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

The incidence of thyroid diseases was evaluated in patients with primary hyperparathyroidism subjected to parathyroidectomy. Eleven patients (26.8%) were affected in this way: 2 with carcinoma, 5 with nodular goitre, and 4 with adenoma. The possible reasons for associations of this kind are discussed, and it is suggested that their high frequency points to a relationship of cause and affect.
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PMID:[Incidence of thyroid diseases in primary hyperparathyroidism]. 37 3

The thyroidal content of calcitonin was investigated in patients with euthyroid goitre, patients undergoing laryngectomies or neck operations and finally patients with primary hyperparathyroidism using method of biological titration. Patients with primary hyperparathyroidism had markedly decreased content of calcitonin in the thyroid gland when compared with the content of calcitonin of both groups of patients without calcium metabolism disturbance. Decreased content of calcitonin in patients with primary hyperparathyroidism can be explained by long lasting hypercalcaemia during which the rate of biosynthesis of calcitonin in the C cells does not keep up with the rate of release of calcitonin into the circulation.
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PMID:Calcitonin activity of the thyroid gland in primary hyperparathyroidism. 69 67

the total hydroxyproline excretion in urine was investigated in 82 patients with hyperthyroidism without data fro a concomitant disease, 50 clinically healthy subjects with euthyroid struma, 10 patients with non endocrine froms of osteoporosis, 4 diabetics with not stable diabetic compensation and 4 patients with primary hyperparathyroidism. The average hydroxyproline values, in the patients with active thyreotoxicosis in 24 hours urine are 56.01-6.03 mg and 16.74 +/- 7.38 mg, after reaching the therapeutic remission. The excretion is with an average of 17.52 +/- 6.03 mg in the patients with euthyroid struma. In patients with primary hyperoparathyroidism-121.60 +/- 18.2 and in patients with diabetes mellitus-51.10 +/- 3.11, in the subjects with osteoporosis-25.83 +/- 10.88 mg. The differences between the patients with active hyperthyroidism and euthyroid struma, as well as after coming to a terapeutic remission are statistically highly significant.
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PMID:[Urinary hydroxyproline in hyperthyroidism]. 89 28

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.
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PMID:Large parathyroid functioning carcinoma (1,200 g) presenting as a substernal goiter. 156 Jan 89

Two patients with the rare association of Cushing's syndrome and primary hyperparathyroidism are reported. Initially, both patients suffered from Cushing's syndrome due to adrenal cortical adenomas with typical features and laboratory findings. Five years after treatment of the Cushing's syndrome by removal of the tumor, asymptomatic mild hypercalcemia was incidentally noticed in both patients, which suggested the occurrence of primary hyperparathyroidism. An enlarged parathyroid gland was removed surgically in both cases and was histologically shown to be a parathyroid adenoma. The levels of serum calcium returned to normal after parathyroidectomy. Papillary adenocarcinoma of the thyroid in one patient and adenomatous goiter in the other were also incidentally detected at operation. These findings suggest that Cushing's syndrome resulting from an adrenal cortical adenoma may be another presentation of multiple endocrine neoplasia type I.
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PMID:Hyperparathyroidism associated with Cushing's syndrome due to an adrenal cortical adenoma. 222 44

Psychiatric symptoms in primary hyperparathyroidism (PHPT) are usually characterized as depressive. In this study 13 patients with PHPT and six control patients with atoxic nodular goiter underwent psychiatric ratings with the comprehensive psychopathological rating scale (CPRS) the day before surgery. The 21 items in this scale were grouped into clusters. The ratings were repeated after successful removal of a parathyroid adenoma. Diurnal serum concentrations of cortisol, melatonin and prolactin were studied pre- and postoperatively in eight of the patients. Patients with PHPT had significantly higher CPRS total scores, 8.5 +/- 1.3, compared with goiter controls, 1.9 +/- 0.8, and showed a significant improvement of psychiatric symptoms after excision of the parathyroid adenoma, to 3.3 +/- 0.9. The preoperative diurnal and peak levels of cortisol and melatonin were higher (P less than 0.05) than after surgery. Serum melatonin fell to levels lower than those in healthy controls. Correlations were found between some clusters or items and cortisol or melatonin. Serum prolactin levels were normal and unaltered by parathyroid surgery. It is concluded that patients with PHPT show well defined psychiatric symptoms many of which are correlated to alterations in serum cortisol and melatonin accompanying PHPT. The improvement of symptoms seen after successful surgery further suggests that PHPT is associated with a specific psychiatric disorder similar to but distinguishable from major depressive disorder.
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PMID:Characteristic changes in psychiatric symptoms, cortisol and melatonin but not prolactin in primary hyperparathyroidism. 317 94

A case of primary hyperparathyroidism due to diffuse parathyroid hyperplasia, with thyroid goiter, bilateral renal lithiasis and fibrocystic osteitis is reported. Precise identification of parathyroid glands was achieved by U.S. and U.S.-assisted fine-needle aspiration. The role of the different diagnostic procedures has been evaluated in order to assess preoperatively a correct surgical approach.
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PMID:Primary hyperparathyroidism. A case report. 322 79

Ultrasonic localization of enlarged parathyroid glands has been attempted in a consecutive series of 23 patients with primary hyperparathyroidism. Seven of 15 patients with operatively verified diagnosis, had predictive ultrasound scans (47% consistency) and 10 of 16 adenomas were identified (63%). A possible explanation for these unsatisfactory results could be a high incidence of coexisting nodular thyroid lesions, and significantly enlarged thyroid glands in these patients.
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PMID:Concomitant thyroid disease in hyperparathyroidism. Reasons for unsatisfactory ultrasonographical localization of parathyroid glands. 352 34

Computerized axial tomography (CAT) was used to study 39 patients with known thyroid disease and 14 patients with primary hyperparathyroidism. In all, CAT was performed only when information that was required for diagnosis or therapy was not available from other less expensive techniques. The greatest value was found in the evaluation of cryptic symptoms or structures in the neck after surgery for thyroid cancer, the assessment of the extent of thyroid cancer, the localization of aberrant thyroid tissue, the etiology of unexplained recurrent laryngeal nerve paralysis and the identification and delineation of mediastinal goiter. In six of 14 patients undergoing neck exploration for primary hyperparathyroidism CAT correctly localized the site of the enlarged parathyroid glands including one mediastinal parathyroid adenoma and one patient with two parathyroid adenomas.
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PMID:Computerized axial tomography in the diagnosis and management of thyroid and parathyroid disorders. 654 39

The relationship between the type of operation for primary hyperparathyroidism and the incidence of postoperative hypocalcemia has not been completely elucidated. The pre- and postoperative serum calcium concentrations in 107 patients with this disease who were operated upon for the first time utilizing several different procedures were evaluated. Group 1. Prior to 1978, our aim was the excision of an adenoma, if present, and any other questionably enlarged parathyroid glands. All other appearing glands that could be found were biopsied. If parathyroid normal hyperplasia was present clinically, three and one-half glands were removed. Group 2. (1980 through 1981). A bilateral neck exploration was performed. If an adenoma was present, this was removed. However, only one or two other parathyroid glands were biopsied. The last normal appearing gland was intentionally left undisturbed. If hyperplasia was present, 2 glands were resected and remnants of two other glands were left in situ. Following their initial neck exploration, 52 of 57 (91%) Group 1 patients were cured. During the first 4 postoperative days, 48% had one or more serum calcium values of 7.9 mg/dl or lower (our criterion for significant postoperative hypocalcemia). None had permanent hypoparathyroidism, however. Their serum calcium concentrations fell to the same level whether one, two or three glands were excised. All 50 patients in Group 2 were cured by their initial neck exploration. Only 26% developed serum calcium values of 7.9 mg/dl or lower (p less than 0.05. when compared to Group 1). However, one patient who had the removal of a large substernal goiter and a parathyroid adenoma has manifested prolonged hypocalcemia. Our data demonstrate that by performing a more conservative operation, transient postoperative hypocalcemia can be lessened. Furthermore, it is quite suggestive that excessive parathyroid biopsy may be deleterious and should be avoided.
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PMID:Postoperative hypocalcemia - its relation to operative techniques. 662 12


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