第2章:一次性副甲状腺功能障碍症:诊断
Benjamin Bouillet1, Jean-Philippe Bertocchio2, Claire Nominé-Criqui3
1Department of Endocrinology, Diabetology and Nutrition, CHU de Dijon, 21000 Dijon, France; Inserm Research Center U1231, Padys Team, 21000 Dijon, France; University of Burgundy, 21000 Dijon, France.
Annales d'endocrinologie
|January 16, 2025
概括
初级甲状腺功能障碍症往往无症状,需要对器官损伤进行查. 诊断依赖于生物标志物,如血液中的和副甲状腺激素水平,特别是在非典型的病例中.
科学领域:
- 内分泌学 在内分泌学.
- 生物化学 生物化学
背景情况:
- 由于常规血液检查,在无症状个体中越来越多地诊断出原发性副甲状腺症 (PHPT).
- PHPT的经典临床症状涉及骨,脏和肌肉,在甲状腺外科手术后可能会逆转.
- 影响心血管,消化和神经心理系统的非经典表现也被认可,手术后的可逆性不确定.
研究的目的:
- 概述初级甲状腺功能障碍症的诊断策略,重点是识别无症状患者的目标器官损伤.
- 根据生物标记,区分典型和非典型的PHPT形式.
- 突出非典型的PHPT演示的诊断工具.
主要方法:
- 系统的血测定用于查.
- 评估经典 (骨,脏,肌肉) 和非经典 (心血管,消化,神经心理) 症状.
- 生物诊断基于甲状腺前激素 (PTH) 水平相对于血中的.
- 在典型的PHPT中评估高血症,升高的PTH和尿/分泌率.
- 对非典型形式的诊断方法,包括正常的PTH与高血症或正常的血症与升高的PTH,考虑到像维生素D缺乏症这样的条件.
- 使用口服负荷测试和非典型病例的Pro-FHH得分.
主要成果:
- 诊断PHPT越来越依赖于检测无症状患者的器官损伤.
- 经典症状在手术后是可逆的,而非经典症状的可逆性是不确定的.
- 典型的PHPT的特征是高血症,高PTH和增加的尿.
- 非典型的形式带来诊断挑战,需要特殊的测试,如口服负荷测试和Pro-FHH得分.
结论:
- 对目标器官损伤的系统查和评估对于诊断无症状原发性副甲状腺炎至关重要.
- 生物标志物,特别是和PTH之间的关系,是诊断的关键.
- 非典型的表现需要专门的诊断工具,以确保PHPT的准确识别和管理.
更多相关视频
07:12Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
3.3K
07:13Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
Published on: March 14, 2017
14.5K
相关概念视频
00:59The Parathyroid Glands
1.9K
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.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
1.9K
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
88
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
88
01:17Hormones and Bone Tissue
2.6K
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.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.6K
01:21Skeleton and Calcium Homeostasis
4.4K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.4K
01:15Myasthenia Gravis: Diagnostic Tests
610
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
610
00:51Synthesis and Functions of Calcitonin
1.6K
Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
1.6K