Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have developed a sensitive, specific solid-phase immunoradiometric assay (IRMA) of parathyroid hormone-related protein (PTH-RP) with use of affinity-purified polyclonal immunoglobulins. Antibodies recognizing PTH-RP(37-74) are immobilized to a polystyrene bead to "capture" analytes from the sample; antibodies to epitopes within the 1-36 amino acid region of PTH-RP are labeled with 125I. This IRMA recognizes PTH-RP(1-74) and PTH-RP(1-86) equivalently, but does not detect N-terminal or C-terminal fragments of PTH-RP, intact human parathyrin (PTH), or fragments of PTH. PTH-RP is not stable in plasma at 3-5 degrees C or room temperature, but a mixture of aprotinin (500 kallikrein units/L) and leupeptin (2.5 mg/L) improves PTH-RP stability in blood samples. In plasma collected in the presence of these protease inhibitors from normal volunteers and patients with various disorders of calcium metabolism, PTH-RP concentrations were above normal (greater than 1.5 pmol/L) in 91% (42 of 46) of patients with hypercalcemia associated with nonhematological malignancy. In plasma from patients with other hypercalcemic conditions (e.g., primary hyperparathyroidism, sarcoidosis, and vitamin D excess), PTH-RP was undetectable. Above-normal concentrations of PTH-RP and total calcium decreased to normal in a patient with an ovarian cyst adenocarcinoma after surgical removal of the tumor. We conclude that PTH-RP is related to and probably the causative agent of hypercalcemia in most patients with cancer, and that measurements of PTH-RP are useful in the diagnosis and management of patients with tumor-associated hypercalcemia.
 ...
PMID:Modified immunoradiometric assay of parathyroid hormone-related protein: clinical application in the differential diagnosis of hypercalcemia. 154 Sep 98

Parathyroid carcinoma is a rare tumor responsible for 0.5-5% of primary hyperparathyroidism. It is usually small (not more than 27 g) and the precise diagnosis of malignancy is made when local or distant metastases are found. We describe a case of a 37 yr old male presenting with a substernal goiter and no specific symptoms except hypertension. This mass had cysts and calcifications and it was in the anterior upper mediastinum. The patient had severe hypercalcemia (Ca greater than 14 mg/dl), high PTH levels and mild renal failure. Bone scanning showed signs of hyperparathyroidism. The patient was subjected to total thyroidectomy and removal of the mass en block. The tumor was circumscribed lobulated and mostly cystic. It weighed 1,200 g (380 g after evacuation of cysts) and measured 12 x 9 x 4.5 cm. Histologic examination showed a highly differentiated adenocarcinoma of parathyroid with metastasis in a regional lymph node. Almost 4 years later the patient is alive and well without hypercalcemia and without evidence of distant metastases.
 ...
PMID:Large parathyroid functioning carcinoma (1,200 g) presenting as a substernal goiter. 156 Jan 89

We have examined circulating concentrations of a parathyroid hormone-like peptide (PLP) in patients with malignancies and in patients with hyperparathyroidism. The radioimmunoassay employed reacts with synthetic amino-terminal fragments of PLP but not with parathyroid hormone. Elevated plasma PLP concentrations were observed in 50% of patients with malignancy and hypercalcemia and in 15% of normocalcemic cancer patients, mean values being higher in the former group. Detectable plasma PLP concentrations were found in 2 of 39 control subjects. In 2 patients with breast cancer plasma PLP declined concomitantly with a reduction in tumor burden. Adenocarcinoma of the breast and squamous cell carcinomas were most frequently associated with high plasma PLP levels although a variety of histologic types were represented. The presence of metastases on bone scans did not correlate with either the severity of hypercalcemia or the extent of PLP elevation. Increased concentrations of plasma PLP were also observed in 4 of 20 patients with primary hyperparathyroidism and in 5 of 16 patients with chronic renal failure and secondary hyperparathyroidism. Gel filtration analysis of immunoreactive PLP in plasma from 2 hypercalcemic breast cancer patients revealed heterogeneity, with, in each case, both large (greater than 15 kD) and small (6-7 kD) molecular weight amino-terminal moieties. The results document the presence of PLP in the circulation of patients with cancer and are consistent with a pathogenetic role for PLP in the hypercalcemia of malignancy irrespective of whether skeletal metastases have occurred. PLP may also contribute to the skeletal and/or renal manifestations of hyperparathyroid states.
 ...
PMID:Circulating concentrations of parathyroid hormone-like peptide in malignancy and in hyperparathyroidism. 231 98

Eleven patients who had clinical and biochemical evidence of primary hyperparathyroidism were studied using dual isotope technetium-thallium parathyroid subtraction imaging. The parathyroid scans correctly identified all surgically proven parathyroid adenomas. Three abnormal foci also were identified that were not parathyroid adenomas. These were caused by adenocarcinoma metastatic to a lymph node, primary papillary carcinoma of the thyroid, and parathyroid hyperplasia. This report also demonstrates the importance of surgically examining all abnormal sites of uptake.
 ...
PMID:Dual isotope parathyroid imaging. 302 75

Ten hypercalcaemic patients with solid tumours were studied to evaluate the renal response on PTH infusion as assessed by nephrogenous cAMP excretion and maximum tubular re-absorption of phosphate. In addition, 20 normocalcaemic patients, 11 with an adenocarcinoma and 9 with a squamous cell carcinoma, were studied. All cancer patients had moderately extensive disease. Results were compared with those of 9 patients with primary hyperparathyroidism and with 10 elderly controls. All groups studied had comparable renal function, magnesium and 25-hydroxy-vitamin D levels. Comparable results were obtained in patients with an adenocarcinoma and in controls. cAMP response (delta nephrogenous cAMP) was significantly lower in the hypercalcaemic patients with a solid tumour compared with the controls (8.13 +/- 4.68 nmol/100 ml glomerular filtrate vs 29.52 +/- 25.62 nmol/100 ml glomerular filtrate; P less than 0.005). In the group of patients with primary hyperparathyroidism delta nephrogenous cAMP was 13.41 +/- 7.54 nmol/100 ml glomerular filtrate (P less than 0.06 vs controls). The group of patients with a squamous cell cancer showed an intermediate value of 14.83 +/- 10.74 nmol/100 ml glomerular filtrate (P less than 0.025 vs the normocalcaemic adenocarcinoma patients, but NS vs controls). In two hypercalcaemic patients with a solid tumour in whom PTH infusion was repeated after normalization of serum calcium no influence on renal responsiveness was observed. Responses of maximum tubular re-absorption of phosphate were lowest in the group of hypercalcaemic patients with a solid tumour and in the patients with primary hyperparathyroidism compared with controls (0.11 +/- 0.10 vs 0.22 +/- 0.09 mmol/l and 0.09 +/- vs 0.22 +/- 0.09 mmol/l; P less than 0.025 and P less than 0.005, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:End-organ resistance to PTH infusion in hypercalcaemic and normocalcaemic patients with solid tumours. 302 41

Of 2,058 patients who had surgically proven primary hyperparathyroidism at the Mayo Clinic from 1965 through 1979, 51 or 2.5 percent had associated nonmedullary thyroid carcinoma. A history of radiation exposure to the head and neck was obtained in 14 of 43 patients questioned. Thyroid disease consisted of grade 1 papillary adenocarcinoma in 48 cases and pure follicular adenocarcinoma in 3 cases. The parathyroid disease included 41 single adenomas and 5 cases of parathyroid hyperplasia; 5 patients had 2 adenomas. At follow-up, none of the patients had evidence of metastatic thyroid carcinoma. Ten patients were receiving calcium or vitamin D supplementation for protracted hypocalcemia presumably due to the increased insult to the parathyroids from combined bilateral thyroidectomy and parathyroidectomy. More consecutive thyroidectomy, along with parathyroid autotransplantation when indicated, will provide definitive treatment of the thyroid cancer and at the same time minimize the risk of postoperative hypoparathyroidism.
 ...
PMID:Primary hyperparathyroidism and nonmedullary thyroid cancer. 706 49

A 9-year-old castrated male domestic shorthair cat with dysuria, anorexia, vomiting, and lethargy was admitted to the veterinary teaching hospital. A large, firm mass was palpable in the ventral cervical region. Hypercalcemia, azotemia, and nonregenerative anemia were evident on serum biochemical analysis and CBC, and multiple uroliths were detected by abdominal radiography. At necropsy, light microscopy of the ventral cervical mass revealed a parathyroid adenocarcinoma. Light microscopy of sections of the kidneys revealed multifocal, chronic, lymphocytic/plasmacytic, tubulointerstitial nephritis, as well as moderate multifocal acute tubular necrosis. On quantitative analysis, the uroliths were composed of calcium oxalate. Determination of serum calcium concentration is indicated in cats with calcium oxalate urolithiasis to aid in detection of primary hyperparathyroidism.
 ...
PMID:Calcium oxalate urolithiasis in a cat with a functional parathyroid adenocarcinoma. 775 34

We describe a familial occurrence of primary hyperparathyroidism. The proband is a 60-year-old woman who had a parathyroid adenoma. Her older sister had a parathyroid adenoma with cementifying jaw fibroma and her younger sister died of parathyroid adenocarcinoma with pulmonary metastasis at the age of 38. We have not yet obtained evidence for other endocrine disorders suggesting multiple endocrine neoplasia (MEN) in this pedigree. The proband is complicated with Wilms' tumor. It is now widely accepted that respective predisposed genes of MEN type 1 and Wilms' tumor, and PTH gene are located on chromosome 11. The manifestation observed in this case may be related to mutational abnormalities on chromosome 11.
 ...
PMID:Familial primary hyperparathyroidism complicated with Wilms' tumor. 791 71

We report a rare case of Turner's syndrome coexisting with thyrotoxicosis and parathyroid adenocarcinoma resulting in hyperparathyroidism. This 45-year-old female patient presented with primary amenorrhea and poor development of secondary sexual characteristics. She also experienced repeated bone fractures, and body weight loss. Multiple risk factors of osteoporosis developed simultaneously in this patient. The interesting interactive relationship of hypercalcemia between thyrotoxicosis and primary hyperparathyroidism was noted. The best choice was surgery for both cases. Calcium supplements and various hormone replacements in addition to regular investigative radionuclide scans were required.
 ...
PMID:[Primary hyperparathyroidism with parathyroid adenocarcinoma in a patient with Turner's syndrome complicated with thyrotoxicosis]. 833 57

To evaluate the scintigraphy images of 99mTc-tetrofosmin in the primary hyperparathyroidism, we studied 8 patients, 5 males, with ages between 17 and 82 (median = 50) years old, and with clinical and laboratory manifestations of hyperparathyroidism (calcium metabolism and PTH elevated); parathyroid scintigraphy was realized after 20mCi (740 MBq) intravenously injection of 99mTc-tetrofosmin, and were acquired images (10, 60 and 120 min.) in a large field gamma camera. All patients were submitted to surgery. The histology of surgical specimens showed seven adenomas and one adenocarcinoma of parathyroids; the scintigraphic images showed four lesions in the inferior right lobe and four in the inferior left lobe of thyroid and have global correlation with surgical findings. There was preferential retention of the tracer in the earlier images (10 min) in all cases (100%) and in the later images (120 min.) in 5 cases (62.5%). In conclusion, the earlier images (10 min) were more diagnostic than the later in the primary hyperparathyroidism study. It is possible that other tumoral lesions have similar behavior with 99mTc-tetrofosmin.
 ...
PMID:[Scintigraphic images im primary hyperparathyroidism with 99m Tc-Tetrofosmin]. 961 Dec 78


1 2 Next >>