- Development of Tertiary Hyperparathyroidism during the Treatment of Hypophosphatemic Osteomalacia.
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W S Shinn, S Lim, Y M Cho, T Y Kim, M K Moon, D J Park, K S Park, S Y Kim, B Y Cho, H K Lee, Y K Youn, S K Oh
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J Korean Endocr Soc. 2001;16(4-5):520-527. Published online October 1, 2001
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 Abstract
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- Osteomalacia is characterized by the accumulation of an increased amount of unmineralized bone matrix. Of the several possible causes, hypophosphatemia is one of the major and mainly results from intestinal malabsorption of phosphate or from renal tubular phosphate loss. Oral phosphate supplementation is the mainstay of therapy for hypophosphatemic osteomalacia of diverse causes, but secondary hyperparathyroidism may be induced by such treatment. Although concomitant therapy with vitamin D is recommended for the prevention of this complication, it can nevertheless occur and sometimes results in tertiary hyperparathyroidism. We report the development of tertiary hyperparathyroidism in a patient with sporadic non-familial hypophosphatemic osteomalacia who had been treated with long-term phosphate therapy despite undergoing concomitant vitamin D therapy.
- Changes of Thyroid Function According to the Stages of Normal Pregnancy.
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W B Kim, B H Yoon, J H Chung, S I Lee, M S Kim, T G Oh, B Y Cho, H K Lee, C S Koh
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J Korean Endocr Soc. 1994;9(3):183-189. Published online November 6, 2019
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Abstract
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- It is well known that normal pregnancy is accompanied by a rise in serum concentrations of thyroxine-binding globulin(TBG) and human chorionic gonadotropin (hCG). Alterations of biochemical parameters of thyroid function are recognized during gestation and sensitive tests to evaluate the alterations easily are required. Therefore, a cross-sectional study was undertaken in 140 healthy pregnant women to evaluate the efficacy of free T_4 measured by 2-step RIA compared to other thyroid function tests and to confirm the changes of thyroid function according to the stages of normal pregnancy.The sensitivities of free T_4 index, free T_4(by 2-step RIA), T_3 and TSH were realtively high(99.3%, 93.6%, 92.9%, 83.6%, respectively) compared to those of T_4 and T_3 bead upgake(49.3%, 21.4%) during all stages of pregnancy. There were positive correlations between free T_4 index and free T_4 or total T_4(r=0.68, r=0.72; p<0.001). The values of free T_4 index sharply decreased from 3.22+-0.10(meam +-SEM) during 6th-12th week to an plateau after 16th-20th week of gestation(p<0.01). The serum concentrations free T_4 and T_3 bead uptake also significantly decreased from 1.65+-0.05 ng/dl, 24.7+- 0.7% during 6th-12th week to an plateau after 16th-20th week of gestation, respectively(p<0.001), No differences were found in the changes of serum concentrations of T_3, T_4 and TSH according to the stages of pregnancy.In conclusion, it is adequate to measure some tests including free T_4 index and free T_4 to evaluate thyroid function during pregnancy. The thyroid physiology and changes of thyroid function according to the stages of pregnancy should be considered in the interpretation of thyroid function status during pregnancy.
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