ABSTRACT
Introduction. Parathyroid hormone (PTH) is a linear peptide constituted by 84 amino acids and active in its 1-84 form, but a wide range of PTH forms produced by its post-transcriptional modifications are present in blood. Many assays with different specificities are commercially available. The aim of our study was to compare a 2nd and 3rd generation in healthy population in order to better define the reference range in the healthy population residing in our region. Materials and Methods. 108 subjects (53 females and 55 males) referring to the transfusion donor were enrolled in the study centre in April 2016 and underwent PTH levels measurements with a 3rd generation kit (chemiluminescent immunoassay DiaSorin Liaison) and with a 2nd generation kit (immunoradiometric assay Total Intact PTH Assay (Coated Tube), Scantibodies). Also calcium, phosphate, creatinine, and 25OHD3 were measured. A questionnaire on lifestyle and dietary habits was obtained. RESULTS: The median PTH values obtained with the 2nd generation assay and the whole 3rd generation assay were 20.26 pg/ml and 23.11 pg/ml, respectively. Bland-Altman method showed substantial concordance between the two PTH assays, although with an overestimation of the 3rd generation method over the 2nd generation method. There was no correlation between 3rd generation PTH and 25OHD3 and creatinine. Calcium was negatively correlated with PTH only when measured with 3rd generation kit. CONCLUSIONS: On the basis of our data, obtained from healthy subjects, we can conclude that the reference range used by our laboratory was too narrow and was necessary to reestablish normal ranges according to our population. This is useful to avoid hyperparathyroidism misdiagnosis.
ABSTRACT
Aortobronchial fistula is an uncommon clinical entity, with unpredictable clinical course and significant mortality. Here, we describe a case of fistulous tract between a descending aortic graft and a branch of the left upper lobar bronchus leading to massive hemoptysis causing death for hemorrhagic shock in a 72-year-old man.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Aortic Diseases/etiology , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Bronchial Fistula/etiology , Hemoptysis/etiology , Prosthesis-Related Infections/etiology , Vascular Fistula/etiology , Aged , Aortic Diseases/microbiology , Aortic Diseases/pathology , Autopsy , Bronchial Fistula/microbiology , Bronchial Fistula/pathology , Cause of Death , Fatal Outcome , Humans , Male , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/pathology , Shock, Hemorrhagic/etiology , Vascular Fistula/microbiology , Vascular Fistula/pathologyABSTRACT
We describe a case of a 65-year-old woman admitted to the hospital for suspected of epileptic crisis. She was affected by diabetes and hiatal hernia for which she was taking Proton Pump Inhibitors (PPIs) for about 8 years. She showed hypocalcaemia, hypomagnesaemia, hyperparathyroidism and severe hypovitaminosis D. We exclude malabsorption and magnesium loss. After restored vitamin D levels, stopped use of PPI, start calcium and magnesium supplementation normal values of the ions were restored. This case underlies the importance of evaluate magnesium routinely, other than calcium and vitamin D, and use PPI more carefully.
