RESUMO
Primary hyperparathyroidism associated with multiple endocrine neoplasia type I (hyperparathyroidism/multiple endocrine neoplasia type 1) differs in many aspects from sporadic hyperparathyroidism, which is the most frequently occurring form of hyperparathyroidism. Bone mineral density has frequently been studied in sporadic hyperparathyroidism but it has very rarely been examined in cases of hyperparathyroidism/multiple endocrine neoplasia type 1. Cortical bone mineral density in hyperparathyroidism/multiple endocrine neoplasia type 1 cases has only recently been examined, and early, severe and frequent bone mineral losses have been documented at this site. Early bone mineral losses are highly prevalent in the trabecular bone of patients with hyperparathyroidism/multiple endocrine neoplasia type 1. In summary, bone mineral disease in multiple endocrine neoplasia type 1 related hyperparathyroidism is an early, frequent and severe disturbance, occurring in both the cortical and trabecular bones. In addition, renal complications secondary to sporadic hyperparathyroidism are often studied, but very little work has been done on this issue in hyperparathyroidism/multiple endocrine neoplasia type 1. It has been recently verified that early, frequent, and severe renal lesions occur in patients with hyperparathyroidism/multiple endocrine neoplasia type 1, which may lead to increased morbidity and mortality. In this article we review the few available studies on bone mineral and renal disturbances in the setting of hyperparathyroidism/multiple endocrine neoplasia type 1. We performed a meta-analysis of the available data on bone mineral and renal disease in cases of multiple endocrine neoplasia type 1-related hyperparathyroidism.
Assuntos
Densidade Óssea , Hiperparatireoidismo Primário/fisiopatologia , Nefropatias/etiologia , Neoplasia Endócrina Múltipla Tipo 1/complicações , Desmineralização Patológica Óssea , Osso e Ossos/metabolismo , Seguimentos , Humanos , Hiperparatireoidismo Primário/etiologia , Hiperparatireoidismo Primário/cirurgia , Neoplasia Endócrina Múltipla Tipo 1/genética , Neoplasia Endócrina Múltipla Tipo 1/cirurgia , Hormônio Paratireóideo/sangue , Resultado do TratamentoRESUMO
Primary hyperparathyroidism associated with multiple endocrine neoplasia type I (hyperparathyroidism/multiple endocrine neoplasia type 1) differs in many aspects from sporadic hyperparathyroidism, which is the most frequently occurring form of hyperparathyroidism. Bone mineral density has frequently been studied in sporadic hyperparathyroidism but it has very rarely been examined in cases of hyperparathyroidism/multiple endocrine neoplasia type 1. Cortical bone mineral density in hyperparathyroidism/multiple endocrine neoplasia type 1 cases has only recently been examined, and early, severe and frequent bone mineral losses have been documented at this site. Early bone mineral losses are highly prevalent in the trabecular bone of patients with hyperparathyroidism/multiple endocrine neoplasia type 1. In summary, bone mineral disease in multiple endocrine neoplasia type 1related hyperparathyroidism is an early, frequent and severe disturbance, occurring in both the cortical and trabecular bones. In addition, renal complications secondary to sporadic hyperparathyroidism are often studied, but very little work has been done on this issue in hyperparathyroidism/multiple endocrine neoplasia type 1. It has been recently verified that early, frequent, and severe renal lesions occur in patients with hyperparathyroidism/multiple endocrine neoplasia type 1, which may lead to increased morbidity and mortality. In this article we review the few available studies on bone mineral and renal disturbances in the setting of hyperparathyroidism/multiple endocrine neoplasia type 1. We performed a meta-analysis of the available data on bone mineral and renal disease in cases of multiple endocrine neoplasia type 1-related hyperparathyroidism.
Assuntos
Humanos , Densidade Óssea , Hiperparatireoidismo Primário/fisiopatologia , Nefropatias/etiologia , Neoplasia Endócrina Múltipla Tipo 1/complicações , Desmineralização Patológica Óssea , Osso e Ossos/metabolismo , Seguimentos , Hiperparatireoidismo Primário/etiologia , Hiperparatireoidismo Primário/cirurgia , Neoplasia Endócrina Múltipla Tipo 1/genética , Neoplasia Endócrina Múltipla Tipo 1/cirurgia , Hormônio Paratireóideo/sangue , Resultado do TratamentoRESUMO
A artrite reumatóide possui diferentes espectros de apresentação, não somente pela diversidade de achados clínicos, mas também no aparecimento de marcadores sorológicos. Dentre estes está o fator antinuclear, que pode ser encontrado em 10 a 65% dos pacientes. Alguns autores acreditam que a presença do fator antinuclear esteja associada a pior prognóstico, mas esta afirmação não é de consenso na literatura. Objetivos: verificar a prevalência de fator antinuclear positivo em portadores de artrite reumatóide e estudar a sua correlação com elementos clínicos. Material e Métodos: foram estudados 113 pacientes portadores de artrite reumatóide quanto à idade do diagnóstico, sexo, presença de nódulos reumatóides, presença de alterações radiológicas (osteoporose justa articular e erosões) em raios X de mãos e presença de fator reumatóide. Esses dados foram correlacionados com a presença do fator antinuclear. Resultados: a prevalência de fator antinuclear positivo foi de 21,24%, sem diferença estatisticamente significativa entre os sexos (p=0,553). Os títulos variaram entre 1:40 e 1:320, sendo a maioria (83,3%) padrão pontilhado. Não houve significância estatística entre o fator antinuclear positivo e idade de início da doença (p=0,4611) ou presença de alterações radiológicas (p=0,4397). Houve correlação significante entre fator antinuclear positivo e presença de nódulos reumatóides, onde 50% dos pacientes com nódulos tinham este anticorpo (p=0,0197). Conclusão: o presente estudo concluiu que os pacientes com artrite reumatóide nodular possuíam mais fator antinuclear positivo, o que pode ser indicativo de associação deste anticorpo com doença mais acentuada...