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PRİMER HİPERPARATİROİDİZM: KLİNİK ÖZELLİKLERİ, LABORATUVAR VE TEDAVİ SONUÇLARI

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Primary hyperparathyroidism: Clinical features, laboratory results and outeome. We studi-ed 37 patients with PHPT admİtted to istanbul University Hospital between 1988-1998 years. Paticnts ranged in age from 30 to 69 years (mean 52.97 years), and ineluded 28 women and 9 men. Most patients had bone pain and wcakness. Hypcrtension was deteeted in 11 (29.7) pati-ent. Althought preoperative serum caleium levels were elevated in most patients, one (2.7%) patient's caleium level was in normal limits. With radiological cxamination of bones, we deteeted osteopenia İn 18 (48.6%), subperiosteal resorption in 6 (16.3%), bone eysts in 8 (21.6%), Brown tumours İn 5 (13.5%), salt and pepper appcarance of the skull in 4 (10.8), and pathological fraetures in 5 (13.5%) patients. Nephrolithiasis was present in 9 (24.3) patients. Thirty two (86.5%) patients were operated. Two (5.4%) patients did not accept the operation and medical management was proposed to the three (8.1%) patients. Postoperatİve serum caleium levels did not return to normal levels in three (9.7%) patients. Two of them were reope-rated. Serum caleium levels returned to normal limits after ectopic parathyroid tissues were fo-und and excised. In histopathological cxamination of operated patients, it was determined that 26 (81.2%) patients had parathyroid adenomas, three (9.4%) patients had hypeplasia and two (6.3%) patients had carcinomas. Parathyroid tissue was not found in one patient. Differentia-ted fhyroid carcinoma was diagnosed in four (12.5%) cases. Two of them vvere papillary thyroid carcinoma, the others wcre micropapİUary thyroid carcinoma. At the site of surgicai wound, alarge hematoma occured in one (3.1%) patient. This patients was reoperated and hematom was drained. Temporary postoperative hypoparothyroidism occured in eight (25%) and permanent hypoparathyroİdism in eight (25%) patients
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Abstract (Original Language): 
Bu çalışmada, 1988-1998 yıllan arasında İstanbul Tıp Fakültesi Hastanesine başvuran, 28'i kadın (%75.7), 9'u erkek (%24.3) olmak üzere toplam 37 primer hipeıparatiroidizm'H hasta incelendi. Hastaların yaş ortalaması 52.97+9.61 (yaş aralığı 30-69) yıl idi. Hastaların çoğunda (%64.9) kemik ağrısı ve yürüme güçlüğü yakınması vardı. On bir hastada (%29.7) hipertansiyon saptandı. Bir hastada (%2.7) serum kalsiyum düzeyi normal sınırlar içindeydi. Radyolojik incelcmedel8 hastada (%48.6) osteopeni, 6 hastada (%16.3) subperiostal rezorpsiyon, 8 hastada (%21.6) kemik kisti, 5 hastada (%13.5) Brown tümörü, 4 hastada (%10.8) kranİumda tuz-biber görünümü, 5 hastada (%13.5) patolojik kırık görüldü. Dokuz hastada (%24.3) nefrolitia-zis tespit edildi. Otuz iki hasta (%86.5) ameliyat edildi, 2 hasta (%5.4) ameliyatı kabul etmedi, 3 hastaya da (%8.1) takip önerildi. Ameliyat edilen hastaların 3'ündc (%9.7) operasyon sonrası serum kalsiyum düzeyi normale dönmedi. Bunların ikisinde tetkikler sonucunda ektopik para-tiroid bezi bulundu ve yeni bir cerrahi girişimle bez çıkarıldıktan sonra kalsiyum düzeyi normale döndü. Üçüncü hastada ise adenomuıı yeri araştınlamadı. Bir hastada ameliyat esnasında paratiroid adenomu bulunamadı, ancak ameliyat sonrası kalsiyum düzeyi normalin altına inmişti ve histopatolojik incelemede tiroid içinde paratiroid adenomu saptandı. Histopatolojİk incelemede 26 hastada (%81.2) adenom, 3 hastada (%9.4) hiperplazi, 2 hastada (%6.3) paratiroid karsinomu tespit edildi, 1 hastada ise paratiroid dokusuna rastlanmadı. Adenomu olan 3 hastada ve hiperplazi olan 1 hastada olmak üzere toplam 4 hastada (%12.5) birlikte tiroid kanseri saptandı. Bunlardan 2'si papiller, diğer 2'si ise mikropapiîler tiroid kanseri idi. Ameliyat edilen hastaların Tinde (%3.1) ameliyat yerinde büyük bir hematom oluştu, bu hasta ikinci defa ameliyat edildi ve hematom boşaltıldı. Sekiz hastada (%25) geçici, 8 hastada da (%25) kalıcı hipoparatiroİdizm meydana geldi.
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  • 1
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  • Turkish

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