Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Denk aan vitamine D, vitamine B12, coeliakie, bijnier, vitiligo, gewrichten, vasculitis, hypoparathyreoïdie, hyperparathyreoïdie
*anna*
Berichten: 178
Lid geworden op: 12 sep 2013, 01:22

Re: Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Bericht door *anna* » 12 dec 2016, 19:00

Bella,
Vond deze info. Misschien kende je de laatste site al?
https://www.medischcontact.nl/nieuws/la ... um=twitter
en
http://dutchparathyroid.nl/

Groet, Anna

Bella
Berichten: 47
Lid geworden op: 04 jul 2014, 12:01

Re: Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Bericht door Bella » 13 dec 2016, 07:54

Welbedankt Anna!

Lijkt 'n prima aanspreekpunt, klim straks gelijk even in de pen.
Weldadig, die erkenning...

Groet,
Bella
Nuchter bloedprikken, dus niet eten en geen schildklierhormoon slikken, geeft de betrouwbaarste waarden. De behandeling met schildklierhormoon is bedoeld om altijd, dus ook 's ochtends vroeg, voldoende schildklierhormoon tot je beschikking te hebben.

ineke
Berichten: 322
Lid geworden op: 08 nov 2014, 17:53

Re: Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Bericht door ineke » 08 jan 2017, 13:54

Op deze Engelse site info (met afbeeldingen) over hypo- en hyperparathyreoïdie te vinden en met vragen/discussies.
(Eveneens over andere ziektebeelden).




Hyperparathyroidism
http://m.patient.media/images/parathyroid%20glands.gif

What is hyperparathyroidism?
Why do we need calcium and phosphate?
What causes hyperparathyroidism?

What are the symptoms of hyperparathyroidism?
Often people with primary hyperparathyroidism either have no symptoms, or only have mild symptoms. You may only find out that you have hyperparathyroidism because blood tests that are carried out for another reason show a high level of calcium in your blood.

If you have primary or tertiary hyperparathyroidism and do develop symptoms, these are due to a high level of calcium in your blood (hypercalcaemia). They can include:
•Tiredness.
•Weak and easily tired muscles.
•Feeling sick (nausea), being sick (vomiting) and feeling off your food.
•Constipation.
•Tummy (abdominal) pain.
•Feeling very thirsty and passing urine frequently.
•Depression/low mood.

In extreme cases, if left untreated, a high calcium level can lead to confusion, loss of consciousness, heart rhythm disturbances and, rarely, death. You may also have high blood pressure if you have hyperparathyroidism. It is unclear why this happens.

If you have secondary hyperparathyroidism, your calcium level is not high but low, so you do not develop all of the symptoms described above. However, you can develop bone complications (see below) and the symptoms related to that.

Are there any complications of hyperparathyroidism?
Not everyone with hyperparathyroidism has complications. However, sometimes complications may develop. If you have primary or tertiary hyperparathyroidism, these complications are mostly due to a long-standing high level of calcium in your blood. They can include:
•Kidney stones. Small stones may be passed in the urine without you noticing. Larger stones may get stuck, causing pain in your loin area that you then feel in your groin. You may also notice blood in your urine. See separate leaflet called Kidney Stones for more details.
•Corneal calcification. Calcium can collect (be deposited) in the surface covering of your eye (cornea). This doesn't usually cause any symptoms.
•Pancreatitis. This is inflammation of your pancreas gland. Rarely, a high level of calcium due to hyperparathyroidism can cause pancreatitis. This can cause severe upper tummy (abdominal) pain. See separate leaflet called Acute Pancreatitis for more details.
•Stomach (peptic) ulceration. A high calcium level can make your stomach produce too much acid and lead to stomach ulceration. See separate leaflet called Stomach (Gastric) Ulcer for more details.
•Kidney damage. A prolonged high calcium level in your blood can damage your kidneys and cause CKD.

In all types of hyperparathyroidism (including secondary hyperparathyroidism), the increased level of parathyroid hormone circulating in your blood causes high amounts of calcium to be released from your bones. This can cause weakness and 'thinning' of your bones - a condition known as osteopenia or, if more severe, osteoporosis. Your bones may become more susceptible to breaks or fractures. See separate leaflet called Osteoporosis for more details.

How is hyperparathyroidism diagnosed?
Will I need any further investigations?
What are the treatment options for hyperparathyroidism?
Possible complications after surgery
What is the outlook (prognosis) for hyperparathyroidism?
Other advice
References
http://patient.info/health/hyperparathyroidism-leaflet

Als PDF:
http://m.patient.media/pdf/8458.pdf?v=6 ... 1426463758

Gerelateerd aan hyperparathyreoïdie
http://patient.info/health/hyperparathy ... et/related



Hypoparathyroidism
http://m.patient.media/images/parathyroid%20glands.gif

What is hypoparathyroidism?
Why does the body need calcium and phosphorus?
Who gets hypoparathyroidism?
What causes hypoparathyroidism?
- Acquired hypoparathyroidism
- Transient hypoparathyroidism
- Congenital hypoparathyroidism
- Inherited hypoparathyroidism
- Pseudohypoparathyroidism
- Pseudopseudohypoparathyroidism


What are the symptoms of hypoparathyroidism?
People experience the different symptoms of hypoparathyroidism in different ways. The symptoms are largely due to the effects of low levels of calcium in the blood.

Mild symptoms usually develop slowly and may be fleeting or they may require a small adjustment in medication (see below). Severe symptoms may come on rapidly and need urgent treatment. This may be with calcium given directly into the vein via a drip (intravenously).

Possible symptoms that may occur include:
•Muscle pains.
•Tummy (abdominal) pains.
•Tingling, vibrating, burning or numbness of the fingers, toes or face.
•Twitching of the muscles of the face.
•Carpopedal spasm (contraction, or tightening, of the muscles of the hands and feet).
•Seizures.
•Fainting.
•Confusion.
•Memory problems.
•Tiredness.
•Eyesight problems.
•Headaches.
•Brittle nails.
•Dry skin and hair.
•Painful periods.

Are there any complications of hypoparathyroidism?
Any complications that may arise are largely due to the low levels of calcium in the body. Complications can include:
•Kidney stones.
•Cataracts.
•Disturbance of the normal electrical activity of the heart. This can lead to irregularities in the heart rhythm which can in turn lead to collapse.
•Stunted growth, teeth problems and problems with mental development can occur if low calcium levels are not treated in childhood.

How is hypoparathyroidism diagnosed?
What are the aims of treatment?
What are the treatment options?
What is the outlook (prognosis)?
Can hypoparathyroidism be prevented?
Another point about hypoparathyroidism
References
http://patient.info/health/hypoparathyroidism-leaflet

Als PDF:
http://m.patient.media/pdf/7186.pdf?v=6 ... 6678325045

Gerelateerd aan hypoparathyreoïdie
http://patient.info/health/hypoparathyr ... et/related




Over de schildklier:
Hyperthyreoïdie
http://patient.info/health/overactive-t ... thyroidism

Hypothyreoïdie
http://patient.info/health/underactive- ... thyroidism


.

ineke
Berichten: 322
Lid geworden op: 08 nov 2014, 17:53

Re: Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Bericht door ineke » 14 apr 2017, 15:01

Onderstaand info via het Schildkliernetwerk.

(In het Schildklier Netwerk werken dokters van verschillende specialismen en uit verschillende ziekenhuizen nauw met elkaar samen rondom de zorg aan en het onderzoek naar (bij)schildklierziekten)


Impact trial

IMPlementation of a symptom based Algorithm for Calcium management after total Thyroidectomy (IMPACT-trial)

Achtergrond:
Hypocalciëmie is een veel voorkomende complicatie na totale thyreoïdectomie. Ongeveer een kwart van de patiënten heeft postoperatief een verlaagd serum calcium. Resectie van één of meerdere bijschildklieren, maar ook (tijdelijke) ischemie of oedeem in het operatiegebied zijn mogelijke oorzaken van postoperatieve hypocalciëmie. Een evidence based richtlijn voor de behandeling van dit veelvoorkomende probleem bestaat helaas niet. De behandeling wordt doorgaans gebaseerd op het serum calcium en soms ook het parathormoon (PTH). Recent onderzoek suggereert echter dat dit in veel gevallen resulteert in overbehandeling en dat behandeling van alleen symptomatische patiënten efficiënt en veilig is. Naar aanleiding van deze observatie is voor de Nederlandse praktijk een behandelalgoritme ontwikkeld voornamelijk gebaseerd op symptomen. De verwachting is dat dit algoritme zal leiden tot optimalisatie van diagnostiek en onnodige behandeling kan voorkomen. Het aantal bloedafnames en polikliniekbezoeken en daarmee de belasting voor de patiënt zullen hierdoor afnemen.

Doel:
Het doel van deze studie is het onderzoeken van de effectiviteit en veiligheid van een nieuw behandelalgoritme voor de behandeling van hypocalciëmie na totale thyreoïdectomie. Dit zal worden onderzocht in een prospectieve multicenter trial in tien ziekenhuizen in de regio Rotterdam.

Inclusiecriteria:
1. Geplande totale of totaliserende thyreoïdectomie
2. Leeftijd ≥ 18 jaar

Exclusiecriteria:
1. Preoperatief afwijkend gecorrigeerd serum calcium
(referentiewaarden 2.20 -2.65 mmol/L)
2. Hyperparathyreoïdie
3. Epilepsie in de voorgeschiedenis
4. Zwangerschap
5. Onvoldoende beheersing van de Nederlandse taal
6. Wilsonbekwaam


Behandelalgoritme
http://www.schildkliernetwerk.nl/docume ... oritme.pdf

Dagboek
http://www.schildkliernetwerk.nl/documenten/Dagboek.pdf

Tijdschema IMPACT-trial
http://www.schildkliernetwerk.nl/docume ... nisch).pdf

Zakkaartje > Implementation of a symptom based algorithm for calcium management after total thyroidectomy (IMPACT-trial)
http://www.schildkliernetwerk.nl/docume ... aartje.pdf


Website:
http://www.schildkliernetwerk.nl/in-beeld/


.

ineke
Berichten: 322
Lid geworden op: 08 nov 2014, 17:53

Re: Informatie over bijschildklieren / hypo- en hyperparathyreoïdie

Bericht door ineke » 16 apr 2017, 12:23

Volledig artikel in Journaal van de European Society of Endocrinology


Published online before print March 3, 2017, doi: 10.1530/EJE-16-1065
Eur J Endocrinol June 1, 2017 176 R269-R282

Review
DIAGNOSIS OF ENDOCRINE DISEASE: Expanding the cause of hypopituitarism

Abstract
Hypopituitarism is defined as one or more pituitary hormone deficits due to a lesion in the hypothalamic–pituitary region. By far, the most common cause of hypopituitarism associated with a sellar mass is a pituitary adenoma.
A high index of suspicion is required for diagnosing hypopituitarism in several other conditions such as other massess in the sellar and parasellar region, brain damage caused by radiation and by traumatic brain injury, vascular lesions, infiltrative/immunological/inflammatory diseases (lymphocytic hypophysitis, sarcoidosis and hemochromatosis), infectious diseases and genetic disorders.

Hypopituitarism may be permanent and progressive with sequential pattern of hormone deficiencies (radiation-induced hypopituitarism) or transient after traumatic brain injury with possible recovery occurring years from the initial event. In recent years, there is increased reporting of less common and less reported causes of hypopituitarism with its delayed diagnosis.
The aim of this review is to summarize the published data and to allow earlier identification of populations at risk of hypopituitarism as optimal hormonal replacement may significantly improve their quality of life and life expectancy.

Figure 1
(A and B) A 57-year-old woman presenting with headache, dyplopia and ptosis. Sellar MRI ((A) sagittal and (B) coronal views) shows an invasive sellar mass with propagation to the sphenoid sinus and clivus. Pathology report: Pituitary plasmacytoma IgA kappa+.

Figure 2
A 62-year-old woman with euthyroid multinodular goiter presenting with bitemporal hemianopsia and moderate hypeprolactinemia. (B) Sellar MRI shows a large suprasellar mass. (C) Pathology report: Metastasis from papillary carcinoma of thyroid not previously diagnosed. From: Stojanovic M et al. European Thyroid Journal 2013 1 277–284. (reproduced with permission).

Figure 3
(A and B) A 10-year-old boy developed a sudden onset of diabetes insipidus, somnolence and visual field impairment. Sellar MRI (A sagittal and B coronal views) shows a large suprasellar mass. Pathology report: non-Langerhans cell histiocytosis WHO grade III.

en meer figuren zie:
http://www.eje-online.org/content/176/6 ... gures-only


Conclusion
The less common and unusual causes of hypopituitarism are always challenging, and there is a long delay in arriving at the diagnosis.
However, a high index of suspicion is needed when patients present with a history of cranial irradiation, head trauma, vascular injury, cancer treated with specific immune therapy causing hypophysitis, history of systemic diseases and bacterial, tuberculosis, viral, fungal and parasitic infections.
Once suspected, the diagnosis can be confirmed with pituitary function tests and imaging.

The pattern of pituitary hormone deficiencies depends on the nature of the underlying pathological process. Hypopituitarism may be permanent in some instances or transitory in other necessitating repeated assessment. It is unclear who and how often to screen, but certainly, a lengthy follow-up is needed. Some of the so-called uncommon causes of hypopituitarism, such as traumatic brain injury, may in the near future be a common cause, as the number of people sustaining head trauma is increasing.


Volledig artikel:
http://www.eje-online.org/content/176/6/R269.full

NB
Je kan het artikel lezen in het Nederlands - zie knop vertalen bovenin de balk > Google.



Als pdf:
http://www.eje-online.org/content/176/6 ... l.pdf+html


.

ineke
Berichten: 322
Lid geworden op: 08 nov 2014, 17:53

Richtlijn behandeling chronische hypoparathyroidie

Bericht door ineke » 16 apr 2017, 17:35

European Society of Endocrinology Clinical Guideline


NB - betreft richtlijn 2015


doi: 10.1530/EJE-15-0628
Eur J Endocrinol August 1, 2015 173 G1-G20
Treatment of chronic hypoparathyroidism in adults

1 Section of Specialized Endocrinology, Clinic of Medicine, Oslo University Hospital, Oslo, Norway
2 Faculty of Medicine,University of Oslo, Oslo, Norway
3 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
4 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
5 Endocrine Research Unit, Department of Veterans Affairs, San Francisco VA Medical Center, University of California, San Francisco, California, USA
6 Endocrine Surgery Unit, Hospital Universitari del Mar, Barcelona, Spain
7 Renal Division, Ghent University Hospital, Ghent, Belgium
8 Division of Endocrinology, Department of Medicine
9 Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
10 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark


Abstract
Hypoparathyroidism (HypoPT) is a rare (orphan) endocrine disease with low calcium and inappropriately low (insufficient) circulating parathyroid hormone levels, most often in adults secondary to thyroid surgery.
Standard treatment is activated vitamin D analogues and calcium supplementation and not replacement of the lacking hormone, as in other hormonal deficiency states.
The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of chronic HypoPT in adults who do not have end-stage renal disease.
We intend to draft a practical guideline, focusing on operationalized recommendations deemed to be useful in the daily management of patients.

This guideline was developed and solely sponsored by The European Society of Endocrinology, supported by CBO (Dutch Institute for Health Care Improvement) and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles as a methodological base.

The clinical question on which the systematic literature search was based and for which available evidence was synthesized was: what is the best treatment for adult patients with chronic HypoPT? This systematic search found 1100 articles, which was reduced to 312 based on title and abstract. The working group assessed these for eligibility in more detail, and 32 full-text articles were assessed. For the final recommendations, other literature was also taken into account. Little evidence is available on how best to treat HypoPT. Data on quality of life and the risk of complications have just started to emerge, and clinical trials on how to optimize therapy are essentially non-existent. Most studies are of limited sample size, hampering firm conclusions. No studies are available relating target calcium levels with clinically relevant endpoints. Hence it is not possible to formulate recommendations based on strict evidence.
This guideline is therefore mainly based on how patients are managed in clinical practice, as reported in small case series and based on the experiences of the authors.

Een van de figuren:
Monitoring and treatment of chronic hypoparathyroidism. *If dose of calcium or activated vitamin D is changed, re-evaluation of serum calcium levels is recommended after 1–2 weeks.
http://www.eje-online.org/content/173/2/G1/F1.large.jpg


© 2015 European Society of Endocrinology
Volledig richtlijn met alle tabellen/figuren:
http://www.eje-online.org/content/173/2 ... l.pdf+html


.

Plaats reactie

Wie is er online

Gebruikers op dit forum: Geen geregistreerde gebruikers en 1 gast