Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous chordae rupture of the tricuspid valve is relatively rare, unlike the mitral valve. We present a 27-year-old male with chronic renal failure on hemodialysis therapy for treatment of parathyroid adenoma. The echocardiography showed the severe tricuspid regurgitation with chordae rupture which was not noted 1 year ago. In addition, the papillary muscle of both mitral and tricuspid valve was shortened and calcified extensively. However, in his clinical history, the specific causes for chordae rupture, such as chest trauma or endocarditis, were not disclosed. It was presumed that dilated right ventricle with volume or pressure overloading and secondary hyperparathyroidism are probably responsible for the chordae rupture of tricuspid valve.
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PMID:Spontaneous chordae rupture of tricuspid valve in patient with chronic renal failure. 1703 22

The purpose of this paper is to describe the case of a 12-year-old patient with end-stage chronic renal failure. The patient presented with an osteolytic lesion in the mandible with expansion of the buccal, lingual, and occlusal cortical bone, as well as dislocation of the teeth in the area. The calcium, creatinine, and parathormone (PTH) contents of the blood were elevated. A histopathological examination of the jaw lesion revealed the presence of a brown tumor lesion, which is associated with hyperparathyroidism (HPT). An adenoma was found in the upper left parathyroid, a finding compatible with the diagnosis of tertiary HPT. In spite of the continuous ambulatory peritoneal dialysis instituted, the osteolytic lesion kept on growing. A conservative treatment employing an association of intralesional corticosteroid and salmon calcitonin (inhaled) was carried out. After 14 months of therapy, a reduction in size and complete calcification of the lesion were achieved. Aesthetic osteoplasty of the jaw was then performed.
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PMID:Highly aggressive brown tumor in the jaw associated with tertiary hyperparathyroidism. 1724 37

Hyperparathyroidism is the clinical syndrome that results from elevated circulating parathyroid hormones, leading to multiple systems manifestations, and is divided into three kinds: primary, secondary and ternary.This patient's main chief complaint was intermittent melena for 3 days,with the diagnosis of upper gastrointestinal hemorrhage according to endoscopy. Hypercalcemia, hypophosphatemia and high level of circulating parathyroid hormone and chronic renal failure were also found during hospitalization. Furthermore, MIBI showed a parathyroid adenoma located near the isthmus in the lower part of the left lobe. The patient had undergone nephrectomy because of kidney carcinoma 2 years ago. Primary hyperparathyroidism usually has the common gastrointestinal syndrome , but upper gastrointestinal hemorrhage reported as the chief complaint is rare and we had never seen similar reports before.
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PMID:[A case of primary hyperparathyroidism with chief complaint of upper gastrointestinal bleeding]. 1765 62

Intact PTH measures not only 1-84 PTH, but also other fragments such as 7-84 PTH. Lately, a measurement of 1-84 PTH has been available as whole PTH assay and the ratio of whole PTH/intact PTH is considered to be between 0.5 and 0.7 in patients on hemodialysis. Therefore, intact PTH should be higher than whole PTH. We present a 57-year-old male with chronic renal failure on hemodialysis whose whole PTH was higher than intact PTH (the reversed ratio of whole PTH/intact PTH). He showed one enlarged parathyroid gland by an ultrasonic test, CT examination and RI subtraction study. After this gland was removed by surgery, the ratio of whole PTH/intact PTH normalized. The size of the resected gland was 22 x 15 x 11 mm. The histologic examination revealed adenoma. This indicates that, if patients with chronic renal failure showed the reversed ratio of whole PTH/intact PTH, the possibility that they could have primary hyperparathyroidism in addition to secondary hyperparathyroidism should be considered.
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PMID:The reversed ratio of 1-84 PTH (whole PTH)/intact PTH in a patient on hemodialysis associated with primary hyperparathyroidism. 1839 9

Renal hyperparathyroidism is one of the main and serious complications that occur in chronic kidney disease and particularly during long-term maintenance dialysis. Several recent trials indicate that a high calcium phosphorus product is correlated with high cardiovascular morbidity and mortality and poor outcome. Thus, it is important to improve the control of hyperparathyroidism in chronic renal failure patients. Several methods have been reported for treating severe hyperparathyroidism resistant to medical therapy. Total parathyroidectomy and transplantation or excision of tumor is considered as the treatment of choice. More recently, interventional methods with percutaneous ethanol or calcitriol injection have been developed. These latter techniques have been reported as an alternative to surgical treatment for patients with high perioperative risk. We report the occurrence of laryngeal recurrent nerve palsy, vocal fold paralysis, and hemiplegia after a successful injection of ethanol in a left parathyroid adenoma in a maintenance hemodialysis patient and discuss the restrictions of the procedure and alternative treatments in view of the available studies.
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PMID:Percutaneous ethanol injection treatment of severe hyperparathyroidism in maintenance dialysis: risks and benefits. 1937 20

A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months' duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12-62 pg/ml), but her serum calcium was normal (total=9.4 mg/dl, nv 8.5-10.5; ionized=5.0 mg/dl, nv 4.2-5.4) due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1) primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2) it was associated with a brown tumor of unusual location (right supra-acetabular region).
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PMID:Supra-acetabular brown tumor due to primary hyperparathyroidism associated with chronic renal failure. 2045 61

Nephrocalcinosis is a rare cause of chronic renal failure. We describe a 64 year-old man, who was admitted to hospital due to chronic renal failure. An ultrasound examination and a computed tomography of the kidneys showed bilateral, severe nephrocalcinosis. He had hypercalcaemia, hyperparathyroidism, and a bone disease caused by an adenoma in one of the parathyroid glands. After removal of the adenoma, the plasma calcium level was in control, but renal function deteriorated. The patient was treated with dialysis and renal transplantation.
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PMID:[Primary hyperparathyroidism as a cause of chronic renal failure]. 2234 75

Simultaneous bilateral spontaneous rupture of the quadriceps tendon is a very rare condition and only a few cases have been reported in the literature. The etiology is not clear yet. But it occurs infrequently in patients with chronic metabolic disorders. A 30-year-old female patient with simultaneous bilateral spontaneous quadriceps tendon rupture visited our hospital. She had chronic renal failure and her parathyroid hormone level was elevated due to parathyroid adenoma. We report a surgical repair of both quadriceps tendons of a patient with chronic renal failure as well as management of hyperparathyroidism.
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PMID:Simultaneous bilateral quadriceps tendon rupture in patient with chronic renal failure. 2257 Aug 43

During GH therapy for 2.3-9.6 years, male adult-onset GH-deficient patients with a diagnosis of a nonfunctioning adenoma have no increased all-cause mortality. However, women with adult-onset GH deficiency (GHD) are still at slightly higher risk. This general improvement in mortality is due to a more contemporary regimen of cardiovascular drugs, a refinement of surgical procedures, besides the introduction of GH therapy improved hormone replacement regimens with lowered glucocorticoid replacement, updated approaches of sex steroids for women, and less use of cranial radiotherapy. The underlying disease is the most important predictor for mortality: eg, a craniopharyngioma, malignant causes of hypopituitarism, previous Cushing's disease, and the presence of diabetes insipidus/aggressive tumors. The main cause of increased mortality was cerebrovascular diseases and infectious/respiratory diseases in ACTH-deficient patients. Furthermore, there was a significant impact of young age at disease onset and of death from secondary brain tumors, with a higher risk after cranial radiotherapy. Reports on four cohorts of GH-treated childhood-onset GHD patients have been published. Two of them included only patients with idiopathic isolated GHD, neurosecretory dysfunction, idiopathic short stature, or being born short for gestational age. Increased mortality in circulatory disorders, ill-defined diseases, and bone cancer were recorded in one study, but not in the other smaller study, where suicide and accidents caused the majority of deaths. A third childhood-onset GHD cohort included patients with a background of malignant tumors, craniopharyngioma, pituitary adenomas, pituitary aplasia/hypoplasia, and trauma. An increase of all-cause mortality was recorded in both males and females. The fourth cohort included isolated GHD and idiopathic short stature (60%), but also diagnosis of chronic renal failure and Turner's syndrome. In these latter studies, an underlying serious condition was the most important factor for death, with central nervous system tumors (recurrent or new tumor) being the leading cause of mortality.
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PMID:Update in mortality in GH-treated patients. 2403 Sep 44

A 16-yr-old male clouded leopard (Neofelis nebulosa) was presented for lethargy and anorexia. A cutaneous abdominal mass extending from the pubis to just caudal to the xiphoid process was present. A biopsy revealed histologic lesions consistent with an atypical mycobacterial infection consisting of diffuse, severe, pyogranulomatous dermatitis and panniculitis, with clear vacuoles and 3-5 microm, intravacuolar, faintly eosinophilic, filamentous bacilli that stained positively with FiteFaraco modified acid-fast stain. The clouded leopard had biochemical findings suggestive of chronic renal failure and euthanasia was elected. Histological evaluation of tissues collected at postmortem examination revealed multicentric B-cell lymphoma involving the oral cavity, liver, spleen, and multiple lymph nodes, bilateral testicular seminomas, thyroid follicular cell adenoma, thyroid C cell adenoma, and biliary cystadenomas. Bacterial culture and molecular sequencing identified the causative agent of the cutaneous abdominal mass as belonging to the Mycobacterium fortuitum group.
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PMID:Cutaneous atypical mycobacteriosis in a clouded leopard (Neofelis nebulosa). 2406 8


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