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Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism
BMC Surgery ( IF 1.6 ) Pub Date : 2019-09-11 , DOI: 10.1186/s12893-019-0603-8
Jing Wang , Ming Zeng , Guang Yang , Yaoyu Huang , Buyun Wu , Jing Guo , Ningning Wang , Changying Xing

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. 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). 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). 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.

中文翻译:

甲状旁腺切除术对尿毒症继发性甲状旁腺功能亢进患者肿瘤钙化的影响

肿瘤性钙化病(TC)是一种罕见的疾病,源于尿毒症继发性甲状旁腺功能亢进症(SHPT)。但是,在某些患者中,甲状旁腺切除术(PTX)似乎在缓解TC方面无效。在这项研究中,我们调查了PTX和TC收缩之间的关系。我们回顾性随访了9例接受PTX治疗的TC患者,将其分为两组:“有效组”(A组)的患者,TC大小减小了80%以上;“无效组”(B组)的其余患者)。我们招募了9名SHPT相关TC患者(7名男性;平均年龄38.6±10.9岁)。由于突然死亡,排除了一名患有钙化病的患者。PTX导致TC消退的效率为62.5%(A组5例)。A组的TC总持续时间较短(6 [5.5,6.0]个月vs. 9 [8.0,10.0]个月; P = 0。02)和更高的血清碱性磷酸酶水平(ALP; 408.0 [217.9,1101.7] vs. 90.8 [71.0,102.1] pg / ml; P = 0.03)和高敏感性C反应蛋白(hs-CRP; 82.7 [55.0] ,112.4]对比3.1 [3.1,4.5] mg / l; P = 0.02)。A组在手术1周内的平均钙补充量显着高于B组(96.8 [64.1,105.3] g vs. 20.1 [13.1,32.7] g; P = 0.04)。两组患者在PTX之前表现出相似的血清磷酸盐水平,但是在随访时间(3个月,P = 0.03; 6个月,P = 0.03),B组的这些磷酸盐水平高于A组。预先存在的TC持续时间较短和PTX之前较高的ALP水平以及PTX之后较低的血清磷酸盐水平与有效的SHPT-TC收缩有关。03)和高敏感性C反应蛋白(hs-CRP; 82.7 [55.0,112.4] vs. 3.1 [3.1,4.5] mg / l; P = 0.02)。A组在手术1周内的平均钙补充量明显高于B组(96.8 [64.1,105.3] g vs. 20.1 [13.1,32.7] g; P = 0.04)。两组患者在PTX之前表现出相似的血清磷酸盐水平,但在随访时间(3个月,P = 0.03; 6个月,P = 0.03),B组的这些磷酸盐水平高于A组。预先存在的TC持续时间较短和PTX之前较高的ALP水平以及PTX之后较低的血清磷酸盐水平与有效的SHPT-TC收缩有关。03)和高敏感性C反应蛋白(hs-CRP; 82.7 [55.0,112.4] vs. 3.1 [3.1,4.5] mg / l; P = 0.02)。A组在手术1周内的平均钙补充量显着高于B组(96.8 [64.1,105.3] g vs. 20.1 [13.1,32.7] g; P = 0.04)。两组患者在PTX之前表现出相似的血清磷酸盐水平,但在随访时间(3个月,P = 0.03; 6个月,P = 0.03),B组的这些磷酸盐水平高于A组。预先存在的TC持续时间较短和PTX之前较高的ALP水平以及PTX之后较低的血清磷酸盐水平与有效的SHPT-TC收缩有关。105.3] vs. 20.1 [13.1,32.7] g;P = 0.04)。两组患者在PTX之前表现出相似的血清磷酸盐水平,但在随访时间(3个月,P = 0.03; 6个月,P = 0.03),B组的这些磷酸盐水平高于A组。预先存在的TC持续时间较短和PTX之前较高的ALP水平以及PTX之后较低的血清磷酸盐水平与有效的SHPT-TC收缩有关。105.3] vs. 20.1 [13.1,32.7] g;P = 0.04)。两组患者在PTX之前表现出相似的血清磷酸盐水平,但在随访时间(3个月,P = 0.03; 6个月,P = 0.03),B组的这些磷酸盐水平高于A组。预先存在的TC持续时间较短和PTX之前较高的ALP水平以及PTX之后较低的血清磷酸盐水平与有效的SHPT-TC收缩有关。
更新日期:2019-09-11
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