Hiperparatiroidismo primário com gamapatia monodonal: uma mera associacão?
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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.
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- 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
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Direitos de Autor (c) 1994 Medicina Interna
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
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