Post-surgical follow-up of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1

The bone mineral density increments in patients with sporadic primary hyperparathyroidism after parathyroidectomy have been studied by several investigators, but few have investigated this topic in primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Further, as far as we know, only two studies have consistently evaluated bone mineral density values after parathyroidectomy in cases of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Here we revised the impact of parathyroidectomy (particularly total parathyroidectomy followed by autologous parathyroid implant into the forearm) on bone mineral density values in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Significant increases in bone mineral density in the lumbar spine and femoral neck values were found, although no short-term (15 months) improvement in bone mineral density at the proximal third of the distal radius was observed. Additionally, short-term and medium-term calcium and parathyroid hormone values after parathyroidectomy in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 are discussed. In most cases, this surgical approach was able to restore normal calcium/parathyroid hormone levels and ultimately lead to discontinuation of calcium and calcitriol supplementation.

Sindrome de Zollinger-Ellison: uma revisao / Zollinger-Ellison syndrome: review article

Apesar de sua raridade, a Sindrome de Zollinger-Ellison (SZE) foi alvo de intensos estudos, os quais contribuiram para a construcao da moderna endocrinologia gastrointestinal. Tradicionalmente, as estrategias diagnosticas e terapeuticas voltaram-se apenas ao controle da hipersecrecao gastrica, obtido geralmente atraves da gastrectomia total. Entretanto, com o desenvolvimento de drogas eficazes na inibicao da secrecao gastrica, as atencoes tem se voltado as possibilidades de resseccao cirurgica e cura do processo neoplasico. A localizacao do tumor (atraves de estudos bioquimicos, radiologicos e endoscopicos) e uma etapa essencial para o...