• 대한두경부종양학회지
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• 제15권1호
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• pp.80-84
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• 1999

Primary hryperparathyroidism is a relatively rare disease entity in Korea. It's characterized by severe skeletal and renal changes due to hypersecretion of parathyroid hormone, and rarely shows peptic ulceration, hypertension, pancreatitis and impaired mentality. Recently the determination of the serum calcium level has become a routine laboratory test and the awareness of primary hyperparathyroidism has been incerased, the disease is being diagnosed with increasing frequency. Primary hyperparathyroidism is most commonly caused by parathyroid adenoma and rarely hyperplasia, cancer of parathyroid glands. The authors operated sucessfully a case of primary parathyroid adenoma by diagnosed by nuclear medical diagnostic work-up. The patient had anterior neck mass(soft, non tender nodule) on physical examination, multiple goiter on thyroid ultrasonogram and scan. The parathyroid lesion was difficult to find preoperatively.

• 대한두경부종양학회지
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• 제10권1호
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• pp.31-37
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• 1994

Primary hyperparathyroidism is rare disease entity which secretes parathyroid hormone in excessively resulting in hypercalcemia. It involves skeletal system, urinary tract, gastrointestinal tract, and central nervous system. Recently the determination of the serum calcium and parathyroid hormone level has become a routine laboratory test and the localization of involved gland by neck ultrasonogram and parathyroid gland substraction scan has reduced operative complications. For the purpose of improvement of diagnosis and treatment, the authors analyzed the clinical characteristics of 6 cases of primary hyperparathyroidism(adenoma 5 cases, carcinoma 1 case) during 10 years and report with literatures.

• 대한두경부종양학회지
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• 제15권1호
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• pp.76-79
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• 1999

The relationship between acute pancreatitis and hyperparathyroidism has been described extensively in the past. Despite the rarity, the clinical progression of pancreatitis associated with hyperparathyroidism has been known to be so rapid and severe that it may cause death. When, furthermore, the pancreatitis is caused by hyperparathyroidism, the recovery from disease can be hardly expected unless the hyperparathyroidism is corrected. We present a case of acute pancreatitis in a 68-year-old man that have been caused by primary hyperparathyroidism. The clues of hyperparathyrodism were hypercalcemia and elevated parathyroid hormone, but he showed subtle or negative symptoms of hypercalcemia. After the excision of parathyroid adenoma, serum calcium level returned to normal and the symptoms and function of pancreas were recovered.

• 한국임상약학회지
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• 제23권2호
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• pp.142-150
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• 2013

Background: Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease, affecting most of those who are receiving dialysis. Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower PTH levels in dialysis patients. Objective: This study aimed to assess efficacy, safety and appropriateness of use of cinacalcet in dialysis patients. Method: This retrospective study was performed on total 24 cases with identified intact parathyroid hormone (iPTH), serum calcium and phosphorus levels before and 4 weeks after cinacalcet initiation at a teaching hospital from July 1st, 2011 to October 31st, 2012. Results: Cinacalcet decreased iPTH by 19% from baseline after 4weeks treatment and it was statistically significant (p<0.001). Cinacalcet also significantly decreased iPTH levels regardless of dialysis modality (hemodialysis group versus peritoneal dialysis group) and severity of SHPT (iPTH 300-800 pg/ml group versus iPTH >800 pg/ml group). Serum calcium, phosphorus and Ca x P levels were decreased without statistical significance. Gastrointestinal events, headache and hypocalcemia were the most common side effects. Monitoring for iPTH and serum calcium was not performed appropriately. 43.7% patients initiated cinacalcet therapy at serum calcium level< 9.0 mg/dl. Conclusion: In conclusion, cinacalcet lowers parathyroid hormone levels with no serious side effects. However, it is required to avoid cinacalcet treatment in patients with low serum calcium levels and monitor iPTH and serum calcium levels during cinacalcet administration.

• Journal of Oral Medicine and Pain
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• 제38권3호
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• pp.247-253
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• 2013

신성골이영양증 (Renal osteodystrophy)은 만성 신질환 환자에서 관찰되는 골격성 변화를 특징으로 하는 질환으로 칼슘과 인 대사의 변화, 그리고 이차성 부갑상선 기능항진증의 결과로 나타난다. 방사선학적으로 지골의 말단, 장골과 악골 부위의 골막하 부위의 침식을 흔하게 관찰할 수 있다. 악안면 영역에서 골변화는 골밀도의 감소, 방사선 투과성 병소 (갈색 종양 : brown tumor), 피질골의 비박화와 치조백선의 소실을 보인다. 그러나 이러한 골변화가 악관절에 발생하는 것은 흔치 않은 일이다. 본 증례는 양측 하악 과두의 골변화를 보인 신성골이영양증 환자를 보고하고자 한다. 지난 10년 간 혈액 투석 치료와 3개월 전 신장암 수술 병력이 있는 41세 남자 환자가 좌측 턱의 통증을 주소로 2011년 2월 단국대학교 치과대학부속 치과병원 구강내과에 내원하였다. 양측 악관절의 골관절염과 유사한 방사선학적 소견을 보였고, 전치부 개방교합이 관찰되었다. CBCT를 이용한 방사선학적 특징과 생화학적 지표를 통해 신성골이영양증으로 인한 양측 턱관절의 골관절염으로 진단 되어 환자는 내과에서 신성골이영양증의 치료 방법의 하나인 칼슘 및 비타민 D 복용고 부갑상선 절제술을 시행 받았고, 그 동안 턱관절의 통증 조절을 위해 본원에서는 행동 요법과 약물 치료, 물리치료만 시행하였다. 약 1년 3개월 후 재검사에서 하악골의 골밀도와 피질골 두께가 증가하였고, 하악 과두 외형이 비교적 명확하게 바뀌었다. 골변화는 만성 신장 질환의 초기 단계부터 시작되므로 치과의사는 이러한 질환의 징후 및 가능성을 신속히 감별할 수 있어야 한다. 또한 골관절염과 신성골이영양증의 치료 프로토콜이 다르기 때문에 두 질환을 감별하는 것이 중요하다.

• 대한두경부종양학회지
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• 제12권1호
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• pp.58-64
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• 1996

The parathyroid adenoma is the most common cause of the primary hyperparathyroidism. The characteristic of primary hyperparathyroidism is hypercalcemia and high value of serum parathyroid hormone. The primary hyperparathyroidism with parathyroid adenoma is treated by excision of parathyroid gland involved. Especially, parathyroid storm in patients with primary hyperparathyroidism is more prevalent than commonly appreciated. The symptoms and signs of the syndrome are not only due to the hypercalcemia, but also to the toxic effects of the parathyroid hormone. Its wide, but nonspecific clinical presentations make it easily confused with other cardiovascular or renal diseases. The mortality rate in untreated cases of parathyroid storm is essentially 40%. A 33 year old woman with primary hyperparathyroidism was found to have a left lower parathyroid adenoma, presented with hypercalcemic crisis. Initially, good responsiveness to a saline infusion, furosemide administration was noted. Unfortunately, she became consciousness disturbance after fine-needle aspiration of the parathyroid tumor. The recurrent storm was refractory to medical therapy, but was treated succesfully by emergent surgical removal tumor revealed a parathyroid adenoma with parathyroid hormone. Hypercalcemia was alleviated postoperatively. These observations corroborated a functioning parathyroid adenoma.

• Childhood Kidney Diseases
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• 제10권1호
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• pp.58-64
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• 2006

최근 들어 모유 단독 수유의 장기화 및 잘못된 식이 제한 등으로 인한 비타민 D 결핍성 구루병의 발병이 점차 증가하고 있는 시점에서, 비타민 D 결핍성 구루병 및 이와 동반된 저칼슘혈증성 경련에 대한 예는 다소 보고된 바 있으나, 비타민 D 결핍으로 인해 골 병변 뿐 아니라 저칼슘 혈증, 부갑상선 기능 항진증, 나아가 신세뇨관성 산증까지 초래한 예는 보고된 바가 없었다. 저자들은 8개월간 모유 단독 수유만 유지하던 중 저칼슘혈증성 경련을 주소로 내원하여 골 병변을 동반한 비타민 D 결핍성 구루병과 부갑상선 항진 및 근위 세뇨관성 산증을 진단 받은 후, 적절한 칼슘, 비타민 D, 중탄산염 투여 후 완전히 회복된 환자의 1례를 경험하였기에 보고하는 바이다.

• 한국임상수의학회지
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• 제24권4호
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• pp.522-528
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• 2007

A 3-year-old male Maltese dog(weighing 2.5 kg) was referred with an excessive movement of mandible and depression. Comprehensive diagnostic investigation revealed an end-stage of renal disease with secondary hyperparathyroidism. The renal allograft was performed after the condition of dog was stabilized by hemodialysis and medical treatment. After transplantation, the renal function of this dog was returned to normal. thereafter, the dog died suddenly without apparent clinical signs. The subsequent pathological studies revealed the actual etiology of death was not clearly identified However acute pancreatitis caused by abrupt introduction of food after prolonged luting might be involved in the etiology. This case study showed the necessity of pancreatic function test in postoperative management after renal transplantation.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.7-12
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• 2014

만성 콩팥병의 장기 예후를 결정하는 요인 중 심혈관계 합병증의 중요성은 잘 알려져 있다. 그러나 소아 환자의 경우 전형적인 증상 발현이 적어 그 임상적 중요성이 간과되는 경향이 있다. 현재까지 알려진 심혈관계 합병증의 위험인자로는 고혈압, 당뇨병, 이상지질혈증, 비만과 같은 전통적인 위험 인자와 빈혈, 이차성 부갑상선 기능항진증, 산화 스트레스, 염증과 같은 새로운 위험 인자 등이 알려져 있다. 소아 만성 콩팥병의 경우 주로 좌심실 비대나 경동맥 내중막 두께의 증가 및 관상동맥의 석회화 같이 대부분 겉으로 드러나지 않는 증상이므로 위험 인자에 대한 철저한 관리와 지속적인 추적 관찰이 필수적이다.

• 대한두경부종양학회지
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• 제15권2호
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• pp.235-238
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• 1999

Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with primary hyperparathyroidism. In the patients with chronic renal failure, the incidence is extremely low. Only 13 cases of parathyroid carcinoma with chronic renal failure have been described in the world literature. We report a case of parathyroid carcinoma in a 43-year-old man who has been suffered from chronic renal failure for 19 years. To our knowledge, this is the first case of parathyroid carcinoma occurring in the thyroid gland associated with secondary hyperparathyroidism.