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)

Although patients with primary hyperparathyroidism (1 degree HPT) were euthyroid, we measured serum thyroid hormone levels in 16 patients with 1 degree HPT together with 17 patients with hypercalcemia due to malignant diseases (HCM). In patients with 1 degree HPT, serum levels of T3, T4 and T3U were within normal range, but serum rT3 (reverse T3) levels (205 +/- 37 pg/ml, mean +/- SD) were significantly decreased as compared with those in normal controls (276 +/- 44 pg/ml, P less than 0.01). A significant inverse correlation was observed between the serum levels of rT3 and parathyroid hormone (PTH) (r = 0.54, P less than 0.05). After parathyroidectomy, serum rT3 levels were significantly elevated (240 +/- 56 pg/ml) compared to preoperative levels (P less than 0.01). Low levels of serum rT3 seemed to be attributed to the high levels of serum PTH. On the other hand, serum levels of T3 and T4 were low and serum rT3 levels were high in patients with HCM. Low serum rT3 allows for the differentiation of patients with 1 degree HPT from those with HCM.
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PMID:Low serum reverse T3 levels in patients with primary hyperparathyroidism. 362 22

An acute increase in serum calcium stimulates calcitonin (CT) secretion, but the effects of chronic hypercalcemia are controversial. Histopathological studies have shown C-cell hyperplasia in primary hyperparathyroidism (1 degree HPT), although circulating levels of CT have been variously reported to be normal, elevated, or depressed. We reexamined this relationship using CT RIA in conjunction with a silica extraction technique that conveys improved sensitivity and specificity for monomeric CT. Nine men and seven women with surgically documented 1 degree HPT were studied preoperatively before and after a short calcium infusion (2 mg Ca/kg, for 5 min), as were 72 normal men and 76 normal women. Basal whole plasma immunoreactive CT and silica-extractable CT concentrations in 1 degree HPT were indistinguishable from normal, regardless of sex. In addition, the whole plasma and silica-extractable CT responses to calcium stimulation were normal or blunted in patients with 1 degree HPT. We conclude that hypercalcemia resulting from 1 degree HPT is not associated with augmented CT secretion in response to an iv calcium infusion.
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PMID:Plasma calcitonin in primary hyperparathyroidism: failure of C-cell response to sustained hypercalcemia. 373 44

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

After confirming hypercalcemia by 3 successive measurements of the total plasma calcium corrected for a plasma protein concentration of 72 g/l, which excludes spurious hypercalcemia due to dehydration, the physician orientates the aetiological diagnosis bearing in mind that primary hyperparathyroidism PHPT is the cause of 85 p. 100 of all asymptomatic forms of hypercalcaemia whilst overt or occult malignancy is the main cause (60 p. 100) of symptomatic forms of hypercalcaemia with PHPT responsible for 20 p. 100 of cases. Other causes, including drug toxicity with Vit D, calcium, Vit A, lithium, thiazide and aluminium hydroxide, sarcoidosis, hyperthyroidism, Addison's disease, pheochromocytoma and familial endocrine disorders are much rarer. Nevertheless, these rarer causes must be excluded on the clinical history and examination followed by radiological (chest X ray, plain abdomen X ray, bone X rays) and simple biological tests. The latter and/or scans tests should also help in a rapid diagnosis of metastatic carcinoma and multiple myeloma, so that the major diagnostic problem is to distinguish primary HPT from occult malignancy. This problem is greatly facilitated by reliable assays of C terminal or medium PTH rather than renal CAMP which is increased in 80 p. 100 of occult malignancies. When PTH assays is unavailable or unreliable Dent's hydrocortisone suppression test may be useful as a fall in'serum calcium is associated with occult malignancy in 70 p. 100 of cases and non-suppression is associated with PHPT in 91 p. 100 of cases. Discriminant analysis of the usual biochemical parameters may be helpful in this differential diagnosis and is accurate in about 90 p. 100 of cases. However, the association of PHPT and malignancy is also possible and not fortuitous.
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PMID:[Stages of the etiological diagnosis of hypercalcemia]. 389 Jun 61

The use of C-terminal parathyroid (C-PTH) assays, performed at a commercial laboratory, was evaluated for one year at Charity Hospital, New Orleans. Of 72 patients, the most frequent diagnosis was primary hyperparathyroidism (1 degree HPT) (n = 17, 24 percent), followed by malignancy (n = 15, 21 percent), chronic renal disease (n = 10, 14 percent), and thiazide diuretics (n = 5, 7 percent). In the 1 degree HPT group, all were hypercalcemic (mean serum calcium, 11.6 ml per dL) and had elevated C-PTH. Patients with malignancy had higher mean serum calcium levels than patients with 1 degree HPT. Three patients with malignancy had elevated C-PTH; two had suspected coexisting 1 degree HPT and neoplasm; and one had suspected pseudohyperparathyroidism. Patients with chronic renal disease undergoing dialysis treatment had the highest C-PTH recorded (all had elevated C-PTH) but only 50 percent were hypocalcemic. Three of the five patients on thiazide diuretics had increased C-PTH, indicating that the withdrawal of this drug may unmask underlying hyperparathyroidism. Appropriate reasons for ordering C-PTH include evaluation of hypercalcemia (n = 32, 44 percent) or hypocalcemia (n = 12, 17 percent); indicated clinical reasons not included in the hyper- or hypocalcemic groups, including chronic renal disease in patients undergoing dialysis or transplant (n = 5, 7 percent); in suspected 1 degree HPT, (n = 5, 7 percent); and in patients with renal stones (n = 2, 3 percent) or on thiazide diuretics (n = 2, 3 percent). Based on laboratory and clinical criteria, C-PTH assay was appropriately used in 81 percent of the patients surveyed (58/72).
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PMID:Use of C-terminal parathyroid assays in a large metropolitan hospital. 397 May 18

In order to obtain a good separation line between patients with primary hyperparathyroidism (1 degree HPT) and those with non-parathyroidal hypercalcemia (NPHC), serum chloride (Cl) and phosphate (P) concentrations were analyzed. Ninety-nine per cent of the patients with 1 degree HPT had a Cl/P ratio greater than or equal to 33, but 29% of patients with NPHC were also included in this range. When the (Cl-90)/P ratio was used to separate into two groups, 98% of the patients with 1 degree HPT had a ratio greater than or equal to 5.0, and 94% of the patients with NPHC had a ratio less than 5.0. From these results, while high sensitivity was achieved both with the Cl/P and (Cl-90)/P ratios, the (Cl-90)/P ratio provided higher specificity. Therefore we conclude that the (Cl-90)/P ratio was excellent in distinguishing 1 degree HPT from other types of hypercalcemia.
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PMID:Clinical usefulness of the (chloride-90)/phosphate ratio for distinguishing primary hyperparathyroidism from hypercalcemia due to other causes. 404 94

FBH is characterized by symptomless hypercalcemia, low urinary calcium excretion, normal iPTH values, generally normal parathyroid histology, and failure of subtotal parathyroidectomy is normalize serum calcium. We studies six patients with FBH from three kindreds, six patients with sporadic 1 omicron HPT, and six healthy volunteers. To characterize the renal response to PTH, 14 of the subjects had infusions of bovine PTE (300 U intravenously over 15 min) and, separately, stimulation of endogenous PTH release by infusion of disodium EDTA (50 mg/kg over 2 hr). PTE induced striking increases of UcAMP (nM/100 ml of GF) that were indistinguishable between controls and subjects having FBH. However, the rise of UcAMP in 1 omicron HPT was significantly reduced (p < 0.001) compared to controls or the FBH group. EDTA-induced hypocalcemia raised serum iPTH and UcAMP in all three groups; the increases of iPTH (two assays of differing specificity) were greatest in 1 omicron HPT and least in FBH. In contrast, increases of UcAMP were greatest in FBH and 1 omicron HPT and indistinguishable from one another. The increase of UcAMP considered as a function of the increase in PTH showed significantly greater UcAMP responses in FBH than in the other groups. These results are consistent with primary or secondary alterations of renal responsiveness to PTH in both FBH and 1 omicron HPT, which may in part explain the different renal tubular calcium handling in the two conditions.
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PMID:Urinary cyclic 3',5'-adenosine monophosphate responses to exogenous and endogenous parathyroid hormone in familial benign hypercalcemia and primary hyperparathyroidism. 625 80

Clinical and biochemical evidence of primary hyperparathyroidism (prim. HPT) is reported in an infant with hypotonia, feeding problems and constipation from birth. Following a partial parathyroidectomy at the age of 12 months, the clinical condition improved. In her sister, mother and three other maternal relatives a familial hypocalciuric hypercalcemia (FHH) was subsequently demonstrated. All were clinically healthy in spite of increased total and ionized serum calcium, normal serum parathyroid hormone concentration, low urinary calcium excretion and normal renal excretion of cyclic AMP. Similar findings appeared in our patient after parathyroidectomy. An autosomal dominant inheritance of FHH is suggested. It is thus demonstrated, that a mother with FHH may give birth to healthy children with FHH as well as to infants with prim. HPT associated with FHH.
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PMID:Primary hyperparathyroidism in infancy associated with familial hypocalciuric hypercalcemia. 631 30

To evaluate the effect of parathyroid hormone (PTH) on diastolic function, left ventricular (LV) diastolic filling dynamics were studied using pulsed Doppler echocardiography in patients with untreated primary hyperparathyroidism (HPT; mean age 59 years) and control subjects. In patients with primary HPT, the ratio of peak flow velocity of atrial filling wave to peak flow velocity of early filling wave (A/E) was studied immediately before and 1 month after parathyroidectomy (PTX). A/E is significantly higher in the patients with primary HPT than in the control subjects. A/E decreased significantly after PTX. A/E was strongly correlated with PTH levels, but not with calcium levels in patients with primary HPT. It is concluded that LV diastolic function is abnormal in patients with primary HPT, which could result from elevated PTH rather than hypercalcemia.
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PMID:Effect of parathyroid hormone on left ventricular diastolic function in patients with primary hyperparathyroidism. 756 64

Hypercalcemia accompanying with the elevation of parathyroid hormone (PTH) is critical for the differentiation of primary hyperparathyroidism (I HPT) from other diseases which show hypercalcemia. Recently, the reliable immunoassays for PTH especially for intact-PTH have been established and widely introduced in the clinical field. Marked development of cellular and molecular biology also contribute to the exploration of the mechanism of calcium/bone metabolism. The diagnosis of I HPT can be easily established in some patients by their typical clinical findings. Many of them, however, usually show asymptomatic hypercalcemia while some patients show normocalcemia. It is highly important to evaluate the parathyroid function precisely by several biochemical or hormonal parameters related to calcium metabolism for complete diagnosis and treatment.
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PMID:[Hypercalcemia is the most common manifestation of hyperparathyroidism]. 775 74


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