Document Detail


Bone demineralization, a factor of increasing significance in the management of primary hyperparathyroidism.
MedLine Citation:
PMID:  2588113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The significance of bone demineralization was evaluated for 97 patients treated surgically for primary hyperparathyroidism since 1980. Of 31 patients studied by bone densitometry, 16 showed moderate to severe osteoporosis. In approximately 20% of the total group, bone demineralization, including a bone fracture problem in some, was the dominant or a major indication for operation. Serial bone studies in six patients taken preoperatively or in patients not operated on for primary hyperparathyroidism showed an average loss of bone mineral density of 0.9% per year, whereas in four patients treated surgically serial studies showed an average increase of 9.8% per year. Although estrogen intake reduced serum calcium levels, significant bone demineralization or fractures were present in four patients aged 40 to 59 years and in five patients more than 60 years of age who had taken estrogens for many years. We conclude that in primary hyperparathyroidism, bone demineralization (1) justifies surgical correction in a significant number of patients; (2) should be evaluated, especially in elderly women; (3) is not prevented by estrogen intake, which may instead confuse decision making; (4) is reversed after surgical correction, but suggestions of incomplete reversal emphasize importance of this factor; (5) should be considered in postoperative management; and (6) involves many variables.
Authors:
M A Block; G E Dailey; D E Muchmore
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  106     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-01-08     Completed Date:  1990-01-08     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1063-8; discussion 1068-9     Citation Subset:  AIM; IM    
Affiliation:
Divisions of General Surgery, Scripps Clinic Medical Group, Inc., La Jolla, Calif.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Density
Bone and Bones / physiopathology
Calcium / blood
Female
Fractures, Bone / etiology
Humans
Hyperparathyroidism / complications,  physiopathology*,  surgery
Male
Middle Aged
Osteoporosis / complications*,  physiopathology
Retrospective Studies
Chemical
Reg. No./Substance:
7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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