Hiperparatiroidismo primário com gamapatia monodonal: uma mera associacão?

Autores

  • José Pereira de Sousa Interno do Internato Complementar de Medici­na Interna, Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra
  • João Gabriel Interno do Internato Complementar de Medici­na Interna, Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra
  • Helena Figueiredo Interno do Internato Complementar de Medici­na Interna, Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra
  • Ávila Costa Assistente Hospitalar de Medicina Interna, Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra
  • Borges Alexandrino Assistente Hospitalar Graduado de Medicina Interna, Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra
  • Políbio Serra e Silva Professor da Universidade de Coimbra e Direc­tor do Serviço de Med. II dos Hospitais da Uni­versidade de Coimbra

Palavras-chave:

.

Resumo

Descreve-se o caso clínico de um doente de 66 anos, de sexo masculino e raça branca, interna­do no Serviço de Med II dos H.U.C por hipercal­cemia, em 26 de Julho de 1991 .

Teve alta com o diagnóstico definitivo de hiper­paratiroidismo primário e gamapatia monoclo­naL

A referência à associação de gamapatia mo­ nocional ( de significado indeterminado, ou mie­loma múltiplo), com hiperparatiroidismo primá­rio, já não é recente.

Apesar disso não abundam os artigos que re­latam tal associação. Actualmente a maioria dos autores pensa que se trata de mera coincidên­cia de duas situações frequentes.

O referido quadro levanta-nos importantes pro­blemas de diagnóstico, com implicações terapêu­ticas subsequentes.

O doente cujo caso clínico se descreve apresen­ tava também um carcinoma papilar da tiróide, associação a ser abordada em comunicação posterior e a propósito de um caso clínico.

Downloads

Não há dados estatísticos.

Referências

- Abugassa S; MD; Nordenstromn J; MD, PhD; Eriksson S; MD; Mollerstrom G; MD; and Alveryd A; MD, PhD. Skeletal remi­neralization after surgery for Primary and Secundary Hyper parathyroidism. Surgery 1990; 107: 128-133

- Arnaud CD; MD; and Kolb F O. The calciotropic hormones and metabolic bone disease. ln: Basic and Clinical Endocrinolo­gy, Edited by Francis S. Greenspan, MD, Third Edition,1991

- Avio! L V. Hyperparathyroidism, Estrogens and Osteoporose. Hospital Practice 1991: 115-134

- Bajorunas DR. Clinical manifestations of Cancer-related Hyper­ calcemia. Seminars in Oncology 1990; 17, 2, 16-25

- Budayr A A et al. Increased serum levels of a parathyroid hormo­ ne-like protein in malignancy-associated hypercalcemia. Ann lntern Med 1989; 111: 807

- Burtis J W; MD; Brady T G; BS; Orloff J J; MD; Ersback J B, Baand col. Immunochemical characterization of circulating para­ thyroid hormone-related protein in patients with humoral hypercalcemia of cancer. N Engl J Med 322: 1106- 1112

- Dexter R N; MD;FACP; Mllinax F; MD; Estep H; MD; and Wil­liams R C; MD; FACP. Monoclonal IgG Gammopathy and Hyperparathyroidism. Annals of Internal Medicine 1972; 77: 759-764

- Gandara D R; MD; and Mackenzie M R; MD; Differential Diagno­sis of Monoclonal Gammopathy. The Medical Clinics of North America 1988; 72, 5: 1155-1167

- Heath H; MD; Hodgson S F; MD; and Kennedy MA; BS. Primary Hyperparathyroidism. Incidence, Morbility, and Potencial Eco­ nomic Impact in a Community. N Engl J Med 1980; 302: 189- 193

- Jackson R M; MD; and Orland M J. Parathyroid Adenoma in a patient with Multiple Myeloma. Southern Medical Journal 1979; 72: 1336-1337

- Karstrup S, Holm H H, Glenthoj A, Hegedus L. Nonsurgical tre­atment of Primary Hyperparathyroidism with sonographicaly guided percutaneous injection of ethanol: Results in a Selec­ted Series of Patients. American Roentgen Ray Society 1990; 154: 1087-1990

- Kristiansen J H, Mortensen J B, Pederson K O, Jensen S and Glud T. Renal tubular reabsorption of calcium and sodium in Primary Hyperparathyroidism. Acta Endoc. 1990; 123: 194-202

- Lloyd M N H, Lees W R and Milroy EJ G. Pre-operative localiza­ tion in Primary Hyperparathyroidism. Clinical Radiology 1990; 41: 2239-243

- Logue FC, Fraser W D, Gallacher SJ, Cameron D A, O'Reilly J and col. The loss of circadian rhithm for intact Parathyroid Hormone and Nephrogenous Cyclic AMP in patients with Pri­ mary Hyperparathyroidism. Clinical Endocrinology 1990; 32: 475-483

- McElduff A, Lissner D, Wilkinson M and Posen S. Parathyroid hormone sensitivity in Primary Hyperparathyroidism and Idi­opathic Hypercalciuria: Effects on Postadenylate Cyclase pra­meters. JCE & M 1990; 70: 1457-1461

- Muggia F M. Overview of Cancer-related Hypercalcemia: Epi­demiology and Etiology. Seminars in Oncology 1990; 17-2, 3-9

- Mundy G, Cove D H, Fisken R. Primary Hyperparathyroidism: changes in the pattern of clinical presentation. The Lancet 1980; 1317-1320

- New Conference. Diagnosis and Management of Asymptomatic Primary Hyperparathyroidism: Consensus Development Con­ference Statement. Annals of lnternal Medicine 1991; 114: 593-597

- Paillard M, Lacave R, Gardin J P, Prigent A, Patron P. Actualité de l'hyperparathyroidie primaire. La Presse Médicale 1984: 29: 1779-1785

- Parisien M; MD; Silverberg, SJ; MD; Shane E; MD; Dempster, D W; PhD. Bone disease in Primary Hyperparathyroidism. En­docrinology and Metabolism Clinics of North America. 1990; 19: 19-34

- Parisien M; MD; Silverberg, S J; MD; Shane E; MD; La Cruz D, Lindsay R, Bilezikian J P and Dempster D W. The Histomor­phometry of bone in Primary Hyperparathyroidism: Preser­vation of cancellous bone structure. J.C.E.& M.1990; 70: 930-938

- Potts J T; JR. Management of asymptomatic Hyperparathyroi­dism. J.C.E. & M 1990; 70: 1489-1493

- Pulitzer D R; MD; Martin P C; MD; Collins P C; MD; Reitmeyer ; MD. Cutaneous vascular calcification with ulceration in Hyper­ parathyroidism. Arch Pathol Jab Med 1990; 114: 482-484

- Rao D S; MBBS. Primary Hyperparathyroidism: Changing pat­ terns in presentation and treatment decisions in the Eighties. Henry Ford Hosp Med J 1985; 33: 194-197

- Rao D S; MD; Antonelli R; MD; Kane K R; MD; KuhnJ E; MD and Hetnal C; MD. Primary Hyperparathyroidism and Monoclo­nal Gammopathy. Henry Ford Hosp Med J 1991; 39: 41- -44

- Schnur M; MD; Appel G B; MD; Bilezikian J P; MD. Primary Hyperparathyroidism and Benign Monoclonal Gammopathy. Arch Intern Med 1977; 137: 1201-1203

- Tohme J F, Bilezikian J P, Clemens T L, Silverberg S J, Shane E and Lindsay R. Suppression of parathyroid hormone secreti­on with oral calcium in normal subjects and patients with Pri­mary Hyperparathyroidism .JCE & M 1990; 70: 951-956

- Wallfelt C; MD; Ljunghall S; MD; Bergstrom R; PhD; Rastad J; MD; and Akerstrom G; MD. Clinical characteristics and surgi­cal treatment of sporadic primary hyperparathyroidism with emphasis on chief cell hyperplasia. Surgery 1990; 107: 13-19

- WoodheadJ S. The measurement of circulating Parathyroid Hor­mone. Clin. Biochem. 1990; 23: 17-21

Ficheiros Adicionais

Publicado

31-03-1994

Como Citar

1.
Pereira de Sousa J, Gabriel J, Figueiredo H, Costa Ávila, Alexandrino B, Serra e Silva P. Hiperparatiroidismo primário com gamapatia monodonal: uma mera associacão?. RPMI [Internet]. 31 de Março de 1994 [citado 25 de Junho de 2024];1(1):29-36. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/2432

Edição

Secção

Casos Clínicos

Artigos Similares

Também poderá iniciar uma pesquisa avançada de similaridade para este artigo.

Artigos mais lidos do(s) mesmo(s) autor(es)

1 2 3 > >>