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The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Primary hyperparathyroidism presenting as acute hypercalcemic crisis: a case report.

Gia Gill1, Veena Agrawal2, Paul Kerr3

  • 1Department of Otolaryngology-Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, GB421 - 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada. ggill2@manitoba-physicians.ca.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|January 10, 2023
PubMed
Summary

Hyperparathyroid crisis, a severe form of primary hyperparathyroidism, can be triggered by hemorrhage into a parathyroid adenoma. Medical management proved ineffective, highlighting the need for urgent surgical intervention in such cases.

Keywords:
Atypical adenomaHypercalcemiaHyperparathyroidParathyroid adenoma

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Area of Science:

  • Endocrinology
  • Surgical Pathology

Background:

  • Hyperparathyroid crisis is a rare, severe manifestation of primary hyperparathyroidism.
  • Hemorrhage into a parathyroid adenoma is an uncommon inciting event.

Observation:

  • A 60-year-old male presented with acute confusion, weakness, and severe hypercalcemia (4.79 mmol/L) with elevated parathyroid hormone.
  • Despite aggressive medical management for 5 days, including fluids, denosumab, calcitonin, pamidronate, and cinacalcet, his hypercalcemia persisted.

Findings:

  • The patient developed profound hypercalcemia, requiring intubation and renal replacement therapy.
  • Surgical exploration revealed a large, hemorrhagic, atypical parathyroid adenoma.
  • The patient ultimately died from complications of anticoagulation therapy for deep vein thrombosis.

Implications:

  • This case underscores the challenges in medically managing hyperparathyroid crisis.
  • Hemorrhage into a parathyroid adenoma can precipitate severe hypercalcemia.
  • Urgent surgical parathyroidectomy is the definitive treatment for this condition.