Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0151825 (bone pain)
 3,118 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 38-yr-old woman with Crohn's disease and short bowel on home total parenteral nutrition was studied. Metabolic bone assessments were done prospectively. Daily total parenteral nutrition included 500 IU vitamin D2, 6 to 8 mmol calcium, 10 to 15 mmol phosphorus, 12 to 16 mmol magnesium, and trace elements including zinc, cooper, and chromium. After 6 months, while asymptomatic, chemistries and x-rays were normal. Calcium bone index was 0.79. The bone biopsy showed mild hyperkinetic picture. At 26 months, she had a spontaneous rib fracture and bone pains in the hands and lower back. Chemistries were normal except that calcium bone index was 0.75. Bone biopsy showed mild osteomalacia. Vitamin D2 was withdrawn for 2 months and then restarted at 1000 IU/wk. She improved symptomatically for 4 months, but then developed rib fractures, and the bone pains recurred. After 48 months, chemistries were normal, except that the calcium bone index was 0.57 and bone biopsy showed regression of osteomalacia toward normal. Vitamin D2 was now withdrawn for 6 months, resulting in loss of bone pain. Vitamin D2 may produce a metabolic bone disease, requiring prolonged withdrawal for improvement.
 ...
PMID:Metabolic bone disease in a patient on long-term total parenteral nutrition: a case report with review of literature. 644 Oct 20

Although hypercalcemia is a well-known complication of malignant diseases, hypocalcemia seems to be a rather rare one. A 34-yr-old woman with advanced breast cancer who presented hypocalcemia is described. She had generalized multiple osteolytic bone metastases which were progressive in spite of chemo-endocrine and radiation therapy. She was admitted because of severe bone pain and dyspnea caused by bilateral pleural effusion. Laboratory examination on admission showed that the serum calcium was 9.6 mg/dl, serum total protein 5.9 g/dl, serum inorganic phosphorus 4.6 mg/dl, and serum alkaline phosphatase 29.6 King-Armstrong units. The serum calcium gradually fell to 7.0 mg/dl on the 45th hospital day when the serum total protein was 6.8 g/dl and she complained of paresthesia in the extremities. On the 58th day, severe tachycardia and hypotension developed and she died of congestive heart failure on the 67th hospital day. At that time the serum calcium was 5.4 mg/dl. During her hospital course, the plasma parathyroid hormone levels were examined repeatedly and were 0.4, 0.6, 0.6 and 0.7 ng/ml (normal; less than 0.5 ng/ml). Autopsy revealed that cancer invaded the space between the thyroid and the trachea and no parathyroid glands could be found even in the mediastinum. Microscopically the parathyroid glands were replaced completely by the cancer cells. These observations indicate that metastasis of breast cancer to the parathyroid glands caused relative hypoparathyroidism, resulting in hypocalcemia. In addition, congestive heart failure which was refractory to digitalis and diuretics might have been caused by impaired contractility of the myocardium associated with hypocalcemia.
 ...
PMID:A case of advanced breast cancer associated with hypocalcemia. 688 61

Over 12 years, 49 patients with hyperparathyroidism secondary to chronic renal failure under treatment with hemodialysis were treated with total parathyroidectomy. A portion of one gland was implanted in the sternocleidomastoid muscle. The operative indications were elevation of parathormone, serum calcium, and phosphorus, levels, pruritus, bone pain, pathologic fractures, and myalgia. Special postoperative complications discussed are hyperkalemia, hemorrhage, and respiratory obstruction. There were no operative deaths. No postoperative tetany was seen. Total parathyroidectomy should be performed in chronic renal failure patients with persistent elevation of serum calcium and parathormone levels, and who have pain, fractures, or soft tissue calcification. All postoperative parathyroidectomy patients should be observed for possible hyperkalemia.
 ...
PMID:Surgical management of renal hyperparathyroidism in the dialysis patient. 708 63

Total parathyroidectomy and autotransplantation of tissue to the forearm was practiced in 50 chronic renal failure patients as treatment for secondary hyperparathyroidism. Four hyperplastic glands were removed in all cases. Followup observation ranged from 3 to 42 months. Serum parathyroid hormone, alkaline phosphatase, calcium and phosphorus levels decreased significantly following the procedure (P less than 0.005) and remained stable during the period of observation. Significant bone pain present in 26 patients improved or ceased in 19; pruritus, present in 39 patients, universally improved. Strong radiographic suggestion of secondary hyperparathyroidism, present in 38 patients, improved or disappeared in 17. Three patients remained functionally hyperparathyroid, requiring further tissue removal. Autograft function 3 to 7 days after transplantation was demonstrated in 3 cases by differential parathyroid hormone concentration determinations. Essentially all patients experienced symptomatic improvement after surgery and most showed objective evidence of improved calcium-phosphorus metabolism and bone healing.
 ...
PMID:Total parathyroidectomy and autotransplantation. 731 61

A 60-year-old woman was evaluated for bone pain and incapacitating weakness. Initial laboratory studies showed a serum calcium level of 10.1 mg/dL, severe hypophosphatemia (1.1 mg/dL), and an elevated alkaline phosphatase level. X-ray films showed changes consistent with osteomalacia. Further studies revealed hypercalciuria (448 mg/24 hr) but absent urinary phosphorus. These data indicated phosphate malabsorption. Excessive use of an aluminum hydroxide-containing antacid was the cause of this patient's failure to absorb dietary phosphate. The features of this syndrome are reviewed to increase physicians' awareness of this illness, which occurs particularly in the elderly and is easily treated.
 ...
PMID:Osteomalacia and weakness from excessive antacid ingestion. 743 92

Radiotherapy may be indicated for the management of bone metastases because of associated pain, fracture, or neurologic complications. For metastatic bone pain, simple low-dose radiation treatment is usually effective for local problems. When there are multiple sites of bone pain, external beam irradiation using wide-field hemibody techniques is highly effective. An alternative to this approach is the administration of radioisotopes that may localize to the sites of bone metastases, either because they are tumor specific (radioiodine for thyroid cancer) or bone seeking (radioactive phosphorus [32P] and strontium [89Sr]). The primary treatment of pathologic fracture is surgery where possible, but radiotherapy has a major role in postoperative treatment and in treatment of fractures that are inoperable either because of their site, such as a rib or pelvis, or because of the general poor condition of the patient. For neurologic complications such as spinal cord compression or nerve root compression, radiotherapy appears to be as beneficial as decompressive surgery in most situations, except where there is bony instability. The role of radiotherapy in the prophylactic setting is discussed. Prevention of pathologic fracture and spinal cord compression may be possible in high-risk patients.
 ...
PMID:Radiotherapy in the management of bone pain. 754 90

We investigated (1) the prevalence of aluminium overload among 96 patients with symptomatic bone disease haemodialysed from 1987 to 1989 in the Sao Paulo area, Brazil; (2) the effect of 6 months desferrioxamine (DFO) treatment (1-2g/week). All patients underwent a first bone biopsy. Aluminium overload (extent of stainable bone aluminium more than 20% trabecular surface) was observed in 74 of 96 patients. Forty overloaded patients were divided into patients with high bone formation rate (BFR) (group 1; n = 17) and patients with low BFR (group 2; n = 23), and had a second biopsy after DFO therapy. In both groups aluminium surface was reduced after treatment (P < 0.001), osteoblast surface (P < 0.02-P < 0.01) and plasma parathyroid hormone (iPTH) (P < 0.01) increased. In group 1 BFR remained high. In group 2 BFR remained low in 16 patients (2a) and increased in seven (P < 0.02) (2b). In group 2a plasma phosphorus was below that in group 2b patients, before (P < 0.03) and after (P < 0.01) DFO. The histological features of group 2a patients resembled hypophosphataemic osteomalacia, those of group 2b patients aluminium osteodystrophy. These data show a high prevalence of aluminium overload in Brazilian patients. Low-dose DFO therapy was safe, decreased bone pain, prevented fractures, and reduced stainable bone aluminium. Bone lesions only partially improved, suggesting that low phosphorus intake and/or plasma calcitriol concentrations may have prevented improvement of bone formation and mineralization.
 ...
PMID:Aluminium-related osteodystrophy and desferrioxamine treatment: role of phosphorus. 797 94

Numerous osteometabolic factors are implicated in the bone mass loss which occurs with ageing. Among these a significant role is played by the impairment of intestinal calcium absorption which may be attributed in the elderly to various factors such as the reduction of chlorhydro-peptic secretion, the correlated deficiency of vitamin D and their relative duodenal receptors. In order to evaluate the clinical efficacy of an arginine-lysine-lactose preparation a group of 40 subjects with senile involutional osteoporosis was studied. The subjects were divided into two groups using random criteria and were treated with carbocalcitonin alone (40 UMRC day i.m. on alternative days) or carbocalcitonin association complex. The following parameters were evaluated in basal conditions and after six months of treatment: bone mass density (BMD) using computerised bone mineralometry, bone pain, intake of analgesics, serum levels of calcium, phosphorus, alkaline phosphatase, osteocalcin, parathormone, as well as calciuria and hydroxyprolinuria. The comparison between the two groups shows a more marked increment in BMD in subjects treated with arginine-lysine-lactose, a greater reduction in painful symptoms, and a more evident and significant reduction of parathormone and hydroxyprolinuria levels. These effects appear to be due to a distinct improvement in intestinal calcium absorption mediated by lysine and lactose, and probably to a positive action played by the amino acid at the level of support structures.
 ...
PMID:[The effects of the carbocalcitonin + arginine-lysine-lactose combination in senile involutional osteoporosis]. 802 55

During the last two decades, the clinical presentation of primary hyperparathyroidism (PHP) has changed due to the routine use of multiphasic biochemical screening tests. We assessed 84 patients with PHP treated in our service between 1977 and 1991. The yearly incidence increased from 1.6 to 7.6 patients/year with the introduction of multiphasic biochemical testing in our hospital in 1982; likewise the proportion of asymptomatic patients increased from 12.5 to 40.7%. The most frequent presenting symptoms were bone pain and renal colic. Nineteen percent of patients were over 70 years old and this age group had distinct clinical features. The plasma chlorine/phosphorus ratio was abnormal in 95% of cases; on the contrary only 7 of 18 patients had a urinary calcium excretion over 300 mg/day. Cervical ultrasound, performed in 45 patients had a positive predictive value of 78% to localize the lesion. Bone density was below fracture threshold in 50% of studied patients. The principal surgical finding was the presence of adenoma. Twenty one percent of patients had symptomatic hypocalcemia during the first week after surgery; however, only 2.5% of patients continued to have hypocalcemia one month after surgery. One patient had an inferior laryngeal nerve damage and two a cervical hematoma. It is concluded that the introduction of massive calcium measurements has allowed an early diagnosis of asymptomatic PHP, specially in elderly people.
 ...
PMID:[Changes in the clinical presentation of primary hyperparathyroidism. Analysis of 84 cases]. 824 38

We evaluated the course of severe aluminum-related bone disease (ARBD) after the first year of a successful renal transplantation (RTx) in 11 adult patients. Bone pain and muscle weakness, presented in all patients previously to RTx, subsided, and all were able to walk, even the ones who were confined to wheelchairs. Bone necrosis developed in 6 patients, but none required surgical repair. Serum alkaline phosphatase activity increased 2.5 times the upper normal level, up to the 5th month and then declined to normal levels up the 12th month (p < 0.05). The inverse profile was observed in both serum calcium and phosphorus levels. In bone biopsies, there was a significant decrease in all of the following histomorphometric static parameters: osteoid volume, thickness and surface and also in aluminum surface. Also, there was a significant increase in all the dynamic parameters of mineralization: mineral apposition rate, mineralization surface, bone formation rate and adjusted apposition rate. In conclusion, ARBD remarkably improves after 1 year of successful RTx.
 ...
PMID:Reversal of aluminum-related bone disease after renal transplantation. 832 36


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>