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)

Among surgical patients renal diseases association with diabetes mellitus was found in 117, with thyroid affection in 82 patients. Twenty-six patients were treated for primary hyperparathyroidism, 46 were operated on for adrenal tumors: pheochromocytoma (23 cases), Conn's syndrome (3 cases). Hyperglycemic coma in patients with acute purulent renal diseases was primarily due to overlooked diabetes mellitus. Thyrotoxic crises emerged after urgent ureterolithotomy in a female patient suffering from toxic goiter, hypothyroid coma occurred in a male subject with undetected hypothyroidism following pyelolithotomy. Clinical variability of the symptoms, no attempts oriented on their detection led to diagnosis of pheochromocytoma, Conn's syndrome, primary hyperparathyroidism in emergency situations or at autopsy. Timely diagnosis and pathogenetic therapy of endocrine crises produced favourable outcomes.
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PMID:[Endocrine crises in patients with kidney diseases]. 794 Nov 21

Over a period of 3 months a 51-year-old woman developed a depressive syndrome with loss of memory, inability to find words, impaired fine movements and phases of spacial disorientation. Biochemical tests demonstrated occasional slight rises in serum calcium (2.8-2.9 mmol/l) and parathormone (4.6-5.2 pmol/l). She had a grade II nodular goitre with normal thyroid function. Ultrasonography of the thyroid suggested a right cranial parathyroid adenoma, confirmed at a right thyroidectomy with resection of the right upper parathyroid, while the other parathyroid glands were grossly normal. Calcium and parathormone levels returned to normal after the operation, as did the neuropsychiatric symptoms (within two months). This typical case illustrates that even in seemingly isolated neuropsychiatric changes an organic disease, like primary hyperparathyroidism, needs to be thought of.
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PMID:[Neuropsychiatric symptoms in primary hyperparathyroidism]. 805 44

Primary hyperparathyroidism (HPT) is a disease caused by an abnormal cytosolic regulation of calcium concentration [Ca++]i leading to an increased secretion of parathyroid hormone and thereby increased levels of extracellular calcium. It is well known that the QT-interval measured at electrocardiography (ECG) is shortened in HPT subjects. Whether this is due to an abnormal intracellular handling of calcium also in the heart or to the raised extracellular calcium levels is not known. In order to study the extent to which the deranged extra- and intracellular levels of calcium in HPT patients were related to ECG characteristics, [Ca++]i was determined in vitro by microfluorometry in surgery-removed parathyroid cells at extracellular calcium concentrations of 0.5 mM and 30.0 mM and ECG was recorded preoperatively in 42 HPT patients and in 15 subjects operated on for atoxic goitre. Serum calcium and plasma-ionized calcium also were measured preoperatively. The QT-interval and ST-segment duration were both shortened in the HPT patients compared to controls (P < 0.001). [Ca++]i at 3.0 mM extracellular calcium divided by that at 0.5 mM was correlated to the QT-interval, when measured at the onset of the T-wave (QoT, r = 0.39, P < 0.03) and early diastolic phase (end of T-wave to onset of p-wave, r = -0.34, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cytoplasmic calcium regulation and the electrocardiogram in patients with primary hyperparathyroidism. 814 4

Primary hyperparathyroidism (HPT) is characterised by a defective calcium sensitivity of the parathyroid glands. HPT is, furthermore, associated with a high prevalence of hypertension. In the present study BP was measured before operation, during surgery and after operation in 42 HPT patients and in 15 control subjects operated for non-toxic goitre. Parathyroid tissue was removed from all patients and the concentration of cytoplasmic calcium [Ca2+]i was determined in vitro in dispersed single cells by means of microfluometry at extracellular calcium concentrations of 0.5 mM and 3.0 mM. The SBP levels were found to be raised both before (158 +/- 23 (SD) mmHg vs. 144 +/- 24 mmHg in controls, P < 0.05), during surgery (maximal level 167 +/- 22 mmHg vs. 146 +/- 16 mmHg in controls, P < 0.01) and after operation (maximal level 180 +/- 26 mmHg vs. 148 +/- 20 mmHg in controls, P < 0.001) in the HPT subject when compared with controls. SBP during surgery was found to be related to the in vitro measured [Ca2+]i in the parathyroid cells at 3.0 mM extracellular calcium concentration or to the ratio of [Ca2+]i at 3.0 mM-0.5 mM (r = -0.25 and -0.27, respectively; P < 0.05). The degree of suppression of PTH release in vitro at 3.0 mM extracellular calcium was found to be related to both systolic and diastolic BP (r = 0.57 and r = 0.53, respectively; P < 0.05) before surgery. In conclusion, BP was found to be raised in HPT patients both before operation as well as during surgery and after operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationship between abnormal regulation of cytoplasmic calcium and elevated blood pressure in patients with primary hyperparathyroidism. 820 37

The authors report their 3-year experience with the diagnosis of parathyroid lesions in primary hyperparathyroidism patients in a geographic area where the occurrence of endemic goiter is medium. Our study was aimed at prospectively assessing preoperative imaging results in these patients. The following imaging methods were used: high-definition and color-Doppler ultrasonography (US), double-tracer 201Thallium-99mTechnetium (T1/Tc) subtraction scintigraphy, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and US-guided fine-needle aspiration of the suspected parathyroid lesions. Preoperative US and scintigraphy were performed in 50 patients with primary hyperparathyroidism; in addition, color-Doppler US studies were performed in 33 patients for vascular characterization of the lesions. In 19 patients, the suspected lesions were punctured under US guidance to measure parathormone (PTHa) and thyroglobulin (TGa) levels in the aspirated material. CT and MRI were performed in 9 patients, to identify a possible ectopic parathyroid gland. Surgery demonstrated 48 solitary parathyroid lesions and one double parathyroid adenoma. In one patient no abnormal parathyroid gland was found. Overall sensitivity rates of US and scintigraphy were 85.7% and 61.2%, respectively. In multinodular goiter patients, the sensitivity rates of US and scintigraphy were 71.4% and 47.6%, respectively. At color-Doppler US the presence of parenchymal vascularization was specific of parathyroid nodules and the method helped differentiate parathyroid lesions from thyroid nodules in 14 multinodular goiter patients. Overall PTHa sensitivity was 72.2% and its specificity 100%. Overall TGa sensitivity was 100% and specificity 94.7%. CT and MRI allowed the detection of 8 ectopic parathyroid lesions. In conclusion, in our personal experience, US should be preferred to double-tracer T1/Tc subtraction scintigraphy in the early examination of primary hyperparathyroidism patients. When US detects a suspected parathyroid lesion, color-Doppler US and PTH and TG sampling can make useful diagnostic tools for reducing false-positive results, especially when thyroid disease is associated.
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PMID:[Preoperative imaging in the detection of parathyroid tumefaction in patients with primary hyperparathyroidism. The authors' own experience]. 868 59

The resting cardiac output pre- and postoperatively in 10 patients with asymptomatic primary hyperparathyroidism has been studied. All patients had normal renal function and arterial blood pressure without a previous history of cardiovascular disease. Ten normotensive patients with a non-toxic goitre awaiting thyroidectomy were studied as controls. The mean cardiac output of the hyperparathyroid patients was 7.2 l/minute (range 5.3-8.9) and of the control group 5.8 l/minute (range 5.2-6.3). Following a successful parathyroidectomy with return of the serum calcium to normal, the mean cardiac output was 6.3 l/minute (range 4.9-7.8) (p < 0.04). In 8 of the 10 patients there was a fall in the cardiac output following surgery; in 2 there was an increase. These results suggest that hyperparathyroid patients often have an elevated cardiac output which may fall following a successful parathyroidectomy.
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PMID:Cardiac output in asymptomatic primary hyperparathyroidism: a stigma of early cardiovascular dysfunction? 891 86

A 49-year-old female with multiple endocrine neoplasia (MEN) type 1 associated with malignant lymphoma, lipoma, functioning adenomatous goiter, non-functioning adrenal tumor, polyneuropathy, postoperative primary hyperparathyroidism, and hepatitis B virus was a human T lymphotropic virus type 1 (HTLV-1) carrier. She underwent parathyroidectomy for primary hyperparathyroidism at age 44. At age 49, examinations of the enlarged para-aortic lymph nodes revealed diffuse small non-cleaved B cell lymphoma in stage II, and other various complications were also found. Multiple tumorigenetic factors were considered to be involved in the present case.
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PMID:Multiple endocrine neoplasia type 1 associated with malignant lymphoma and other complications. 896 95

Neck exploration due to suspicion of primary hyperparathyroidism (pHPT) was performed in 309 instances (298 patients) during a 17 year period, in 44 instances (14%) as a second operation after former goitre surgery or surgery for pHPT. Adenomas were found in 247 patients (83%), 12 patients had double adenomas and one triple adenoma. Hyperplasia was registered in 34 patients (11%) and three had parathyroid cancer. Median weight of adenomas was 1200 mg and hyperplasia 1500 mg. In 14 patients only normal glands were identified. In six of these 14 patients the diagnosis was later withdrawn. In 276 out of 292 patients with pHPT normocalcaemia was established, 16 patients remained hypercalcaemic. Success-rate concerning verification of pHPT was therefore 97% (284 out of 292) and concerning attainment of normocalcaemia 95% (276 out of 292). There was one perioperative death due to myocardial infarction. Four patients had transient unilateral recurrent nerve injury. In one patient with parathyroid cancer vocal cord paralysis was permanent. Follow-up after at least one year revealed normocalcaemia in 91% of the patients, hypercalcaemia in 7% and hypocalcaemia in 2%. Twenty percent of the patients had died 0-12 years, median 2.8 years postoperatively. Death was related to the degree of hyperparathyroidism evaluated by weight of abnormal parathyroid tissue.
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PMID:[Surgical treatment of primary hyperparathyroidism]. 992 95

Acute onset of primary hyperparathyroidism is uncommon; neuropsychiatric signs are prominent clinical features in acute hypercalcemia and they can subside after normalization of serum calcium. Radiation therapy is a well-known risk factor for non medullary thyroid cancer, but it induces also parathyroid tumors. Data from the literature show that patients previously treated with neck radiation have an increased risk of primary hyperparathyroidism. Furthermore concomitant thyroid cancer is more frequent in radiation-induced hyperparathyroidism than in sporadic primary hyperparathyroidism. The case of a 63-year-old female patient who at the age of 14 had been irradiated to the neck for goiter and at the age of 50 had been repeatedly hospitalized for psychosis is presented. She was admitted to the hospital for suspected recurrence of psychosis, but clinical findings and urgent biochemical data showed on the contrary that she had a severe hypercalcemic crisis. Serum parathormone concentrations, neck echography and 99mTc-Sestamibi scintigraphy suggested hyperfunction of the right lower parathyroid gland; therefore the patient was operated on. Pathological examination disclosed a parathyroid adenoma but also two foci of follicular cancer in the right thyroid lobe with a metastasis to a lymph node were observed. Neuropsychiatric signs disappeared after normalization of calcemia and 6 months after operation the patient is free from psychiatric symptoms, despite she had stopped neurolectic drugs. It is underlined that patients who had received neck irradiation must be carefully observed because they are at increased risk of primary hyperparathyroidism and concurrent thyroid cancer.
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PMID:[Acute hyperparathyroidism associated with follicular carcinoma in the thyroid: possible role of juvenile cervical irradiation. Description of a case]. 922 12

The authors reported a twelve year and four-month old girl who had prolonged fever for 2 weeks. Physical examination revealed a painless enlarged thyroid gland with firm consistency. Hyperparathyroidism was suspected because of hypercalcemia, hypophosphatemia, high level of serum alkaline phosphatase, and decreased density of long bones. Thyroid scan showed a cold nodule of the left upper lobe which subsequently proved to be a medullary thyroid carcinoma by high serum thyrocalcitonin level and pathological examination. Her 24-hour urinary vanillyl mandelic acid was in the normal range, and abdominal ultrasonography demonstrated normal adrenal glands. Multiple endocrine neoplasia type IIa (MEN IIa) was diagnosed by medullary thyroid carcinoma and hyperparathyroidism. However, the fully developed syndrome is characterized by the combined occurrence of medullary thyroid carcinoma, primary hyperparathyroidism, and pheochromocytomas. This syndrome is a rare, complex, and potentially lethal disease so early recognition and family screening are very important.
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PMID:Multiple endocrine neoplasia type IIa: a case report. 980 71


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