Détail de la notice
Titre du Document
Recovery pattern of patients with osteitis fibrosa cystica in primary hyperparathyroidism after successful parathyroidectomy. Discussion
Auteur(s)
AGARWAL Gaurav ; MISHRA Saroj K. ; KAR Dilip K. ; ...
Résumé
Background. After parathyroidectomy, recovery of osteitis fibrosa cystica, which continues to dominate presentation of primary hyperparathyroidism in India has not been documented objectively. Methods. We followed up clinical recovery, biochemic markers of bone turnover, bone mineral density, and skeletal radiology in 51 patients with primary hyperparathyroidism and osteitis fibrosa cystica for 9 to 124 months (median, 32 months). Results. After parathyroidectomy, 46 patients had hypocalcemia. During postoperative week 1, bone pain improved in 71 %. During 3 months, appendicular fractures healed in all 33 such patients, and 6 of 7 patients who were bedridden could walk. Mean bone mineral density increments (percent change/y) seen at various sites at 1 week, 3, 6, and 12 months were distal forearm - 37, 28, 23, 21; lumbar spine -165, 104, 101, 106; and total hip - 168, 157, 166, 133. Follow-up radiographs demonstrated prompt recovery though disorderly remineralization. Brown tumors and fractures showed hyperdensities within 3 months. Brown tumors regressed partially in 6 of 27 patients after 6 months. Conclusions. After parathyroidectomy, patients with primary hyperparathyroidism have early, marked, and sustained recovery of osteitis fibrosa cystica. Early (1 week) bone mineral density increments of > 100%/y hint at the skeleton's ability to promptly restore itself. Densitometric recovery is prompt at cancellous (lumbar spine), but not at cortical (forearm) bone sites. Contour
Editeur
Elsevier
Type du document
Conférence : Annual Meeting of the American Association of Endocrine Surgeons, 23, Banff, Alberta, CAN, 2002-04-07
Identifiant
PMID : 12490858 ISSN : 0039-6060 CODEN : SURGAZ
Source
Surgery A. 2002, vol. 132, n° 6, pp. 1075-1085 [11 pages] [bibl. : 20 ref.]
Langue
Anglais
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