Severe tertiary hyperparathyroidism with severe mandibular injury
case report
DOI:
https://doi.org/10.5935/2525-5711.20200024Keywords:
Hyperparathyroidism, Chronic Renal Insufficiency, Osteitis Fibrosa Cystica, Giant cellsAbstract
Objective: The Hyperparathyroidism is a disease characterized by the increased secretion of a Parathyroid hormone (PTH) in the organism, such as generalized osteoporotic pro- cesses and systemic calcifications. In addition to the skeleton in general, the jaws are also affected by the effects of Hyperparathyroidism. The aim of this study is to present a case of a patient with hyperparathyroidism and mandible lesion. Summary Report: Patient L. F, female gender, 32 years old, asymptomatic, chronic renal disease. Suffering from chronic glomerulonephritis for 4 years, she was referred to a university stomatology ambulatory by her nephrologist, due swelling evaluation on the left side of the face. High level of Parathyroid hormone (PTH) associated to mandibular injury incisional biopsy points at hyperparathyroidism diagnosis. If even after the parathyroidectomy been conducted High level of PTH were still present, it is the case tertiary hyperparathyroidism. Conclusion: It is crucial that dental surgeon examine for hyperparathyroidism whenever there are chronic renal patients affected by osteoporotic mandibular changes
References
Haussler M, Whitfield GK, Haussler CA, Hsieh JC, Thompson PD, Selznick SH, et al. The nuclear vitamin D receptor: biological and molecular regulatory properties revealed. J Bone Miner Res. 1998 Apr;13(3):325-49.
Grozavu C, Pantile D. Primary hyperparathyroidism through an ectopic parathyroid adenoma. Chirurgia (Bucur). 2016 Mar/Apr;111(2):156-60.
Kim CS, Kim SW. Vitamin D and chronic kidney disease. Korean J Intern Med. 2014 Jul;29(4):416-27.
Lacativa PGS, Patricio Filho PJM, Gonçalves MDC, Farias, MLF. Indications for parathyroidectomy in hyperparathyroidism secondary to chronic renal failure. Arq Bras Endocrinol Metabol. 2003 Dec;47(6):644-53.
Santos B, Koth VS, Figueiredo MA, Salum FG, Cherubini K. Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: a literature review and case report. Spec Care Dentist. 2018 May;38(3):163-71.
Parikh C, Gutgarts V, Eisenberg E, Melamed ML. Vitamin D and clinical outcomes in dialysis. Semin Dial. 2015 Nov/ Dec;28(6):604-9.
Quioga B, Rodrígue-Palomares JR, Arriba G. Insuficiência renal crônica. Med Sci Direct. 2015 Jun;11(81):4860-4867.
Dagistan S, Miloglu O, Caglayan F. Changes in jawbones of male patients with chronic renal failure on digital panoramic radiographs. Eur J Dent. 2016 Jan/Mar;10(1):64-8.
Meema HE, Meema S. Microscopic quantitation of periosteal resorption in secondary hyperparathyroidism of renal failure. Clin Orthop. 1978 Jan/Feb;(130):297-302.
Mellouli N, Chebil RB, Darej M, Hasni Y, Oualha L, Douki N. Mandibular osteitis fibrosa cystica as first sign of vitamin D deficiency. Case Rep Dentist. 2018 Apr;2018:6814803.
Henriques JCG, Castilho JCM, Jacobs R, Amorim JBO, Rosa RR, Matai CBV. Severe secondary hyperparathyroidism and panoramic radiography parameters. Clin Oral Investig. 2014;18:941.
Guéroult AM, Cameron M. Rare brown tumour of the mandible secondary to tertiary hyperparathyroidism in a renal transplant recipient. BMJ Case Rep. 2019;12(9):e231231.
Saliba W, El-Haddad B. Secondary hyperparathyroidism: pathophysiologyandtreatment.JAmBoardFam Med.2009Sep/Oct;22(5):574-81.
Ibrahem HM. Gnathic bones and hyperparathyroidism: a review on the metabolic bony changes affecting the mandible and maxilla in case of hyperparathyroidism. Adv Med. 2020 Jul;2020:6836123.
Marx RE, Stern D. Fibro-osseous diseases and systemic diseases affecting bone. In: Marx RE, Stern D, eds. Oral and maxillofacial pathology. A rationale for diagnosis and treatment. Batavia, IL: Quintessence Publishing USA; 2006. p. 281-6.
Guney E, Yigitbasi OG, Bayram F, Ozer V, Canoz O. Brown tumor of the maxila associated with primary hyperparathyroidism. Auris Nasus Larynx. 2001 Nov;28(4):369-72.
Henriques JCG, Castilho JCM, Jacobs R, Amorim JBO, Rosa RR, Matai CVB. Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism. Clin Oral Investig. 2013 Jul;17(6):1611-7.
Pitt SC, Sippel RS, Chen H. Secondary and tertiary hyperparathyroidism, state of the art surgical management. Surg Clin North Am. 2009 Oct;86(5):1227-39.
Ohtsuka M, Michaeli D, Wasnich RD. Relationship between phalangeal bone density and risk of vertebral fracture. J Clin Densitom. 2002 Feb;5(1):11-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 1969 Eurisane Mendes Afonso, João César Guimarães Henriques, Lair Mambrini Furtado, Marcus Alves Rocha, Fabio Franceschini Mitri, Cizelene do Carmo Faleiros Veloso Guedes
This work is licensed under a Creative Commons Attribution 4.0 International License.
