Research Article
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Vertigo Hastalarında Kanda Parathormon Bakmalı mıyız?

Year 2019, Volume: 9 Issue: 1, 22 - 28, 01.01.2019

Abstract

ÖZET
Amaç: Vertigo kişi tarafından etrafındaki objelerin veya kendisinin döndüğü şeklinde ifade edilen bir semptom olmasına karşın, hastalar tarafından genel olarak dengesizlik, sersemlik, düşme ve baygınlık hissi olarak tanımlanır. Hastalarda asıl sorun altta yatan hastalığın belirlenmesidir. Vertigoların çoğu periferik nedenlidir ve
ilk sırada benign paroksimal pozisyonel vertigo yer alır. Bunu diğer periferik ve santral nedenler takip etmektedir. Hastalar denge sorunları nedeniyle akut dönemde çoğunlukla acil poliklinikler haricinde Kulak Burun Boğaz, iç hastalıkları, nöroloji polikliniklerine başvururlar. Bu hastalara muayene, görüntüleme yöntemleri, odyoloji
ve denge testleri ile rutin kan testleri yapılmaktadır. Materyal ve Metot: Hastanemize 2011–2017 yılları arasında vertigo yakınması ile başvuran 397 hasta retrospektif olarak değerlendirildi. Bulgular: Çalışmamızda, ilk sırada periferik nedenler ve bunların başında da %44,8 oranında benign paroxysmal positional vertigo saptanmıştır. Hasta gruplarımızda tek yakınması baş dönmesi olan, diğer muayenelerinde özellik bulunmayan 4 (%1) olgumuzda hiperparotiroidi saptanmıştır. Bunların üçünde paratiroid adenomu, diğer olguda hiperplazi belirlenmiştir. Adenom saptananlarda paratiroidektomi sonrası, diğer olgumuzda bifosfonat tedavisi sonrası hem parathormon düzeyleri normale inmiş hem de vertigo yakınmaları tamamen kaybolmuştur. Sonuç: Vertigo hastalarında tanı aşamasında kan testlerinde parathormon değerlerine de bakılması tavsiye edilmektedir.

References

  • 1. Lustig LR, Schindler JS. Ear, Nose and Throat Disorders. In: Papadakis, editors. Current Medial Diagnosis and Treatment. New York; Mc Graw Hill Education 2014 193–234.
  • 2. Taylor J, Goodkin HP. Dizziness and vertigo in the adolescent. Otolaryngol. Clin N Am 2011;2:309–23.
  • 3. Shepard N T, Solomon D. Functional Operation of the Balance System in Daily Activities. The Otolaryngologic Clinics Of North America 2000;33:455–69.
  • 4. Uneri A, Polat S. Vertigo, dizziness and imbalance in the elderly. Laryngol Otol 2008;122:466–9.
  • 5. Yeh MW, Ituarte PH, Zhou HC, Nishimoto S, Liu IL, Harari A et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab 2013;98:1122–9.
  • 6. Zha C, Wang X, Wei H, Ma G. Parathyroid adenoma causing a spontaneous cervical and mediastinal massive hematoma. Int J Clin Exp Med 2015;8:21826–9.
  • 7. Yao XA, Wei BJ, Jiang T, Chang H. The characteristics of clinical changes in primary hyperparathyroidism in Chinese patients. J Bone Miner Metab 2018;1:22–3.
  • 8. Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 2002;17:18–23.
  • 9. Parmar G, Chadha M. The Changing Face of Primary Hyperparathyroidism. Indian J Endocrinol Metab 2018;3:299–300.
  • 10. Jodkowska A, Tupikowski K, B, Szymczak L, BohdanowiczPawlak A, Bolanowski M, Bednarek-Tupikowska G. Interdisciplinary Aspects of Primary Hyperparathyroidism: Symptomatology in a Series of 100 Cases. Adv Clin Exp Med 2016;2:285–93.
  • 11. Vignali E, Viccica G, Diacinti D, Cetani F, Cianferotti L, Ambrogini E et al. Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 2009;94:2306–12.
  • 12. Wermers RA, Khosla S, Atkinson EJ, Achenbach SJ, Oberg AL, Grant CS et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993–2001: an update on the changing epidemiology of the disease. J Bone Miner Res 2006;21:171–7.
  • 13. Bilezikian JP, Potts JT Jr. Asymptomatic primary hyperparathyroidism: new issues and new questions-bridging the past with the future. J Bone Miner Res 2002;17:57–67.
  • 14. Bilezikian JP, Silverberg SJ. Clinical practice. Asymptomatic primary hyperparathyroidism. N Engl J Med 2004;17:1746–51.
  • 15. Jung I, Kim JS. Approach to dizziness in the emergency department. Clin Exp Emerg Med 2015;2:75–88.
  • 16. Post RE, Dickerson LM. Dizziness: A Diagnostic Approach Am Fam Physician 2010;82:361–8.
  • 17. Wu Y, Fan Z, Jin H Guan Q, Zhou M, Lu X, Li Let al. Assessment of Bone Metabolism in Male Patients with Benign Paroxysmal Positional Vertigo. Front Neurol 2018;9:742.
  • 18. Guler I, Baklacı D, Kuzucu I, Kum RO, Ozcan M. Benign Paroksismal Pozisyonel Vertigolu Hastalarda Serum 25-hidroksi vitamin D Düzeylerinde Azalma. KBB-Forum 2018;17:35–9.
  • 19. Voelker CCJ, Goebel JA. Clinical Evaluation of the Patient with Vertigo. In: Johnson JT and Rosen CA, editors. Bailey’s Head &Neck Surgery Otolaryngology Vol 2. Phlidelphia, Lippincott Williams&Wilkins 2014:2673–700.
  • 20. Wipperman J. Dizziness and vertigo. Prim Care 2014;41:115–31.
  • 21. Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol 2016;137:67–82.
  • 22. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician 2017;96:384–89.
  • 23. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ 2014;349:5226.
  • 24. Ugalde I, Bello Segura M, Oneto S, Ciment A. The forgotten electrolyte, when hypercalcaemia manifest as gait instability and altered mental status. BMJ Case Rep 2018;5:224089.
  • 25. Corbetta S, Mantovani G, Spada A. Metabolic Syndrome in Parathyroid Diseases. Front Horm Res 2018;49:67–84.
  • 26. Ota K, Koseki S, Ikegami K, Onishi I, Tomimitsu H, Shintani S. Dropped head syndrome as first manifestation of primary hyperparathyroid myopathy. Rinsho Shinkeigaku 2018;58:193–7.
  • 27. Grubina R, Klocke D K 47-Year-Old Woman With Dizziness, Weakness, and Confusion 2. Mayo Clin Proc 2011;86:1–4.
  • 28. Parks KA, Parks CG, Onwuameze OE, Shrestha S. Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia. Am J Psychiatry 2017;1:620–2.
  • 29. Lendel I, Horwith M. An update from the latest workshop on asymptomatic primary hyperparathyroidism. Otolaryngol. Clin N Am 2004;37:737–51.
  • 30. Smith JA, Stack BC. Pathophysiology of the parathyroid glands. In: Terris DJ, Gourin CG, editors. Thyroid and Parathyroid Diseases Medical and Surgical Management. New York, Thieme 2009:184–197.
  • 31. Vosnakidis A, Polymeropoulos K, Zarogoulidis P, Zarifis I. Atrioventricular nodal dysfunction secondary to hyperparathyroidism. Journal of Thoracic Disease, 2013;5:90–2.
  • 32. Lundberg YW, Zhao X, Yamoah EN. Assembly of the otoconia complex to the macular sensory epithelium of the vestibule. Brain Res 2006 May 26;1091:47–8.

Should We Look For Blood Parathormone in Patients with Vertigo?

Year 2019, Volume: 9 Issue: 1, 22 - 28, 01.01.2019

Abstract

Aim: Though vertigo is a symptom which is defined by an individual as spinning of themselves or an object, it is generally defined
by the patients as the sensation of falling, disequilibrium, dizziness
and fainting. The main problem on the patients is the determination
of the underlying illness. Most of vertigos have peripheral causes
and benign paroxysmal positional vertigo takes the first place. It is
followed by peripheral and central causes. Patients usually consult
the policlinics of Ear, Nose and Throat, internal medicine, neurology in addition to emergency departments with balance disorders.
These patients undergo examinations, screening methods, audiology and balance tests and routine blood tests.
Material and Method: In this study in which 397 patients who
consulted the hospital with complaints of vertigo between 2011
and 2017 evaluated retrospectively.
Results: In our study, first of all peripheral causes and 44.8% of these
were benign paroxysmal positional vertigo. Hyperparathyroidism
was detected in 4 (1%) of the cases in our patient groups that the
only complaint was dizziness and there were no other characteristics in the examinations. Parathyroid adenoma was detected in
three of them and hyperplasia was detected in the other. In the
ones who had adenoma after parathyroidectomy and in the other
case after bisphosphonate treatment, both parathormone levels
decreased to normal and vertigo complaints totally disappeared.
Conclusion: It is recommended that parathormone values should
be taken into account in the blood tests during the process of diagnosis in vertigo patients

References

  • 1. Lustig LR, Schindler JS. Ear, Nose and Throat Disorders. In: Papadakis, editors. Current Medial Diagnosis and Treatment. New York; Mc Graw Hill Education 2014 193–234.
  • 2. Taylor J, Goodkin HP. Dizziness and vertigo in the adolescent. Otolaryngol. Clin N Am 2011;2:309–23.
  • 3. Shepard N T, Solomon D. Functional Operation of the Balance System in Daily Activities. The Otolaryngologic Clinics Of North America 2000;33:455–69.
  • 4. Uneri A, Polat S. Vertigo, dizziness and imbalance in the elderly. Laryngol Otol 2008;122:466–9.
  • 5. Yeh MW, Ituarte PH, Zhou HC, Nishimoto S, Liu IL, Harari A et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab 2013;98:1122–9.
  • 6. Zha C, Wang X, Wei H, Ma G. Parathyroid adenoma causing a spontaneous cervical and mediastinal massive hematoma. Int J Clin Exp Med 2015;8:21826–9.
  • 7. Yao XA, Wei BJ, Jiang T, Chang H. The characteristics of clinical changes in primary hyperparathyroidism in Chinese patients. J Bone Miner Metab 2018;1:22–3.
  • 8. Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 2002;17:18–23.
  • 9. Parmar G, Chadha M. The Changing Face of Primary Hyperparathyroidism. Indian J Endocrinol Metab 2018;3:299–300.
  • 10. Jodkowska A, Tupikowski K, B, Szymczak L, BohdanowiczPawlak A, Bolanowski M, Bednarek-Tupikowska G. Interdisciplinary Aspects of Primary Hyperparathyroidism: Symptomatology in a Series of 100 Cases. Adv Clin Exp Med 2016;2:285–93.
  • 11. Vignali E, Viccica G, Diacinti D, Cetani F, Cianferotti L, Ambrogini E et al. Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 2009;94:2306–12.
  • 12. Wermers RA, Khosla S, Atkinson EJ, Achenbach SJ, Oberg AL, Grant CS et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993–2001: an update on the changing epidemiology of the disease. J Bone Miner Res 2006;21:171–7.
  • 13. Bilezikian JP, Potts JT Jr. Asymptomatic primary hyperparathyroidism: new issues and new questions-bridging the past with the future. J Bone Miner Res 2002;17:57–67.
  • 14. Bilezikian JP, Silverberg SJ. Clinical practice. Asymptomatic primary hyperparathyroidism. N Engl J Med 2004;17:1746–51.
  • 15. Jung I, Kim JS. Approach to dizziness in the emergency department. Clin Exp Emerg Med 2015;2:75–88.
  • 16. Post RE, Dickerson LM. Dizziness: A Diagnostic Approach Am Fam Physician 2010;82:361–8.
  • 17. Wu Y, Fan Z, Jin H Guan Q, Zhou M, Lu X, Li Let al. Assessment of Bone Metabolism in Male Patients with Benign Paroxysmal Positional Vertigo. Front Neurol 2018;9:742.
  • 18. Guler I, Baklacı D, Kuzucu I, Kum RO, Ozcan M. Benign Paroksismal Pozisyonel Vertigolu Hastalarda Serum 25-hidroksi vitamin D Düzeylerinde Azalma. KBB-Forum 2018;17:35–9.
  • 19. Voelker CCJ, Goebel JA. Clinical Evaluation of the Patient with Vertigo. In: Johnson JT and Rosen CA, editors. Bailey’s Head &Neck Surgery Otolaryngology Vol 2. Phlidelphia, Lippincott Williams&Wilkins 2014:2673–700.
  • 20. Wipperman J. Dizziness and vertigo. Prim Care 2014;41:115–31.
  • 21. Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol 2016;137:67–82.
  • 22. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician 2017;96:384–89.
  • 23. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ 2014;349:5226.
  • 24. Ugalde I, Bello Segura M, Oneto S, Ciment A. The forgotten electrolyte, when hypercalcaemia manifest as gait instability and altered mental status. BMJ Case Rep 2018;5:224089.
  • 25. Corbetta S, Mantovani G, Spada A. Metabolic Syndrome in Parathyroid Diseases. Front Horm Res 2018;49:67–84.
  • 26. Ota K, Koseki S, Ikegami K, Onishi I, Tomimitsu H, Shintani S. Dropped head syndrome as first manifestation of primary hyperparathyroid myopathy. Rinsho Shinkeigaku 2018;58:193–7.
  • 27. Grubina R, Klocke D K 47-Year-Old Woman With Dizziness, Weakness, and Confusion 2. Mayo Clin Proc 2011;86:1–4.
  • 28. Parks KA, Parks CG, Onwuameze OE, Shrestha S. Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia. Am J Psychiatry 2017;1:620–2.
  • 29. Lendel I, Horwith M. An update from the latest workshop on asymptomatic primary hyperparathyroidism. Otolaryngol. Clin N Am 2004;37:737–51.
  • 30. Smith JA, Stack BC. Pathophysiology of the parathyroid glands. In: Terris DJ, Gourin CG, editors. Thyroid and Parathyroid Diseases Medical and Surgical Management. New York, Thieme 2009:184–197.
  • 31. Vosnakidis A, Polymeropoulos K, Zarogoulidis P, Zarifis I. Atrioventricular nodal dysfunction secondary to hyperparathyroidism. Journal of Thoracic Disease, 2013;5:90–2.
  • 32. Lundberg YW, Zhao X, Yamoah EN. Assembly of the otoconia complex to the macular sensory epithelium of the vestibule. Brain Res 2006 May 26;1091:47–8.
There are 32 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Nevzat Demirbilek

Cenk Evren

Publication Date January 1, 2019
Published in Issue Year 2019 Volume: 9 Issue: 1

Cite

APA Demirbilek, N., & Evren, C. (2019). Should We Look For Blood Parathormone in Patients with Vertigo?. Kafkas Journal of Medical Sciences, 9(1), 22-28.
AMA Demirbilek N, Evren C. Should We Look For Blood Parathormone in Patients with Vertigo?. KAFKAS TIP BİL DERG. January 2019;9(1):22-28.
Chicago Demirbilek, Nevzat, and Cenk Evren. “Should We Look For Blood Parathormone in Patients With Vertigo?”. Kafkas Journal of Medical Sciences 9, no. 1 (January 2019): 22-28.
EndNote Demirbilek N, Evren C (January 1, 2019) Should We Look For Blood Parathormone in Patients with Vertigo?. Kafkas Journal of Medical Sciences 9 1 22–28.
IEEE N. Demirbilek and C. Evren, “Should We Look For Blood Parathormone in Patients with Vertigo?”, KAFKAS TIP BİL DERG, vol. 9, no. 1, pp. 22–28, 2019.
ISNAD Demirbilek, Nevzat - Evren, Cenk. “Should We Look For Blood Parathormone in Patients With Vertigo?”. Kafkas Journal of Medical Sciences 9/1 (January 2019), 22-28.
JAMA Demirbilek N, Evren C. Should We Look For Blood Parathormone in Patients with Vertigo?. KAFKAS TIP BİL DERG. 2019;9:22–28.
MLA Demirbilek, Nevzat and Cenk Evren. “Should We Look For Blood Parathormone in Patients With Vertigo?”. Kafkas Journal of Medical Sciences, vol. 9, no. 1, 2019, pp. 22-28.
Vancouver Demirbilek N, Evren C. Should We Look For Blood Parathormone in Patients with Vertigo?. KAFKAS TIP BİL DERG. 2019;9(1):22-8.