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

Two patients with both primary hyperparathyroidism and primary hyperaldosteronism are described. Each presented with high blood pressure and a history of renal calculi. Mild hypercalcaemia was associated with raised plasma parathyroid hormone concentrations and a parathyroid adenoma was excised from each. Both patients also had hypokalaemia, hyperaldosteronism and low plasma renin concentrations. Quadric analysis, adrenal vein plasma aldosterone concentrations, adrenal venography and CT scanning all suggested an adrenal adenoma in each patient. This suspicion was confirmed at operation in one patient; the other patient is unfit for adrenal surgery but her blood pressure and plasma potassium concentration have remained within the normal range during prolonged treatment with either spironolactone or amiloride. Because of this unusual association a search was made for parathyroid hormone excess in patients with primary hyperaldosteronism and for aldosterone excess in primary hyperparathyroidism. None was found.
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PMID:Primary hyperparathyroidism associated with primary hyperaldosteronism. 634 7

Seventy six children with documented Fanconi-type idiopathic infantile hypercalcaemia were studied and compared with 41 with the Williams-Beuren syndrome. Clinical comparison showed, as expected, very close similarities but also considerable differences, particularly in the severity of feeding problems and the degree of failure to thrive. The estimated incidence of idiopathic infantile hypercalcaemia alone has remained constant for the past 20 years, at approximately 18 cases per year in the United Kingdom (1 per 47 000 total live births). Long term morbidity in these children is mainly due to mental handicap and arteriopathy, but hypertension (29%), kyphoscoliosis (19%), hyperacusis (75%), and obesity (50%) may be added complications. In one child, hypercalcaemia recurred during adolescence but this seems to be excessively rare. More detailed investigation before treatment is required to discover the aetiology of hypercalcaemia in this condition.
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PMID:Idiopathic infantile hypercalcaemia--a continuing enigma. 646 28

To define the mechanism for the hypercalciuria in spontaneously hypertensive rats (SHR), Ca clearance was evaluated in fasted 23-wk-old SHR and normotensive Wistar Kyoto (WKy) controls. There was no exaggerated calciuria before or after parathyroidectomy. Ca balance was therefore measured in the nonfasted animals, which revealed hyperabsorption in SHR of both sexes with increments 10-fold that of Ca excretion, supporting the primacy of intestinal hyperabsorption. In situ duodenal Ca uptake was also increased in the SHR. Parathyroidectomy did not affect the hyperabsorption. Hypercalcemia (total and ionized) and hypercalciuria in SHR associated with reduced adenosine 3',5'-cyclic monophosphate excretion, were abolished by fasting. Correction of hypertension for 6 mo failed to abolish the hypercalciuria. Bone Ca deposits were increased in 1-yr-old SHR. Ten-week-old SHR, in contrast, displayed mild malabsorption. Our data do not support the "renal leak" hypothesis. Instead, the adult SHR is characterized by increased Ca retention due to primary hyperabsorption, absorptive hypercalciuria, and increased bone Ca deposition. These phenomena are independent of sex, parathyroid hormone, and treatment of the established hypertension.
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PMID:Evidence for an intestinal mechanism in hypercalciuria of spontaneously hypertensive rats. 649 32

Thirty episodes of hypercalcemia were observed in 20 children with solid tumors: principally 9 cases of non Hodgkin's lymphomas, 4 cases of rhabdomyosarcomas and 4 cases of Wilms' tumors. The 2 children with neurological manifestations and hypertension had the most severe symptoms secondary to the high calcium levels. However, hypercalcemia was asymptomatic in 8 of the 20 children. Focal seizures and metastatic calcifications subsequently occurred in 6 children. Emergency treatment of hypercalcemia often had partial or transient efficiency. In contrast, high calcium levels always returned to normal after anti-tumoral treatment.
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PMID:[Hypercalcemia associated with tumors in children. 20 cases]. 650 84

Hypertension refractory to standard dialystic maneuvers developed in a 25-year old female who had been on long-term hemodialysis. Lowering the target dry weight and adding antihypertensives did not ameliorate the hypertension. Hypercalcemia, due to vitamin D administration, was discovered and, following its correction, there was subsequent normalization of the blood pressure. This report discusses some of the mechanisms whereby calcium can interface with blood pressure regulatory mechanisms in individuals with end stage renal disease.
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PMID:Hypercalcemic hypertension in hemodialysis. 654 77

In an effort to identify new trends in the presentation and treatment of primary hyperparathyroidism, 66 patients treated since 1975 were compared with 100 patients diagnosed and treated from 1948 to 1970. Despite widespread use of multichannel analyzers, the late patients had an insignificant increase in diagnosis while asymptomatic (18 percent versus 9 percent in the early group). Hypertension was the most common presenting complaint in patients seen since 1975, compared with renal disease in patients seen before 1970. Findings of diffuse hyperplasia were more common in the late patients (17 percent versus 3 percent in the early patients). There were no differences in rates of operative complications or persistent postoperative hypercalcemia. In the late series of patients persistent hypercalcemia after surgery for hyperplasia was due to inadequate resection of parathyroid tissue. In the adenoma patients, failure to locate the abnormal parathyroid gland was the cause of operative failure.
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PMID:Primary hyperparathyroidism in the seventies. A decade of change? 661 28

A causal relationship between hyperparathyroidism and hypertension has been presumed to exist. In order to determine the nature of any such relationship, 50 patients with primary hyperparathyroidism and diastolic hypertension undergoing surgical correction of hypercalcemia (study group) were compared to 50 matched eucalcemic patients with diastolic hypertension of similar magnitude undergoing equivalent elective surgery (control group). There were no significant differences in average preoperative diastolic pressures, average postoperative diastolic pressures, or the magnitude of early postoperative reduction in diastolic pressure between the study and control groups (P greater than 0.05). Bed rest may play a significant role in the early postoperative reduction in blood pressure frequently observed in patients undergoing correction of hyperparathyroidism.
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PMID:Primary hyperparathyroidism and hypertension. 663 92

Using laboratory tests and the presence of complaints thought to be associated with hyperparathyroidism, we retrospectively studied 160 patients found to have hypercalcemia on a routine multiphasic examination in two different calendar years. Each case was compared to a matched control, and mean follow-up was 8.5 yr. The diagnosis of presumptive hyperparathyroidism was made by attempting to eliminate any confounding causes of hypercalcemia and by performing parathyroid hormone assays in 41 unoperated patients. Fifteen patients had a parathyroid adenoma removed (12 during and 3 after the duration of the study). Except for an increase in the incidence of hypertension in black male patients, we noted no significant differences in symptomatology or renal function between patients and matched controls. We conclude that most patients with mild persistent (presumptive) hyperparathyroidism may be left untreated under surveillance for long periods of time without the development of significant complications.
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PMID:Hypercalcemia: long-term follow-up with matched controls. 665 30

Previous studies indicated a salutary effect of a high-Ca diet on high blood pressure (BP). The mechanism, however, is obscure. With balance and clearance techniques, the role of parathyroid hormone (PTH), volume contraction, hypercalcemia, and PO4 deficiency was evaluated in female spontaneous hypertensive rats (SHR). The antihypertensive effects of a high (4.3%) Ca diet in intact animals (groups I and II) could be reproduced in both 9- and 22-wk-old chronic stable parathyroidectomized (PTX) rats (groups III and IV), when compared with a low (0.22%) or normal (1.2%) CA diet. In both short (7 days) and long (12 wk) term exposure to the high-Ca diet, evidence for volume contraction could not be documented despite hypercalcemia sustained through the 12th wk (10.8 vs. 9.7 mg/100 ml, group I control, P less than 0.02). When produced by ip injections, chronic hypercalcemia of similar magnitudes as oral Ca supplements failed to reduce BP in either intact (group VI) or PTX (group IV) rats. Rats in group IV fed the high-Ca diet displayed marked hypophosphatemia (3.2 vs. 6.9 mg/100 ml), hypophosphaturia (0.15 vs. 15 mg/day), hypermagnesiuria (11 vs. 7.7 mg/day), and drastically reduced net intestinal PO4 absorption (13.3 +/- 7.5 vs. 66.8 +/- 7.5 mg/day) compared with rats fed 1.2% Ca diet. To test the PO4-deficiency hypothesis, additional SHR (group V) were fed either 1.2% Ca diet and injected ip with NaCl or fed 4.3% Ca diet, with half of these animals injected with neutral NaPO4 and half with NaCl.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evidence for the role of PO4 deficiency in antihypertensive action of a high-Ca diet. 670 70

In 75 operatively proved cases of primary hyperparathyroidism (PH) mean systolic and diastolic blood pressure (BP) values were significantly higher pre- than postoperatively. There were 27 patients (36%) who showed hypertension before operation (systolic BP greater than or equal to 150 mm Hg, mean 169 +/- 20 mm Hg). In 20 of these the hypertension was reversible after successful treatment of PH, in seven cases elevated values persisted. The mean age of patients with persisting hypertension was significantly higher than the group with normalization of BP after operation (P less than 0.01). As far as clinical presentation of PH was concerned it were those cases with hypercalcaemic syndrome and with accidentally discovered hypercalcaemia who most often showed hypertension. In cases with recurrent urolithiasis and with osteitis fibrosa as leading symptoms there was no significant increase of hypertension as compared to the whole group. Because of the relatively high incidence of hypertension in PH this possibility should be taken into consideration in each diagnostic clarification of hypertensive patients.
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PMID:Reversible hypertension in primary hyperparathyroidism--pre- and posteroperative blood pressure in 75 cases. 674 60


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