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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of intravenous procaine in the treatment of hyperpyrexia in a patient with hyperparathyroidism has not been previously reported. A case of metastatic malignant melanoma precipitating the syndrome of hypertonicity of muscle, hyperpyrexia, acidemia, hypercalcemia and elevated serum parathormone levels is presented. Mithramycin was used in an attempt to reduce elevated serum calcium concentrations. The use of intravenous procaine in "caffeine rigor" and malignant hyperthermia due to succinylcholine and halothane formed the basis for its trial in this case. The relationship between cyclic AMP and calcium ions is discussed in postulating mechanism of procaine action.
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PMID:The use of procaine in acquired malignant hyperthermia in a patient with malignant melanoma metastatic to the parathyroid gland: a case report. 99 Sep 78

Mean 24-hour urinary excretion of copper and zinc was greater than normal in 17 patients with untreated primary hyperparathyroidism. Mean total serum copper concentration in these patients was slightly greater than the normal mean, whereas mean total zinc concentration was normal. After surgical treatment of hyperparathyroidism there was a transient further increase in urinary copper and zinc concentrations in the 13 patients so studied, with no consistent change in serum copper or zinc concentrations. Five patients were studied for several days after this postoperative peak had passed. Urinary copper and zinc excretion decreased in three in relation to surgical correction of their hyperparthyroidism and remained elevated in one with persistent hypercalcemia. In the fifth patient urinary zinc excretion increased to slightly above the normal range despite successful surgery. These results suggest that changes in urinary excretion of copper and zinc may be useful indicators in the diagnosis and treatment of patients with primary hyperparathyroidism.
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PMID:Altered copper and zinc metabolism in primary hyperparathyroidism. 100 79

Between 1969 and April 1975 24 patients with severe secondary hyperparathyroidism (sHPT) clinically presenting with uremic osteopathy required either total (n=5) or subtotal (n=18) parathyroidectomies, 17 patients were already supported by maintenance hemodialysis, 6 patients suffered from terminal renal insufficiency. The leading clinical symptoms consisted of general osteoporosis, spontaneous fractures, extraosseous calcifications and histologically proven dissecting fibroosteoclasia. After operation 18 patients experienced complete relief from their complaints and repair of their skeletal lesions, 2 patients required reexploration for an undetected hyperfunctioning 4th parathyroid gland, regretfully with no success. In 4 patients with subtotal parathyoidectomy a recurrence of varying intensity with increased PTH-secretion from the remnant had to be registered after months and years.-The indication for surgical treatment of sHPT due to chronic renal failure has to be based on two sets of findings: 1) inadequate longterm suppression of increased PTH secretion by conservative measures like high dialysate calcium concentration or oral calcium intake, serum phosphorus depletion by oral intake of aluminium hydroxyde and possibly also by Vit. D; 2) persistent hypercalcemia, progressive osteodystrophy and severe complaints like bone pain and pruritus.
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PMID:[Surgical aspects of secondary hyperparathyroidism (author's transl)]. 101 8

Report on a patient with osteomalacia due to renal phosphate loss. At onset the patient was aged 43 years. No other tubular defects were detected except glycinuria. The patient was followed over a period of 12 years. 3 years after treatment with oral phosphate and vitamin D3 persistent hypercalcemia developed with highly elevated levels of parathyroid hormone. After removal of one enlarged parathyroid gland serum calcium normalized, but elevated parathyroid hormone levels still persist. The spontaneous occurrence of hypophosphatemic osteomalacia in an adult male and its connections with the development of hyperparathyroidism are discussed.
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PMID:[Sporadic adult hypophosphatemic vitamin D resistant osteomalacia (phosphate diabetes) and hyperparathyroidism]. 101 14

A woman hospitalized because of attempted suicide with diazepam tablets was found to have hypercalcemia and other signs of hyperparathyroidism. Electroencephalogram indicated a brain lesion which was confirmed by a brain scan and angiogram. The hypercalcemia persisted after removal of the meningioma and serum levels of calcium returned to normal only after a parathyroid adenoma was removed during an additional intervention. This association of meningioma with hyperparathyroidism is unique in the literature. The difficulties of diagnosis resulting from the neuropsychiatric symptoms common to the two disorders are discussed.
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PMID:Meningioma associated with parathyroid adenoma. 101 12

The use of the serum auto-analyzer (SMA-12) has resulted in a marked increase in the diagnosis of hyperparathyroidism. Seventy-five patients with asymptomatic hypercalcemia were explored: sixty-eight with solitary adenomas, six with multiple adenomas, and one with diffuse hyperplasia. Postoperatively, all patients reverted to normocalcemia. Surgical exploration of asymptomatic hypercalcemia is advocated to reduce surgical morbidity and mortality and to prevent the development of renal and osseous complications of hyperparathyroidism.
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PMID:Surgical exploration in asymptomatic hypercalcemia. 101 34

Automated laboratory procedures have made possible to "screen" a large population for specific biochemical abnormalities. Primitive hyperparathyroidism is for several respects an excellent disease model for testing "mass screening". Il is often asymptomatic, not uncommon, and is manifested by abnormalities in the levels of serum calcium and inorganic phosphorus, that can be detected cheaply with automated equipment. A computer program has been developed to screen patients with hypercalcaemia. During a period of 18 months 22720 hospitalized patients were investigated by the evaluation of serum calcium, and 80 hypercalcaemic patients were found. The diagnosis of primary hyperparathyroidism was established in 24 patients (in 19 histologically confirmed) so that the incidence of primary hyperparathyroidism (1,05%) compares favorably with that reported from some foreign Authors.
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PMID:[Serum calcium evaluation and incidence of primary hyperparathyroidism in hospitalized patients (author's transl)]. 102 89

Five patients who had gross abnormalities of calcium and phosphorus metabolism due to long standing renal failure are described to illustrate the difficulties with the term "tertiary hyperparathyroidism". One patient who had unequivocal biochemical tertiary hyperparathyroidism was found histologically to have nodular hyperplasia of all four glands even though one gland weighed twice as much (12g) as the combined weight of the other three. Another patient was not hypercalcaemic but had all the other features of the condition including rapid onset of osteitis fibrosa, vascular calcification and a probable parathyroid adenoma, with hyperplasia of the three glands. The other three had hypercalcaemia only after a reduction in the plasma inorganic phosphorus due either to renal transplantation or aluminum hydroxide therapy. The bone histology of the five patients varied from severe osteomalacia to severe osteitis fibrosa. A consideration of the factors involved in causing hypercalcaemia in these patients and a review of the literature leads to the conclusion that the term tertiary hyperparathyroidism is often misleading and best avoided.
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PMID:What is tertiary hyperparathyroidism? 106 86

Four months after a cadaver kidney transplant, kidney stones were found in the renal allograft. Three major predisposing causes of nephrolithiasis were found in the patient, including hyperparathyroidism, renal tubular acidosis, and urinary tract infection. Hypercalcemia was corrected by parathyroidectomy. During the subsequent three years there was no enlargement of the renal stones and adequate kidney function was maintained. Renal tubular acidosis was not severe and seemed to be related to chronic rejection. Urinary tract infection was readily corrected with antibiotics and did not recur after the immediate post-transplant period. Surgical therapy for nephrolithiasis involving a kidney allograft was defferred since urinary flow was not obstructed. This course of management is recommended for use in patients with calculi complicating renal transplantation.
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PMID:Calculi complicating a renal transplant. 109 Nov 78

The fascinating history of the first Memorial Hospital patient who was diagnosed as having hyperparathyroidism is reviewed. The illness presented as a cystic mass in a femur in 1929, which was treated with radiation. When the patient was first seen at Memorial Hospital in 1931, the diagnosis of osteitis fibrosa cystica was made; serum calcium was 14 mg/100 ml. In 1932, 6 years after Mandl performed the first parathyroidectomy ever for osteitis fibrosa cystica, this patient's neck was explored, and a right hemithyroidectomy was done, with removal of two normal parathyroid glands. The parathyroid tumor was finally located and partially removed in 1937 after a second failure at neck exploration in 1936. Correspondence between Dr. Edward D. Churchill at the Massachusetts General Hospital and Dr. Bradley Coley at Memorial Hospital indicated the concern at that time about uncontrollable tetany, which had been fatal in some contemporary cases and which had led to the practice of only partially removing the tumor. Following this, the patient was observed with documented hypercalcemia and chemical evidence of hyperparathyrodism until age 79. The physical and chemical abnormalities over the years up to and including her last exam are presented. The case is important not only from the historical viewpoint, but because it lends a perspective to long-term parathyroid disease, which is becoming less appreciated in this day of the routine serum calcium by SMA-12 screening. The question of partial parathyroidectomy for adenoma or hyperplasia is reviewed, and the question of observation of patients with mild hypercalcemia who probably have parathyroid tumors is discussed.
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PMID:Documented hyperparathyroidism of thirty-six years' duration. 111 47


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