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Díez JJ, Anda E, Pérez-Corral B, Paja M, Alcázar V, Sánchez-Ragnarsson C, Orois A, Romero-Lluch AR, Sambo M, Oleaga A, Caballero Á, Alhambra MR, Urquijo V, Delgado-Lucio AM, Fernández-García JC, Kishore-Doulatram V, Dueñas-Disotuar S, Martín T, Peinado M, Sastre J. Incident comorbidities in patients with chronic hypoparathyroidism after thyroidectomy: a multicenter nationwide study. Front Endocrinol (Lausanne) 2024; 15:1348971. [PMID: 38481445 PMCID: PMC10936239 DOI: 10.3389/fendo.2024.1348971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/15/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Population-based and registry studies have shown that chronic hypoparathyroidism is accompanied by long-term complications. We aimed to evaluate the risk of incident comorbidity among patients with chronic postsurgical hypoparathyroidism in real-life clinical practice in Spain. Methods We performed a multicenter, retrospective cohort study including patients with chronic postsurgical hypoparathyroidism lasting ≥3 years with at least a follow-up visit between January 1, 2022 and September 15, 2023 (group H). The prevalence and incidence of chronic complications including chronic kidney disease, nephrolithiasis/nephrocalcinosis, hypertension, dyslipidemia, diabetes, cardiovascular disease, central nervous system disease, mental health disorders, eye disorders, bone mineral density alterations, fracture and cancer were evaluated. Patient data were compared with a group of patients who did not develop hypoparathyroidism, matched by gender, age, and follow-up time after thyroidectomy (group NH). Results We included 337 patients in group H (median [IQR] age, 45 [36-56] years; median time of follow-up, 8.9 [6.0-13.0] years; women, 84.3%) and 669 in group NH (median age, 47 [37-55] years; median time of follow-up, 8.0 [5.3-12.0] years; women, 84.9%). No significant differences were found in the prevalence of comorbidities at the time of thyroidectomy between both groups. In multivariable adjusted analysis, patients with chronic hypoparathyroidism had significantly higher risk of incident chronic kidney disease (OR, 3.45; 95% CI, 1.72-6.91; P<0.001), nephrolithiasis (OR, 3.34; 95% CI, 1.55-7.22; P=0.002), and cardiovascular disease (OR, 2.03; 95% CI, 1.14-3.60; P=0.016), compared with patients without hypoparathyroidism. On the contrary, the risk of fracture was decreased in patients with hypoparathyroidism (OR, 0.09; 95% CI, 0.01-0.70; P=0.021). Conclusion This study demonstrates that, in the clinical practice of Spanish endocrinologists, a significant increase in the risk of chronic kidney disease, nephrolithiasis and cardiovascular disease, as well as a reduction in the risk of fractures is detected. These results are of interest for the development of new clinical guidelines and monitoring protocols for patients with hypoparathyroidism.
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Affiliation(s)
- Juan J. Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Majadahonda, Spain
| | - Emma Anda
- Department of Endocrinology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Begoña Pérez-Corral
- Department of Endocrinology, Complejo Asistencial Universitario de León, León, Spain
| | - Miguel Paja
- Department of Endocrinology, Hospital Universitario de Basurto, Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - Victoria Alcázar
- Department of Endocrinology, Hospital Severo Ochoa, Leganés, Spain
| | - Cecilia Sánchez-Ragnarsson
- Department of Endocrinology, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Aida Orois
- Department of Endocrinology and Nutrition, Hospital Clínic, Barcelona, Spain
| | - Ana R. Romero-Lluch
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Marcel Sambo
- Department of Endocrinology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Amelia Oleaga
- Department of Endocrinology, Hospital Universitario de Basurto, Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - Águeda Caballero
- Department of Endocrinology, Hospital Universitario de Canarias, Tenerife, Spain
| | - María R. Alhambra
- Department of Endocrinology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Virginia Urquijo
- Department of Endocrinology, Hospital Universitario de Cruces, Bilbao, Spain
| | | | - José C. Fernández-García
- Department of Endocrinology, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain
| | - Viyey Kishore-Doulatram
- Department of Endocrinology, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain
| | - Suset Dueñas-Disotuar
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Tomás Martín
- Department of Endocrinology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Mercedes Peinado
- Department of Endocrinology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Julia Sastre
- Department of Endocrinology, Hospital Universitario de Toledo, Toledo, Spain
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Peinado M, Fernandezrenart M, Capella G, Wilson L, Perucho M. Mutations in the p53 suppressor gene do not correlate with C-k-ras oncogene mutations in colorectal-cancer. Int J Oncol 1993; 2:123-134. [PMID: 21573526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Mutations in the p53 tumor suppressor gene have been analyzed in 196 colorectal tumors previously analyzed for mutations at codons 12 and 13 of the c-K-ras and N-ras oncogenes by a combination of Single Strand Conformation Polymorphism (SSCP) and Cycle Sequencing (CS) using total cellular RNA. Mutations were detected in 3 of 21 adenomas, 84 of 149 primary carcinomas, and 11 of 18 hepatic metastases. Over half of the tumors were homozygous for the mutant p53 allele at the mRNA level. Although deletions were detected in 5 tumors, missense mutations were the most frequent. The spectrum of 63 point mutations was heterogeneous, with all possible nucleotide substitutions ocurring at least once. No correlation was found between the spectrum of p53 gene mutations and the age, sex, race of the cancer patients or the anatomical localization of the tumors, although mutations were significantly more frequent in tumors of the distal colon. Mutations in the p53 gene did not correlate with mutations in the c-K-ras gene, indicating that colorectal cancer can develop through pathways independent not only of the presence of mutations in any of these genes but also of their cooperation.
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Affiliation(s)
- M Peinado
- CALIF INST BIOL RES,11099 N TORREY PINES RD,LA JOLLA,CA 92037
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Abstract
A case of fulminant disseminated pulmonary adiaspiromycosis is reported. The patient, a 35-year-old black male farm worker, presented with a four-week history of generalized weakness, unproductive cough, evening fever, and a weight loss of 8 kg. He died 12 days after hospitalization of respiratory failure due to granulomatous lung disease. The clinical and radiographic findings were indistinguishable from those of miliary tuberculosis. Microscopic examination of material obtained at autopsy revealed the large fungus characteristic of adiaspiromycosis in the center of suppurative granulomas throughout the lungs. This is believed to be the first fatal case of pulmonary adiaspiromycosis reported in humans, and it may have been occupationally acquired.
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Affiliation(s)
- L C Peres
- Department of Pathology, Medical School of Ribeirao Preto, Sao Paulo University, Brazil
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