels of alkaline phosphatase (ALP; 408.0 [217.9, 1101.7] vs. 90.8 [71.0, 102.1] pg/ml; P = 0.03) and high-sensitivity C-reactive protein (hs-CRP; 82.7 [55.0, 112.4] vs. 3.1 [3.1, 4.5] mg/l; P = 0.02). Average calcium supplementation within 1 week of surgery was significantly greater in group A than in group B (96.8 [64.1, 105.3] vs. 20.1 [13.1, 32.7] g; P = 0.04). Patients in both the groups demonstrated similar serum phosphate levels before PTX, but these levels were higher in group B than in group A at follow-up times (3 months, P = 0.03; 6 months, P = 0.03). CONCLUSIONS: The shorter duration of pre-existing TC and higher ALP levels before PTX, as well as lower serum phosphate levels after PTX, were correlated with effective SHPT-TC shrinkage. BioMed Central 2019-09-11 /pmc/articles/PMC6740033/ /pubmed/31510980 http://dx.doi.org/10.1186/s12893-019-0603-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wang, Jing
Zeng, Ming
Yang, Guang
Huang, Yaoyu
Wu, Buyun
Guo, Jing
Wang, Ningning
Xing, Changying
Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title_full Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title_fullStr Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title_full_unstemmed Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title_short Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
title_sort effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6740033/
https://www.ncbi.nlm.nih.gov/pubmed/31510980
http://dx.doi.org/10.1186/s12893-019-0603-8
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