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

Autonomous hyperparathyroidism occurred in 15% of 152 patients maintained by long-term home dialysis during the past nine years. Twenty-two patients with elevated serum parathormone levels and progressive bone disease in the presence of normal serum phosphate and calcium levels were treated by subtotal parathyroidectomy. All had parathyroid hyperplasia. Eighteen of the 22 patients are presently alive and undergo dialysis. Symptoms of bone pain, pruritus, and muscle cramps had improved in three fourths of the patients. The serum parathormone level decreased from a preoperative average of 576 muLEq/mL to an average of 188 muLEq/mL postoperatively. All 18 patients, observed for six to 77 months, showed improvement in x-ray films of their bone disease. The autonomous hyperparathyroidism of end-stage renal disease is corrected by subtotal parathyroidectomy, and the effect is sustained.
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PMID:Results of parathyroidectomy for autonomous hyperparathyroidism. 47 37

The incidence and severity of osteopenic bone disease in primary sclerosing cholangitis is poorly defined. Clinical, biochemical and radiographic assessment and bone mineral density measurements of the lumbar spine were carried out in two groups of patients. Group 1 consisted of 30 patients with advanced primary sclerosing cholangitis; group 2 consisted of 18 patients with newly diagnosed primary sclerosing cholangitis. Only one patient had bone pain. All patients were normocalcemic; two had elevated serum parathormone levels. Fourteen patients (47%) from group 1 but no patients from group 2 had low serum 25-hydroxyvitamin D levels. Mean bone mineral density was significantly reduced in group 1 patients (0.97 +/- 0.04 gm/cm2) compared with age-matched and sex-matched controls (1.25 +/- 0.01 gm/cm2, p less than 0.0001), and in 15 patients (50%) bone mineral density was below the fracture threshold (0.98 gm/cm2). The bone mineral density in group 2 was not significantly different from controls, and no patient was below the fracture threshold. In neither group did bone mineral density correlate with serum bilirubin, 25-hydroxyvitamin D, fecal fat excretion, previous drug therapy or the presence of chronic ulcerative colitis. Histomorphometrical examination of bone from four group 1 patients showed increased bone resorption, reduced bone formation, moderate-to-severe osteopenia and no osteomalacia. In conclusion, severe osteopenic bone disease is common in advanced primary sclerosing cholangitis and, like that seen in other cholestatis diseases, is consistent with osteoporosis.
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PMID:The metabolic bone disease of primary sclerosing cholangitis. 186 Jun 83

Since Schmid (115) and Kruse (74) reported on osteopathies occurring after antiepileptic treatment in children, there have been numerous publications concerning the influence of antiepileptics on mineral metabolism in the bones. The investigators' results range from slight anomalies of the plasma levels of calcium, phosphate, alkaline phosphatase, parathormone and 25-hydroxycholecalciferol to severe bone alterations. In the majority of cases, the severe pictures occurred in retarded, neurologically abnormal, institutionalised children who were treated with a high-dose combination of several antiepileptics for epilepsy which was difficult to treat. The first case reports from adults were published by Dent et al. (26). These patients had also been treated since their early youth with an antiepileptic combination. They displayed fractures and suffered from bone pain and muscular weakness. The good response of the rachitic bone alterations to vitamin D treatment both in children and in adults indicated vitamin D deficiency. These reports prompted systematic investigations on the influence of antiepileptics on bone metabolism in numerous hospitals and outpatient departments. According to the available literature, it can be stated that antiepileptic therapy can lead to shifts in calcium and phosphate metabolism and to a raised activity of serum alkaline phosphatase. In studies comprising control groups, the patient treated with anticonvulsants more frequently displayed variations of clinical laboratory parameters. The frequent observation of vitamin D hypovitaminosis led to the assumption that alterations in vitamin D metabolism by enzyme induction are the cause of the disorders in calcium and vitamin D metabolism. This hypothesis was frequently contradicted in recent years after hypocalcaemia and alterations in the mineral content of the bone after antiepileptic therapy had been reported irrespective of the vitamin D level. Besides a restricted intestinal calcium absorption, an influence of antiepileptics on the hormones regulating calcium and phosphate metabolism was found. Thus, a multifactorial genesis of the disorders in bone mineral balance must be assumed. The fact that the vast majority of outpatients with long-term anticonvulsant therapy do not display any disorders of bone metabolism indicate that there are individually different compensation capabilities (possibly of genetic origin). According to the literature, the probability that adults will develop osteomalacia under antiepileptic therapy is associated with the joint presence of various risk factors.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Osteopathia antiepileptica in adolescents and adults]. 306 13

High-resolution sonography of the neck was performed in 207 patients undergoing renal dialysis to determine the usefulness of sonography in the evaluation of secondary hyperparathyroidism. The sonograms in 62 (30%) of the patients showed enlarged parathyroid glands, with an average of 2.3 glands per patient. Both the number and size of enlarged glands were increased in patients who had been receiving dialysis treatment for more than 6 years. Of the patients who had enlarged parathyroid glands on sonography, only 61% had bone pain, and only 63% had evidence of hyperparathyroidism on bone radiographs. Serum levels of amino-terminal parathormone were within normal limits in 26% of these patients. In 14 patients who underwent total parathyroidectomy, the accuracy of sonography for the detection of enlarged parathyroid glands was 77% (40/52 lesions). Sonography is a valuable technique for the detection of enlarged parathyroid glands in patients with secondary hyperparathyroidism associated with renal dialysis.
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PMID:Sonography for early diagnosis of enlarged parathyroid glands in patients with secondary hyperparathyroidism. 355 24

This study was undertaken to determine the success of surgical treatment of advanced secondary (renal) hyperparathyroidism. From 1978 to 1985, total parathyroidectomy and autotransplantation (TPA) were performed for secondary hyperparathyroidism in 23 patients who had had dialysis for a mean of 6.5 years preoperatively. Indications for surgery included hypercalcemia, bone pain and pathologic fractures, metastatic calcification, and pruritus. Four glands were found and removed in all patients; 100-150 mg of diced tissue were autotransplanted to one forearm. Two patients died of myocardial infarction in the first postoperative week. Bone pain, present in 19 of 23 patients, was relieved almost immediately postoperatively and relief was sustained to death (of unrelated causes) or most recent follow-up in 13 patients. All fractures healed. All patients had markedly elevated serum parathormone (PTH) preoperatively and 14 of 23 were hypercalcemic. The group mean values of serum calcium, alkaline phosphatase, and PTH all fell to and remained in a normal range by 1 year postoperatively in that subset of patients who did not suffer recurrence. Six patients were reoperated on after 12 to 37 months with partial graft excision for recurrent bone pain and hypercalcemia. Bone pain in two of these patients was due to aluminum-associated bone disease and the diagnosis of recurrent secondary hyperparathyroidism was erroneous. The actual recurrence rate was thus 19 per cent. Consistent technical success, with no late hypocalcemia, was achieved and most patients were restored to medical manageability.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A community hospital experience with total parathyroidectomy and autotransplantation for renal hyperparathyroidism. 368 58

Radioactive phosphorus effected substantial palliation of intractable bone pain in 17 of 33 (51.5%) women with metastatic carcinoma of the breast and in 14 of 15 (93.3%) men with metastatic carcinoma of the prostate. No significant difference in the overall response rate was found between androgen and parathormone priming prior to radiophosphorus therapy. The degree of response was not dependent on total dose of 32P within the range of 9--18 mCi (333--666 MBq). Myelosuppression was a transient complication in 9 of 33 patients with metastatic breast carcinoma and in 7 of 15 patients with metastatic prostate carcinoma. Symptomatic hypercalcemia was an infrequent complication of radiophosphorus therapy irrespective of the priming regimen.
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PMID:Evaluation of radioactive phosphorus in the palliation of metastatic bone lesions from carcinoma of the breast and prostate. 615 29

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.
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PMID:Surgical management of renal hyperparathyroidism in the dialysis patient. 708 63

1 alpha-hydroxycholecalciferol [1 alpha (OH)D3], the synthetic analogue of 1,25-dihydroxycholecalciferol, the active metabolite of vitamin D, was administered for a period of 18 to 24 mo to an unselected group of 12 hemodialysis patients and to 2 patients after kidney transplantation. All patients responded with a significant rise in serum Ca and Mg. The whole-body 47Ca retention, used as an index of Ca absorption, rose in eight patients and decreased or remained unchanged in four, but its overall change was not significant. Serum immunoreactive parathormone showed a general tendency to decrease. From the clinical point of view, symptomatic relief of bone pain was seen in most dialysis patients, but no significant change occurred in transplant patients. The main side effects of 1 alpha (OH)D3 treatment were hypercalcemia and pruritus, which generally subsided after the dosage was tapered off.
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PMID:Long-term effects of 1 alpha-hydroxycholecalciferol therapy in chronic hemodialysis patients. 717 69

Sixty-one patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autograft. Symptoms relieved by parathyroidectomy included bone pain, pruritus, soft tissue calcification, muscle weakness and healing of fractures. Serum parathormone levels measured before and after operation in 48 patients returned to normal in all but two patients. Serum alkaline phosphatase levels also returned toward normal after operation, except in one patient with a retained parathyroid gland. Complete radiographic studies before and after operation were available in 30 of 61 patients. Twenty-three of 24 patients with osteitis fibrosa had evidence of healing, and in one patient no change occurred. Osteosclerosis noticed in 23 patients improved slightly in eight patients, did not change in 14 and became worse in one. Pathologic examinations revealed 45 patients to have diffuse hyperplasia and 16 nodular hyperplasia. There were two early postoperative deaths, in the first 30 days, and 16 late postoperative deaths, from four months to four years afterward. In no case did the operation contribute to death. Some patients required the administration of supplemental calcium after operation, but in no instance did profound hypocalcemia occur. No patient developed recurrent hyperparathyroidism.
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PMID:Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft. 724 22

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.
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PMID:[The effects of the carbocalcitonin + arginine-lysine-lactose combination in senile involutional osteoporosis]. 802 55


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