Journal of Bone Metabolism最新文献

{"title":"Effect of Romosozumab on Trabecular Bone Score Compared to Anti-Resorptive Agents in Postmenopausal Women with Osteoporosis.","authors":"Chaiho Jeong, Jinyoung Kim, Yejee Lim, Jeonghoon Ha, Moo Il Kang, Ki-Hyun Baek","doi":"10.11005/jbm.2022.29.4.279","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.4.279","url":null,"abstract":"","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 4","pages":"279"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/f8/jbm-2022-29-4-279.PMC9760771.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10420948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position Statement: Vitamin D Intake to Prevent Osteoporosis and Fracture in Adults.","authors":"Anna Han,&nbsp;Yongsoon Park,&nbsp;Young-Kyun Lee,&nbsp;So Young Park,&nbsp;Clara Yongjoo Park","doi":"10.11005/jbm.2022.29.4.205","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.4.205","url":null,"abstract":"<p><p>Adequate vitamin D status is essential for bone health. New randomized controlled trials investigating the effect of vitamin D supplementation on bone health have recently been published. This position statement updates and expands on the previous 2015 position statement of the Korean Society for Bone and Mineral Research on the adequate vitamin D status for healthy older adults (age ≥ 70 years) and those at high risk of osteoporosis and fracture (adults on osteoporosis medications) to maintain serum 25-hydroxy-vitamin D (25[OH]D) levels ≥ 20 ng/mL but < 50 ng/mL. A serum 25(OH)D level of 30 ng/mL may be beneficial for those on anti-resorptives. Vitamin D can be obtained from ultraviolet light exposure and diet. To reach the target vitamin D status through intake, adults must consume at least 400 IU/day to reach 20 ng/mL and 800 to 1,000 IU/day to reach 30 ng/mL. Foods familiar to the Korean diet that are high in vitamin D content or consumed frequently enough to positively impact vitamin D status are introduced in addition to the amount required to help reach one's target vitamin D status.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 4","pages":"205-215"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/17/jbm-2022-29-4-205.PMC9760769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10420944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LIM Homeobox Transcription Factor 1-β Expression is Upregulated in Patients with Osteolysis after Total Ankle Arthroplasty and Inhibits Receptor Activator of Nuclear Factor-κB Ligand-Induced Osteoclast Differentiation in Vitro.","authors":"Kabsun Kim,&nbsp;Jeong Eun Han,&nbsp;Keun-Bae Lee,&nbsp;Nacksung Kim","doi":"10.11005/jbm.2022.29.3.165","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.165","url":null,"abstract":"<p><strong>Background: </strong>Osteolysis is one of the most common problems that occurs after total hip and knee arthroplasty and has recently become a significant problem after total ankle arthroplasty (TAA). In this study, we investigated the role of LIM homeobox transcription factor 1-β (Lmx1b) in osteoclast differentiation. By evaluating the expression profiles associated with osteolysis following TAA treatment, Lmx1b was found to be differentially expressed in patients with osteolysis after TAA.</p><p><strong>Methods: </strong>To identify the important genes associated with osteolysis after TAA, RNA sequencing was performed by analyzing 8 patient samples: 5 primary TAA samples (control group) and 3 TAA samples revised for flexion instability (osteolysis group). By analyzing the differentially expressed genes and gene ontologies, Lmx1b expression was found to be upregulated in the osteolysis group compared to that in the control group. Focusing on the role of Lmx1b in bone cells, Lmx1b was overexpressed by a retrovirus in osteoclast precursor cells. The cultured cells were stained with tartrate-resistant acid phosphatase, and the expression of osteoclast-related genes was analyzed using real-time polymerase chain reaction.</p><p><strong>Results: </strong>Lmx1b overexpression in osteoclast precursors suppresses osteoclast formation and resorptive activity. The expression of osteoclast marker genes was significantly reduced during osteoclast differentiation by Lmx1b overexpression. Furthermore, Lmx1b is associated with nuclear factor of activated T cells 1 (NFATc1) and inhibited NFATc1 translocation into the nucleus.</p><p><strong>Conclusions: </strong>These results provide novel insights into the anti-bone resorptive effect of Lmx1b on osteolysis after TAA and may lead to the development of effective preventative and therapeutic strategies for peri-implant osteolysis.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"165-174"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/6d/jbm-2022-29-3-165.PMC9511124.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33480913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retropharyngeal Ectopic Parathyroid Adenoma Localized by 18F-Fluorocholine Positron Emission Tomography/Computed Tomography: A Case Report.","authors":"Hyeokjoo Jang,&nbsp;Seunghyun Lee,&nbsp;Dahee Kim,&nbsp;Namki Hong","doi":"10.11005/jbm.2022.29.3.197","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.197","url":null,"abstract":"<p><p>Ectopic parathyroid adenomas of the retropharyngeal space are relatively rare. Herein, we report a case of primary hyperparathyroidism (PHPT) secondary to a retropharyngeal parathyroid adenoma. A 22-year-old woman presented with elevated serum calcium and parathyroid hormone (PTH) levels, revealed during a medical check-up. The patient had a history of ureteral stones and a confirmed low bone mass. Neck 99mTechnetium-sestamibi singlephoton emission computed tomography (CT) and ultrasonography did not reveal any suspicious lesions. There was no evidence of hereditary PHPT based on the results of targeted gene sequencing. Surgical exploration was unsuccessful, and the PHPT persisted after the first surgery. Approximately a year after the failed operation, 18F-fluorocholine (FCH) positron emission tomography/CT (PET-CT) became available, and when performed, it revealed increased uptake in the retropharyngeal space of the right side of the neck. The results of parathyroid venous sampling were concordant with a >2-fold elevation of PTH level in the veins on the right side of the neck compared to the peripheral veins. The 1.8 cm-diameter mass was successfully removed resulting in an 87% reduction in intraoperative PTH level (198.0-26.5 pg/mL). Subsequently, normalizations of calcium and PTH levels were achieved. In summary, ectopic parathyroid adenomas, including retropharyngeal lesions, should also be suspected when investigating an elusive case of PHPT. 18F-FCH PET-CT can be a useful complementary modality for detecting culprit lesions.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"197-203"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/8b/jbm-2022-29-3-197.PMC9511128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33480917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Selective Estrogen Receptor Modulators Monotherapies in Postmenopausal Women with Osteopenia.","authors":"Kyung Wook Kim, Young Il Kim, Ki-Choul Kim","doi":"10.11005/jbm.2022.29.3.185","DOIUrl":"10.11005/jbm.2022.29.3.185","url":null,"abstract":"<p><strong>Background: </strong>The impact of osteopenia as a risk factor for fractures is underrecognized. Moreover, the efficacy of selective estrogen receptor modulators (SERMs) in postmenopausal women with osteopenia is limited. This study aimed to evaluate the efficacy of SERMs in postmenopausal women with osteopenia.</p><p><strong>Methods: </strong>Thirty-two postmenopausal women with osteopenia were treated with 3 types of SERMs medication: raloxifene (group I, N=15), bazedoxifene (group II, N=8), and raloxifene with cholecalciferol (group III, N=9). Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry scans before treatment to after 3 years of treatment once a year.</p><p><strong>Results: </strong>Patients in group I showed significant increases in hip BMD, -1.93 to -1.73 and spine BMD, -1.85 to -1.67. In addition, patients in groups II and III showed significant increases in hip BMD, -1.93 to -1.69 and -2.22 to -1.86, respectively and spine BMD, -2.1 to -1.3 and -2.22 to -1.37, respectively. The BMD increased in the hip and spine by 9.7% and 10.3%, respectively in group I, 38.0% and 12.4%, respectively in group II, and 38.2% and 16.2%, respectively in group III.</p><p><strong>Conclusions: </strong>In this study, we found that SERMs could improve spine and hip BMD. In conclusion, preemptive treatment using SERMs is necessary for postmenopausal women with osteopenia. None of the patients experienced fractures during the follow-up period.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33480915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raloxifene/Vitamin D Combination Therapy vs. Raloxifene Monotherapy on Serum 25-Hydroxy-Vitamin D Level among Postmenopausal Women with Osteoporosis or Osteopenia: A Randomized Controlled Trial.","authors":"You-Bin Lee,&nbsp;Ki-Hyun Baek,&nbsp;Ho Yeon Chung,&nbsp;Dong-Won Byun,&nbsp;Yong-Ki Min","doi":"10.11005/jbm.2022.29.3.155","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.155","url":null,"abstract":"<p><strong>Background: </strong>We compared the efficacy of a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU to raloxifene 60 mg alone on vitamin D status, as indicated by change in serum 25-hydroxy-vitamin D (25[OH]D) levels.</p><p><strong>Methods: </strong>In this 16-week, open-label, randomized, active controlled, multicenter clinical trial conducted in 4 university-affiliated hospitals in Korea, postmenopausal women aged 55 to 70 years with osteoporosis or osteopenia were randomly assigned in a 1:1 ratio to receive raloxifene 60 mg/cholecalciferol 800 IU combination therapy or raloxifene 60 mg monotherapy. Primary endpoint was change in serum 25(OH)D level from baseline to 16 weeks after the intervention.</p><p><strong>Results: </strong>A total of 96 participants were randomly assigned to raloxifene/vitamin D combination therapy (N=49) and raloxifene monotherapy (N=47) groups. At week 16, serum 25(OH)D level increased from baseline, only in the raloxifene/vitamin D combination therapy group. Change in serum 25(OH)D level from baseline to week 16 was higher in the raloxifene/vitamin D combination therapy group (2.7±6.5 ng/mL) than in the raloxifene monotherapy (-1.7±6.2 ng/mL; P=0.0034) group. Proportions and number of adverse events (AEs) categorized by the System-Organ Class were not different between the groups. There was only one severe AE case (spondylolisthesis; raloxifene/vitamin D group), unlikely to be related to trial intervention.</p><p><strong>Conclusions: </strong>Among postmenopausal women with osteoporosis or osteopenia, a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU showed superior efficacy in elevating serum 25(OH)D levels compared with raloxifene 60 mg alone during 16 weeks of follow-up. The safety of raloxifene/vitamin D combination was comparable to raloxifene alone.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"155-163"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/79/jbm-2022-29-3-155.PMC9511125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33493522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Titanium Particles and Ions in the Pathogenesis of Peri-Implantitis.","authors":"Farah Asa'ad,&nbsp;Peter Thomsen,&nbsp;Marcel F Kunrath","doi":"10.11005/jbm.2022.29.3.145","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.145","url":null,"abstract":"<p><p>Titanium (Ti) particles and ions have been investigated in recent years as important factors in the pathogenesis of peri-implantitis. However, their role in the pathogenesis is yet to be fully understood. A review of pertinent literature was performed in various databases to determine the current position of Ti particles and ions role in the pathogenesis of peri-implantitis. There are several in vitro, preclinical and clinical published studies that have addressed the role of Ti particles and ions in the pathogenesis of peri-implantitis. These studies explored the effect of Ti particles and ions in the pathogenesis of peri-implantitis with respect to foreign body reaction, cellular response, epigenetic mechanisms, namely DNA methylation, and the oral microbiome. Studies have shown that the release of Ti particles/ions during implant insertion, early healing stages, late healing stages, and treatments during peri-implantitis might contribute to peri-implantitis through different mechanisms, such as foreign body reaction, cellular response, DNA methylation, and shaping the oral microbiome by increasing dysbiosis. However, further studies are needed to elucidate the complex interactions between all these mechanisms and Ti particles/ions in the pathogenesis and progression of peri-implantitis.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"145-154"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/95/jbm-2022-29-3-145.PMC9511127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33493523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Revised Reimbursement Guideline for Anti-Osteoporosis Medication in South Korea.","authors":"Young-Seung Ko,&nbsp;Yeonsuk Jeong,&nbsp;Jung-Wee Park,&nbsp;Young-Kyun Lee,&nbsp;Kyung-Hoi Koo","doi":"10.11005/jbm.2022.29.3.191","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.191","url":null,"abstract":"<p><strong>Background: </strong>The Korean National Health Insurance (NHI) reimbursement guideline was revised in May 2015 with the aim of preventing secondary osteoporotic fractures. Here we compared the: (1) rate of bone mineral density (BMD) measurements; (2) prescription rate of anti-osteoporosis medication within 3 months after hip fracture surgery (HFS); (3) incidence of a second hip fracture; and (4) first-year mortality rate after HFS.</p><p><strong>Methods: </strong>This before-after study used the revised reimbursement system as a reference period. We retrospectively reviewed the medical records of 515 patients who underwent HFS at a tertiary referral hospital between January 2014 and December 2016. The period 1 group underwent HFS in 2014, while the period 2 group underwent HFS in 2016.</p><p><strong>Results: </strong>Despite the fact that there was no significant intergroup difference in BMD measurement rate, the period 2 group had a higher prescription rate for anti-osteoporosis drugs within 3 months of HFS. However, the incidence of a second hip fracture did not differ between groups. The first-year mortality rate was higher in the period 1 versus period 2 group.</p><p><strong>Conclusions: </strong>Revision of the NHI guideline in May 2015 was associated with an increased prescription rate of anti-osteoporosis medication in osteoporotic hip fracture patients.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/82/jbm-2022-29-3-191.PMC9511126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33480916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles of Follicle-Stimulating Hormone on Bone Metabolism in Late Postmenopausal Women.","authors":"Chaiho Jeong,&nbsp;Jinyoung Kim,&nbsp;Yejee Lim,&nbsp;Jeonghoon Ha,&nbsp;Mee Kyoung Kim,&nbsp;Hyuk-Sang Kwon,&nbsp;Ki-Ho Song,&nbsp;Moo Il Kang,&nbsp;Ki-Hyun Baek","doi":"10.11005/jbm.2022.29.3.175","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.3.175","url":null,"abstract":"<p><strong>Background: </strong>The effects of elevated follicle-stimulating hormone (FSH) levels on physiological changes in the bone remain unclear. This study aimed to clarify the association between FSH concentrations and bone mineral density (BMD) and bone turnover markers (BTM) in late postmenopausal women.</p><p><strong>Methods: </strong>A total of 169 Korean women were enrolled. The participants' ages ranged from 60 to 84 years (mean age, 69.0±5.1) and reported a mean duration of 19.4±6.6 years since menopause (YSM). The participants showed an average body mass index (BMI) of 24.4±2.8 kg/m2. Age, YSM, estradiol, testosterone, and BMI were confounders in the Pearson's partial correlation. A test for trends across the quartiles of FSH levels was performed for each variable.</p><p><strong>Results: </strong>The mean FSH and estradiol concentrations were 61.5 IU/L and 2.9 pg/mL, respectively. Serum FSH concentration was not significantly associated with BMD (lumbar, r=0.09, P=0.30; total hip, r=0.00, P=0.96; and femoral neck, r=0.05, P=0.62). BTM across the FSH quartiles did not show any trend association (bone-specific alkaline phosphate, P=0.31; crosslinked C-terminal telopeptide of type I collagen, P=0.90). Instead, FSH levels were negatively correlated with BMI (r=-0.34, P=0.00). In the multivariate regression model adjusted for age, testosterone, and estradiol, only BMI showed a negative value across the FSH quartiles (β coefficient -0.11, P=0.00).</p><p><strong>Conclusions: </strong>This study identified that high FSH concentrations were not associated with bone loss or high bone turnover in women in the late postmenopausal period.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 3","pages":"175-183"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/c8/jbm-2022-29-3-175.PMC9511130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33480914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid Crisis as Presentation of Atypical Parathyroid Adenoma: Two Diagnostically Challenging Cases.","authors":"Galo Andrés Salvador Landeta,&nbsp;Alexis Trejo Montes,&nbsp;Tania Islem Gamboa Jimenéz,&nbsp;Vargas-Ortega Guadalupe,&nbsp;González-Virla Baldomero,&nbsp;Balcázar-Hernández Lourdes","doi":"10.11005/jbm.2022.29.2.133","DOIUrl":"https://doi.org/10.11005/jbm.2022.29.2.133","url":null,"abstract":"<p><p>Atypical parathyroid adenoma (APA) is a rare cause of primary hyperparathyroidism (PHPT) and represents a diagnostic challenge since it is an intermediate form of parathyroid neoplasm of uncertain malignant potential with atypical histological features that require differential diagnosis of parathyroid carcinoma (PC). We present 2 cases of parathyroid crisis as a presentation of APA. The first case was that of a 56-year-old man with parathyroid crisis, constitutional syndrome, and anemia, with evidence of APA after en bloc resection, evolving with hungry bone syndrome after surgery and curation criteria at 6 months after parathyroidectomy (PTX). The second case was a 64-year-old woman with acute chronic kidney disease and parathyroid crisis, with evidence of APA after selective PTX and >50% reduction in parathyroid hormone levels after surgery; however, persistent PHPT at 6 months post-surgery was observed. These cases represented a diagnostic challenge due to their rare clinical presentation (parathyroid crisis), with a heterogeneous spectrum of target organ damage and infrequent symptoms (constitutional syndrome and acute chronic renal disease), in turn caused by a rare pathology (APA). The presentation of these patients may be indicative of PC; however, histopathological diagnosis is a key to the diagnosis of APA. The differential diagnosis of APA vs. PC in clinical practice is indispensable.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"29 2","pages":"133-140"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/5f/jbm-2022-29-2-133.PMC9208905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39999043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}