Publication details
Hyperparatyreóza- diagnostika, léčba a šance pro pacienta z pohledu chirurga
| Title in English | Hyperparathyroidism, diagnosis, treatment and chances for the patient from the perspective of a surgeon |
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| Authors | |
| Year of publication | 2011 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Hyperparathyroidism (HPT) is a term referring to a hyperfunction of the parathyroid glands. It produces PTH, whose task is to regulate calcium and phosphate in the body. It is possible to distinguish Several types of hyperparathyroidism. Primary HPT, which is the cause of adenoma, parathyroid hyperplasia (Which can also affect multiple bodies), or as part MEN1A syndrome (multiple endocrine neoplasia? type 1). In secondary HPT leads to excessive secretion of parathyroid hormone, in response to persistently low calcium concentration. Hypocalcaemia can occur due to chronic renal insufficiency. If this becomes a secondary form of autonomous, independent of the calcium regulatory circuit, talking about tertiary HPT. The overproduction PTH also occurs in pseudohyperparatyreoidismu (paraneoplastic syndromes Hypercalcemia due to the presence of parathyroid hormone like peptide (PTHrP) in the body, in malignancies such as pancreas, lung or breast cancer. Primary hyperparathyroidism (PHP) is a frequent cause of failure kalciofosfátového metabolism. Typical findings in the biochemistry of PHP is a high level of parathyroid hormone, which following hypercalcemia and hypophosphatemia. The practice is known that such a diagnosis is problem as finding the source of autonomous production of parathyroid hormone. The reason for the emergence of PHP is the most parathyroid gland adenoma, hyperplasia less often and rarely is a cancer parathyroid gland (0.5 - 1.0%). PHP is the basis for the treatment of hypercalcemia of regulation, together with resection of adenoma, and inspection of all other parathyroid glands. Detection of adenomas may in some cases problematic. Basic imaging method is ultrasonography neck. Usually it is supplemented MIBI scintigraphy, is rarely necessary to use CT or MR. Diagnostically and biopsy biochemickýckým examination of aspirate. In cases of adenoma of the operation's success depends largely on the experience of the surgeon, to be attributable to beneficial use of new techniques such as detection gammanavigation adenoma, we use ultrasound localization, which have proven particularly at negative imposed glands. Where indicated extirpation of the parathyroid glands, such as patients with MEN1A, hyperplasia or carcinoma, the reimplantation of parathyroid tissue to eliminate the symptoms of post hypocalcemia and the chances for such therapy in affected patients. |