Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight cases of primary hyperparathyroidism (P-HPT) confirmed pathohistologically, between April, 1974 and January, 1986 at our department, were reviewed. The patients consisted of three males and five females, ranging in age from 38 to 62 years old with an average of 50.3 years. All the cases belonged to the urolithiasis type and seven patients were recurrent or/and multiple stone-formers. Positive rates of the laboratory values studied in relation with P-HPT were 100% in serum Ca, C terminal parathyroid hormone, and % TRP, 87.5% in urine Ca, 75% in serum Cl/P ratio, alkaliphosphatase, 50% in serum Cl, 37.5% in serum P and 0% in urine P. Seven cases had clinically apparent hypercalcemia, while one was a so-called borderline P-HPT with intermittent hypercalcemia. The correct diagnosis of the localization was obtained preoperatively in two cases by angiography and one by C.T and Tl-Tc subtraction scintigraphy. Histological findings of the tumors extirpated by the cervical operation were parathyroid adenomas in six cases and hyperplasia in two. During the course of the postoperative follow up, hypercalcemia and urolithiasis did not recur in any case including two of hyperplasia.
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PMID:[A clinical study of primary hyperparathyroidism]. 378 32

A 34-year-old man with adult-onset Still's disease developed a striking hypercalcaemia during a rapidly destructive polyarthritis with extensive osteoporosis. The hypercalcaemia seemed to be primarily caused by inflammation-induced bone resorption. On prednisone the polyarthritis went into remission and the plasma calcium levels became normal. Other remarkable features in this case were a subluxation of the atlantoaxial joint, a brain-stem haemorrhage, transient hyperuricaemia and hyperuricosuria, and urolithiasis.
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PMID:Adult-onset Still's disease complicated by hypercalcaemia: possible relationship with rapidly destructive polyarthritis. 400 64

Hypercalcemia, hypercalciuria, and hyperphosphatemia are common findings in acromegaly, yet there are only a few reports on the occurrence of urinary stones in these patients. We reviewed the files of 64 patients with acromegaly. A total of 8 patients had evidence of renal calculi: 4 patients underwent nephrolithotomy, 3 had stones which were seen on intravenous pyelography, and 1 patient voided a stone. Moreover, 2 other patients suffered from recurrent typical episodes of renal colic. In view of the high incidence of urolithiasis in our series we believe that more attention should be paid to detection of urinary stones in acromegalics to avoid further complications and suffering.
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PMID:Urolithiasis in acromegaly. 403 39

Due to a hypercalcaemia and changeably appearing hypercalciuria 13 patients with relapsing urolithiasis were under suspicion of a primary hyperparathyroidism. After selective sounding and withdrawal of blood from the cervical veins in all cases the determination of parathormones was performed and always an increased activity of parathormones was found. The exploration of the cervical region carried out could in 11 performed operations in 8 cases prove an adenoma and in 3 cases a hyperplasia as cause of hyperparathyroidism. A localization of the suspected adenoma was in 5 cases possible in combination with the angiography of the thyroid gland. By equally high activity in 3 cases no clear evidence was possible. An improvement of the diagnostics of localization might be achieved by supraselective sounding of the veins. On principle the authors recommend to perform a selective determination of parathormones before operation, which in case of need is to be supplemented by a selective angiography of the thyroid gland.
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PMID:[Diagnosis of primary hyperparathyroidism by selective determination of parathyroid hormones]. 403 77

Patients with recurrent non-infectious calcium urolithiasis were classified metabolically (122 patients). When the magnesium excretion was measured in the metabolic subgroups, a subset of patients (21.6%) could be identified with marked hypomagnesuria as the only metabolic abnormality. A significantly reduced rate of magnesium excretion was found in these normocalciuric stone formers while assessing the overall 24-h urine magnesium excretion or the 24-h urine and fasting urine magnesium to calcium ratio. These differences were apparently not due to factors that might modify renal magnesium excretion, such as parathyroid function, hypercalcemia, hypophosphatemia, alimentary sodium load, age and sex.
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PMID:[Magnesium excretion in recurrent calcium urolithiasis]. 406 Mar 80

Using the ambulatory protocol previously described, 241 patients with nephrolithiasis were evaluated. They could be categorized into 10 groups from the results obtained. Absorptive hypercalciuria type I (87 per cent male) comprised 24.5 per cent and was characterized by normocalcemia, normal fasting urinary calcium (less than 0.11 mg/100 ml glomerular filtration), an exaggerated urinary calcium following an oral calcium load (greater than 0.20 mg/mg creatinine), normal urinary cyclic adenosine monophosphate (AMP) (less than 5.4 nmol/100 ml glomerular filtration) and serum parathyroid hormone (PTH), and hypercalciuria (greater than 200 mg/day during a calcium- and sodium-restricted diet). Absorptive hypercalciuria type II (50 per cent male) accounted for 29.8 per cent; its biochemical features were the same as those for absorptive hypercalciuria type I, except for normocalciuria during a restricted diet and low urine volume (1.42 +/- 0.55 SD liter/day). Renal hypercalciuria (56 per cent male), disclosed in 8.3 per cent, was represented by normocalcemia and high values for fasting urinary calcium (0.160 +/- 0.054 mg/100 ml glomerular filtration), urinary cyclic AMP (6.80 +/- 2.10 nmol/100 ml glomerular filtration) and serum PTH. Primary hyperparathyroidism (57 per cent female), accounted for 5.8 per cent, typically included hypercalcemia, hypophosphatemia, hypercalciuria and high urinary cyclic AMP. Hyperuricosuric calcium urolithiasis (100 per cent male) comprised 8.7 per cent, and was characterized by hyperuricosuria (776 +/- 164 mg/day) and urinary pH exceeding pK for uric acid (5.91 +/- 0.33). In enteric hyperoxaluria (60 per cent female), encountered in 2.1 per cent of cases, urinary oxalate was increased (6.29 +/- 13.2 mg/day). Noncalcium-containing stones were found in 2.1 per cent of the patients with uric acid lithiasis (100 per cent male) and in another 2.1 per cent of the patients with infection lithiasis (60 per cent female). These conditions were typified by low urinary pH (5.29 +/- 0.12) and high urinary pH (6.69 +/- 1.16), respectively. Renal tubular acidosis was found in one patient (male, 0.4 per cent). In 10.8 per cent of the patients (81 per cent male), no metabolic abnormality could be found, although urine volume was low (1.41 +/- 0.51 liter/day). Hypercalciuria could not be differentiated between absorptive hypercalciuria and renal hypercalciuria in 5.4 per cent of the patients. Thus, this ambulatory protocol disclosed a physiologic disturbance in nearly 90 per cent of the cases and provided a definitive diagnosis in 95 per cent of the patients.
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PMID:Ambulatory evaluation of nephrolithiasis. Classification, clinical presentation and diagnostic criteria. 624 14

A 21-year-old man with a history of recurrent urolithiasis was admitted. Hypercalcemia was found and a diagnosis of primary hyperparathyroidism was made. Neck exploration was performed without success. Localization studies were done. Repeated selective arteriography revealed a mediastinal parathyroid adenoma. CT scan as well showed the adenoma in the anterior mediastinum. Ultrasonotomography, 201Tl-chloride and 131I scintigraphy with subtraction image and two venous samplings were negative. Mediastinal exploration with partial sternotomy was performed and a parathyroid adenoma was subsequently removed. Serum calcium and phosphorous levels were normalized, several postoperative days.
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PMID:[A case of mediastinal parathyroid adenoma with primary hyperparathyroidism]. 673 Nov 97

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

In a retrospective study of 120 patients with surgically proved primary hyperparathyroidism, 71 patients who were normotensive and 49 patients (41 percent) who were either hypertensive at the time of parathyroidectomy or had a history of hypertension were compared. The mean serum calcium levels in the normotensive and hypertensive patients were very similar (11.6 +/- 0.1 [SEM] mg/dl, and 11.8 +/- 0.1), ruling against the hypothesis that hypercalcemia per se is the dominant cause of the hypertension of hyperparathyroidism. The mean serum creatinine levels in the two groups were also very similar (1.02 +/- 0.05 and 1.09 +/- 0.05 mg/dl), indicating that the hypertension of hyperparathyroidism is not the consequence of advanced renal parenchymal damage. The hypertensive patients did not have a significantly higher prevalence of urolithiasis. A review of the data in this and related studies leads to the conclusion that the hypertension of hyperparathyroidism is heterogeneous in origin. The mean serum phosphate level in the hypertensive patients was significantly lower than that in the normotensive patients (2.20 +/- 0.06 mg/dl versus 2.69 +/- 0.09 mg/dl, p less than 0.02), which may be due to a decrease in renal tubular phosphate reabsorption secondary to hypertension.
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PMID:Hypertension and hyperparathyroidism. Inverse relation of serum phosphate level and blood pressure. 685 80

Serum immunoreactive PTH (iPTH) was measured in 74 patients with urolithiasis and correlated to the corresponding serum calcium values. Serum iPTH was measured using a rooster antibovine iPTH antiserum which crossreacted with the human hormone within the 44-68 amino acid residue region. Sixty-six of these patients had normal serum iPTH and calcium concentrations. Their calcium values varied from 2.2 mmol/l to 2.6 mmol/l and their serum iPTH concentrations were less than 0.6 micrograms/l. The remaining 8 patients with urolithiasis were judged to have primary hyperparathyroidism because of an abnormal iPTH/calcium relationship. These patients had serum calcium concentrations varying from 2.6 mmol/l to 3.4 mmol/l and iPTH concentrations between 0.35 micrograms/l and 3.03 micrograms/l. The diagnosis was verified histologically in 7 patients after operation. In the last patient iPTH was reduced from 1.01 micrograms/l to 0.21 micrograms/l after surgery, and serum calcium changed from 2.6 mmol/l to 2.2 mmol/l. The combined evaluation of serum iPTH and calcium may improve the diagnosis for hyperparathyroidism and was in our series helpful in making a correct diagnosis in 2 out of 7 patients who had histologically verified disease. In addition, iPTH measurements are valuable to rule out hyperparathyroidism as the cause of hypercalcaemia.
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PMID:Diagnosis of hyperparathyroidism in patients with urolithiasis using measurement of serum immunoreactive parathyroid hormone and serum calcium. 686 14


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