원발성 부갑상선 기능 항진증
Primary Hyperparathyroidism
이기문, 오승근, 최국진, 윤여규, 노동영,
소속 상세정보
이기문 ( Lee Gee-Mun )
서울대학교 의과대학 외과학교실
오승근 ( Oh Seung-Keun )
서울대학교 의과대학 외과학교실
최국진 ( Choi Kook-Jin )
서울대학교 의과대학 외과학교실
윤여규 ( Youn Yeo-Kyu )
서울대학교 의과대학 외과학교실
노동영 ( Roh Dong-Young )
서울대학교 의과대학 외과학교실
KMID : 0371320010600030273
Abstract
Purpose: Primary hyperparathyroidism is the most frequent cause of hypercalcemia and due to the routine examination of serum calcium levels, the number of patients with primary hyperparathyrodism has increased.
Methods: We reviewed sixty patients treated by surgery over the 20-year period at the Department of Surgery, Seoul National University Hospital and retrospectively analyzed both the clinicopathologic and bio-chemcal features of the presented cases and the effective methods of treatment and diagnosis retrospectively.
Results: The study group consists of 60 patients with primary hyperparathyroidism comprised of 18 males and 42 females. The most common presenting clinical manifestations were associated with bone pain in 38 (63%), and recurrent urinary stone in 27 (45%) patients; And 11 patients were asymptomatic. All patients showed hypercalcemia and the serum parathyroid hormone (PTH) level was elevated in all 49 patients after 1992. A preopeative localization study was performed with ultrasonography (USG), computed tomography (CT), Thallium-Technecium (Tl-Tc) substraction scan and Methoxylisobutyl isonitrile (MIBI) scan. Positive localization was made in 71%, 71%, 77% and 71% respectively. Histopathologic findings revealed solitary adenoma in 56 patients and carcinoma in 4 patients. Transient hypocalcemia following surgery occurred in 50 patients and they were treated with calcium. There were no recurrent cases with the exception of one who displayed carcinoma.
Conclusion: In this study, most of the patients were discovered with an advanced clinical and biochemical status but the number of the asymptomatic patients is increasing. Through an accurate preoperative localization, they were successfully treated with parathyroidectomy without major complications.
키워드
원발성 부갑상선 기능 항진증;부갑상선 절제술;부갑상선 호르몬
Primary hyperparathyroidism;Parathyroidectomy;Parathyroid hormone
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