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Department of Medicine, National University Hospital, Singapore
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-surgical option as a bridging therapy to parathyroidectomy would be required to control hypercalcemia while awaiting surgery. Cinacalcet is a positive allosteric modulator of the calcium sensing receptor (CaSR) that increases the sensitivity of the CaSR on the
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Department of Medical Genetics, Cambridge University, Cambridge, UK
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meeting criteria for surgery do not proceed to PTX due to increased surgical and/or anaesthetic risk, or patient preference. In this cohort of patients, medical management with cinacalcet can be considered, and cinacalcet therapy is routinely commissioned
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-secreting C-cells of the thyroid, it mediates the stimulatory action of high calcium on calcitonin secretion. Cinacalcet is a calcimimetic that directly lowers PTH levels by increasing the sensitivity of the CaSR to extracellular calcium. In 1998, the first
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hypercalcemia, but they have some limitations such as significant nephrotoxicity, like pamidronate-induced glomerulosclerosis and acute tubular necrosis. Although cinacalcet has been successfully applied in PHPT, it has been discontinued prematurely due to its
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. Calcified Tissue International 1990 46 (Supplement) S26 – S30 . 5 Marcocci C Chanson P Shoback D Bilezikian J Fernandez-Cruz L Orgiazzi J Henzen C Cheng S Sterling LR Lu J Cinacalcet reduces serum calcium
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are unable or unwilling to undergo PTx ( 11 ). Another option is cinacalcet, a calcimimetic agent, which lowers serum calcium and PTH by increasing the sensitivity of the CaSR to extracellular calcium, thereby decreasing serum PTH and reducing the
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level, cinacalcet should be proposed as it has been shown to reduce fracture rate in older dialysis patients with SHPT ( 57 ). In case of resistance to cinacalcet, a parathyroidectomy should be considered. Figure 2 Proposed algorithm for treatment
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66 Bergwitz (61) 56 M Mandible 228 PE 870 Ru/ml (N <180) NA Persistence Multiple surgeries, cinacalcet Ameloblastic fibrosarcoma 67 Monappa (62) 35 M Right mandible 36 PE NA NA No – PMTMCT 68
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Department of Emergency Medicine, CHU Nantes, Nantes, France
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35 (26.3) Thiazide diuretics 9 (6.8) Amiodarone 7 (5.3) Cinacalcet 6 (4.5) Results are presented as median (Q1–Q3) or number of patients and proportion (%) when appropriate. The relevant biological data
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upper and the right lower parathyroid glands). The patient was started on cinacalcet and 4 mg zoledronic acid monthly due to recurrent severe hypercalcemia of 14.2 mg/dL. However, despite a progressive increase in cinacalcet dose (maximum tolerated dose