Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism
Tóm tắt
Primary hyperparathyroidism is characterized by hypercalcemia with loss of bone mass. After parathyroidectomy, hypocalcemia may develop in some patients due to unregulated bone mineralization. Preoperative administration of bisphosphonates, potent inhibitors of osteoclast activity, may prevent postoperative hypocalcemia after parathyroidectomy. We retrospectively reviewed medical records to investigate the effect of bisphosphonate pretreatment on serum calcium level changes after parathyroidectomy. Twenty-three patients with a diagnosis of primary hyperparathyroidism underwent parathyroidectomy between April 1997 and August 2002. Clinical and laboratory data were collected before and after the operation. These patients were divided into two groups; those showing hungry bone syndrome (n = 9) and those not (n = 14). None of the 9 patients with hungry bone syndrome had received bisphosphonate pretreatment. Of the 14 patients without hungry bone syndrome, 6 had received bisphosphonate pretreatment (P < 0.05). Furthermore, preoperative calcium concentration was not related to the occurrence of hypo-calcemia in those without bisphosphonate pretreatment. In conclusion, administration of bisphosphonates in primary hyperparathyroidism can prevent the occurrence of hungry bone syndrome after parathyroidectomy.
Tài liệu tham khảo
SJ Marx (2000) ArticleTitleHyperparathyroid and hypoparathyroid disorders N Engl J Med 21 1863–1875
AE Kearns GB Thompson (2002) ArticleTitleMedical and surgical management of hyperparathyroidism Mayo Clin Proc 77 87–91 Occurrence Handle11794462
AR Brasier SR Nussbaum (1988) ArticleTitleHungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery Am J Med 84 654–660 Occurrence Handle10.1016/0002-9343(88)90100-3 Occurrence Handle1:STN:280:BieB1M3jtVU%3D Occurrence Handle3400660
F Llach (1990) ArticleTitleParathyroidectomy in chronic renal failure: indications, surgical approach and the use of calcitriol Kidney Int Suppl 29 S62–S68 Occurrence Handle1:STN:280:By6D3MzlsVY%3D Occurrence Handle2214549
DN Cruz MA Perazella (1997) ArticleTitleBiochemical aberrations in a dialysis patient following parathyroidectomy Am J Kidney Dis 29 759–762 Occurrence Handle1:STN:280:ByiA3c3ovVU%3D Occurrence Handle9159312
CM Headley (1998) ArticleTitleHungry bone syndrome following parathyroidectomy ANNA J 25 283–289 Occurrence Handle1:STN:280:DyaK1M%2FhvVaqsA%3D%3D Occurrence Handle9801484
H Fleisch (1998) ArticleTitleBisphosphonates: mechanisms of action Endocr Rev 19 80–100 Occurrence Handle10.1210/er.19.1.80 Occurrence Handle1:CAS:528:DyaK1cXhtlagtLw%3D Occurrence Handle9494781
GA Rodan (2002) ArticleTitleBisphosphonates and primary hyperparathyroidism J Bone Miner Res 17 N150–N153 Occurrence Handle1:CAS:528:DC%2BD38Xoslemsbw%3D Occurrence Handle12412793
A Kumar SH Ralston (1996) ArticleTitleBisphosphonates prevent the hungry bone syndrome Nephron 74 729 Occurrence Handle1:STN:280:ByiC3MvlslI%3D Occurrence Handle8956310
P Vestergaard CL Mollerup VG Frøkjær P Christiansen M Blichert-Toft L Mosekilde (2000) ArticleTitleCohort study of risk of fracture before and after surgery for primary hyperparathyroidism BMJ 321 598–602 Occurrence Handle10.1136/bmj.321.7261.598 Occurrence Handle1:STN:280:DC%2BD3cvmvF2lsw%3D%3D Occurrence Handle10977834
G Kochersberger NJ Buckley GS Leight S Martinez S Studenski J Vogler KW Lyles (1987) ArticleTitleWhat is the clinical significance of bone loss in primary hyperparathyroidism? Arch Intern Med 147 1951–1953 Occurrence Handle10.1001/archinte.147.11.1951 Occurrence Handle1:STN:280:BieD2cfnt1w%3D Occurrence Handle3675096
K Larsson E Lindh L Lind I Persson S Ljunghall (1989) ArticleTitleIncreasing fracture risk in hypercalcemia. Bone mineral content measured in hyperparathyroidism Orthop Scand 60 268–270 Occurrence Handle1:STN:280:BiaA3MbmtVY%3D
S Jansson LE Tisell G Lindstedt PA Lundberg (1991) ArticleTitleDisodium pamidronate in preoperative treatment of hypercalcemia in patients with primary hyperparathyroidism Surgery 110 480–486 Occurrence Handle1:STN:280:By6A287is1Q%3D Occurrence Handle1845370
A al Zahrani MA Levine (1997) ArticleTitlePrimary hyperparathyroidism Lancet 26 1233–1238
EA Mittendorf JI Merlino CR McHenry (2004) ArticleTitlePost-parathyroidectomy hypocalcemia: incidence, risk factors, and management Am Surg 70 114–119 Occurrence Handle15011912
NA Hamdy RE Gray E McCloskey J Galloway JM Rattenbury CB Brown JA Kanis (1987) ArticleTitleClodronate in the medical management of hyperparathyroidism Bone 8 S69–77 Occurrence Handle2961358
GL Plosker KL Goa (1994) ArticleTitleClodronate. A review of its pharmacological properties and therapeutic efficacy in resorptive bone disease Drugs 47 945–982 Occurrence Handle1:STN:280:ByuA28vitlI%3D Occurrence Handle7521833
SR Nussbaum J Younger CJ Vandepol RF Gagel MA Zubler R Chapman IC Henderson LE Mallette (1993) ArticleTitleSingle-dose intravenous therapy with pamidronate for the treatment of hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosages Am J Med 95 297–304 Occurrence Handle10.1016/0002-9343(93)90282-T Occurrence Handle1:STN:280:ByyA2sjmvVI%3D Occurrence Handle8368227
J Gray T Shaw (1993) ArticleTitleUse of biphosphonates in preoperative treatment of patients with hyperparathyroidism Surgery 113 594 Occurrence Handle1:STN:280:ByyB2MrltlQ%3D Occurrence Handle8488482
JG Jimenez-Montero E Lobo-Hernandez A Picado-Larios MA Molina (2002) ArticleTitleSecondary hyperparathyroidism after removal of a parathyroid adenoma Endocr Pract 8 429–432 Occurrence Handle15260008
D Smith BF Murray E McDermott D O'Shea MJ McKenna TJ McKenna (2005) ArticleTitleHungry bones without hypocalcaemia following parathyroidectomy J Bone Miner Metab 23 514–515 Occurrence Handle10.1007/s00774-005-0636-1 Occurrence Handle16261461
JP Bilezikian JT Potts SuffixJr (2002) ArticleTitleAsymptomatic primary hyperparathyroidism: new issues and new questions – bridging the past with the future J Bone Miner Res 17 N57–67 Occurrence Handle12412779
S Jansson E Morgan (2004) ArticleTitleBiochemical effects from treatment with bisphosphonate and surgery in patients with primary hyperparathyroidism World J Surg 28 1293–1297 Occurrence Handle10.1007/s00268-004-7611-1 Occurrence Handle15517486