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Bone Marrow Uptake in Parathyroid Scintigraphy is a Consequence of Extremely High Parathyroid Hormone Levels.
MedLine Citation:
PMID:  23186971     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: We retrospectively evaluated patients with end stage renal disease (ESRD) who were referred to our department for parathyroid scintigraphy. The aim of this study is to investigate the causes of the bone marrow uptake that we observed in the parathyroid scintigraphy.Methods: Eighteen patients (10 F, 8 M; 45-49, mean; 52±13 years old) were included in the study. The follow up period of patients with ESRD were mean 7.7±4.7 years. The mean plasma calcium (Ca) and parathormone (PTH) levels of the patients were 9.7±1.4 mg/dL and 1553.3±691.7 pg/mL respectively. Dual phase Tc-99m MIBI parathyroid imaging and, if necessary, additional Tc-99m pertechnetate scintigraphy were performed. Quantification of the planar early phase parathyroid images was performed from various regions (sternum, humerus, ribs) with the same size rectangular region of interest (176 pixel). Average counts were compared using the Paired Samples Students T test and P< 0.05 was considered statistically significant.Results: Tc-99m MIBI parathyroid imaging revealed prediagnosis of parathyroid hyperplasia in seven, adenoma in three, and ectopic adenoma in two patients. The other patients' scintigraphies were normal as regards parathyroid pathologies. Bone marrow uptake in the sternum, ribs and humerus was observed in six patients. The difference between quantitative values obtained from the regions of interest drawn on the sternum and humerus was also statistically significant compared to patients without bone marrow uptake (P<0.05). All of these six patients' PTH levels were extremely high (>2000 pg/mL; mean: 2413.7±150 pg/mL) compared to the other patients (mean: 1342.8±249 pg/mL).Conclusion: Our results show that bone marrow uptake in parathyroid scintigraphy is a consequence of extremely high PTH levels, compared to those without bone marrow uptake, and thus interpretation of bone marrow uptake in the parathyroid scintigraphy of patients with ESRD should refer to extremely high PTH levels and no further analysis is required.
Authors:
Zehra Pinar Koc; Tansel Ansal Balcı; Ayhan Dogukan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-27
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  -     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-14     Citation Subset:  -    
Affiliation:
Department of Nuclear Medicine, Firat (Euphrates) University Medical Faculty.
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