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 results are presented of an oral calcium tolerance test with 1,000 mg calcium in 20 patients with recurrent renal calcium calculosis, a woman with primary hyperparathyroidism and incipient renal failure (serum creatinine 1.8 mg%), creatinine clearance 55 ml/min) and 9 healthy persons as controls. The serum osteocalcin level was determined before and after the oral test. The results show that the serum osteocalcin level alone is of no differential diagnostic value for differentiation of the various types of hypercalciuria in patients with recurrent renal calcium calculosis. As a marker of osteoblasts functional state however the determination of serum osteocalcin level is of great importance for the early diagnosis of osteoporosis. In 3 patients with renal hypercalciuria, often leading to general osteoporosis, an acute rise of serum osteocalcin level was found after the oral calcium tolerance test. High osteocalcin level was also found in the patient with primary hyperparathyroidism and incipient renal failure.
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PMID:[Serum osteocalcin level as a marker of the functional state of osteoblasts after oral calcium tolerance test]. 326 44

During 1974-1984 altogether 481 patients were treated for end-stage renal disease (ESRD). Eight patients, five women and three men, with chronic pyelonephritis as the primary cause of ESRD, had staghorn urinary calculi as a predisposing factor for renal failure. These eight patients were studied retrospectively concerning epidemiological and bacteriological aspects, the treatment of the stone disease, and the development of uraemia. Anatomical and metabolic abnormalities such as bladder outlet disturbances, primary hyperparathyroidism, phenacetin abuse or metabolic stone disease were found in six patients. The women had all been infected with Proteus mirabilis, whereas the men had been infected with various microorganisms. The average time taken for the development of ESRD, estimated from the first sign of renal impairment, was 7.4 +/- 2.9 (SD) years. Five patients had died before this study commenced. One of the patients still alive was on dialysis treatment. Two patients who were doing well without dialysis were stone free and had sterile urine after successful pyelolithotomy. It is concluded that the prevalence of infectious urinary calculi as a cause of uraemia in patients with ESRD is low. The time taken for uraemia to develop is short in these patients and they often have anatomical abnormalities. Proteus is commonly found in this group of patients. Patients with staghorn calculi, urinary tract infection and impairment of renal function are at risk of developing uraemia.
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PMID:Infection-induced urinary calculi and renal failure. 332 3

The authors have evaluated bone mineral content in the vertebral spongiosa by means of Computed Tomography. The method proposed by Genant and Cann has been applied to examine 164 healthy volunteers and 108 patients. Both healthy males and females showed a progressive bone mineral loss increasing with age; the bone mineral loss was most severe in females during the 4th and 5th decade of life. Pathology included patients with osteoporotic fractures (vertebral and femoral neck), patients with partial gastrectomy, renal failure, primary hyperparathyroidism, Cushing syndrome, corticosteroid therapy. Bone mineral values were significantly lower in most pathologic groups. Computed Tomography proves thus to be a valuable method to assess bone mineral content and to identify patients at risk for fractures.
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PMID:[Evaluation of mineral bone content using quantitative computerized tomography]. 335 84

Biochemical indices of bone formation (serum osteocalcin and bone alkaline phosphatase isoenzyme) and osteoclastic function (plasma tartrate resistant acid phosphatase) were measured in 43 patients undergoing chronic hemodialysis and in 27 patients with primary hyperparathyroidism. The mean values for bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase but not for osteocalcin were significantly higher in primary hyperparathyroidism as compared with dialyzed patients. A significant positive correlation was found between the biochemical indices of osteoblasts and osteoclasts both in primary hyperparathyroidism and in dialyzed patients, indicating biological coupling between bone resorption and formation under these conditions. The regressions of osteocalcin vs bone alkaline phosphatase isoenzyme and/or plasma tartrate resistant acid phosphatase in dialyzed patients paralleled those in primary hyperparathyroidism but their distance differed significantly. It is concluded that in patients with renal failure, an increase in circulating osteocalcin by a relatively constant portion reflects decreased renal clearance. Any additional increase in osteocalcin serum level indicates an increased skeletal production of osteocalcin. The clinical value of bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase appears to be comparable with that of serum osteocalcin in primary hyperparathyroidism, and more exact than osteocalcin in renal failure.
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PMID:Serum osteocalcin, bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase in patients on chronic maintenance hemodialysis. 350 96

There are a variety of water and electrolyte disorders in patients with cancer. These disorders occur during the growth of tumors, generally as a consequence of inadequate intake and absorption of electrolytes, renal failure secondary to tumor or rapid tumor destruction and production of metabolically active substances by the tumor. In this paper, the electrolyte abnormalities associated with cancer were reviewed. Hyponatremia is one of the most common clinical electrolyte abnormalities in advanced cancer. Some patients may have hyponatremia, in spite of increased total body sodium and absence of a defect in water diuresis. This status is designated as "sick cell syndrome" or "essential hyponatremia". In addition, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in association with various tumors has been described. This syndrome is principally due to water retention, but can also be due to continuous urinary loss of sodium, and hypo-osmolality. Hypercalcemia is associated with coexistent primary hyperparathyroidism, prostaglandin (PGE2) or osteoclast-activating factor. It now seems likely that ectopic PTH is rarely the cause of hypercalcemia in nonparathyroid cancer. There are no data supporting the ectopic production of vitamin D-like substance as an important factor in the hypercalcemia of cancer. There are three general categories in which patients with hypercalcemia and cancer may be placed: those with bone metastases, those without bone metastases of solid tumors and those with hematologic malignancies. Hypokalemia is associated with ectopic ACTH- and insulin--producing tumors, and is often found in patients with mucin-secreting, potassium-losing adenocarcinoma of the colon.
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PMID:[Electrolyte abnormalities associated with cancer: a review]. 352 93

The metabolic manifestations and operative findings in 10 patients with a diagnosis of parathyroid carcinoma were analyzed to determine whether they differ from those in patients with parathyroid adenomas and similar degrees of hypercalcemia. Two groups of patients with parathyroid adenomas were used for comparison. Group A consisted of eight patients with "atypical" benign adenomas (mean preoperative level of serum calcium: 13.4 mg/dl); group B consisted of 13 patients with benign typical adenomas--all with preoperative serum calcium levels greater than or equal to 13.0 mg/dl (mean: 14.2 mg/dl). The patients with carcinoma (mean preoperative level of serum calcium: 15.3 mg/dl) had a frequency of osteoporosis and osteitis fibrosa cystica (50%) comparable with that of group A (33%) and group B (62%). Seventy percent of the patients with carcinoma had renal disease (nephrolithiasis, nephrocalcinosis, or impaired renal function), whereas only 38% of group A and 15% of group B had similar disorders. The patients with carcinomas had the highest frequency of combined bone and renal disease (50% versus 14% in group A and 15% in group B). Anemia, peptic ulcer disease, and hypertension occurred with similar frequencies in the three groups. Three patients with recurrent parathyroid carcinoma died of profound hypercalcemia, renal failure, or cardiac arrhythmia. In general, although patients with parathyroid carcinomas have more profound metabolic abnormalities than do patients with primary hyperparathyroidism, the metabolic manifestations in patients with parathyroid carcinoma are comparable with those in patients with parathyroid adenomas and profound hypercalcemia. Furthermore atypical adenomas share many anatomic and histopathologic features with parathyroid carcinomas, and distinguishing between the two is sometimes possible only in cases of tumor recurrence.
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PMID:Parathyroid carcinoma versus parathyroid adenoma in patients with profound hypercalcemia. 358 61

The performance and clinical utility of a 'C-terminal' parathyroid hormone (PTH) radioimmunoassay (Dac-Cel, Wellcome Diagnostics) is described. Parathyroid hormone, as measured by the Dac-Cel method, is stable in whole blood samples for at least 24 h. 84% of patients with hypercalcaemia due to primary hyperparathyroidism have values above the upper limit seen in normocalcaemic subjects (0.5 micrograms/L), with detectable serum PTH demonstrable in the remaining 16%. In patients with hypocalcaemia due to hypoparathyroidism serum PTH was undetectable in 73% and 'inappropriately' low in the remainder. In 50% of patients with malignancy-associated hypercalcaemia serum PTH was undetectable, but was above 0.5 micrograms/L in 13%. Increased PTH concentrations were invariably found in patients with renal failure. The Dac-Cel method is a reliable and robust technique for measurement of PTH and in conjunction with determination of calcium facilitates the diagnosis of primary parathyroid disorders. Caution is required in the interpretation of PTH measurements in patients with renal failure; the significance of detectable PTH in some patients with malignancy-associated hypercalcaemia is not clear.
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PMID:Performance and clinical utility of a commercially available 'C-terminal' PTH assay. 376 72

An adult Keeshond had clinical signs associated with hypercalcemia, including inappetence, polyuria, polydipsia, and vomiting. Blood biochemical findings and urinary clearance studies were consistent with a diagnosis of primary hyperparathyroidism. Histomorphometric analysis of trabecular bone in an iliac crest biopsy indicated increased bone remodeling activity. Surgical exploration of the neck revealed an oval mass, which was removed by blunt dissection. Histologic diagnosis was parathyroid gland adenoma. The dog died because of renal failure on the eighth postoperative day. This report defines primary hyperparathyroidism in the dog, thus facilitating diagnosis for the veterinary clinician.
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PMID:Primary hyperparathyroidism in a dog: biochemical, bone histomorphometric, and pathologic findings. 380 43

In 89 patients with disorders in calcium regulation either C-terminal or N-terminal PTH or both, were elevated. In haemodialysis patients the results of C-terminal and N-terminal PTH measurements showed the same trend in 10 patients; in 30 patients only C-terminal and in four patients only N-terminal PTH was elevated. In patients with renal failure, creatinine clearance less than 30 ml/min, both C-terminal and N-terminal PTH were elevated in five patients, C-terminal PTH in 12 patients and N-terminal PTH in none of the patients studied. Fourteen patients with primary hyperparathyroidism were studied; in ten both C-terminal and N-terminal PTH were elevated, in two only C-terminal PTH and in another two only N-terminal PTH was elevated. The results show that there seems to be a better clinical correlation for hyperparathyroidism, in haemodialysis patients and patients with renal failure, using N-terminal PTH determinations rather than C-terminal PTH determinations, because in haemodialysis patients and patients with renal failure split products of the C-terminal region of PTH give unrealistically high PTH results.
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PMID:Comparison of C-terminal and N-terminal PTH in secondary hyperparathyroidism in renal failure. 386 28

It may sometimes be difficult to distinguish primary from secondary hyperparathyroidism when advanced renal failure coexists. We report here the case of a patient with end-stage renal failure who had severe hyperparathyroidism. Cervical exploration revealed only the presence of four parathyroid glands normal in size and histological appearance which were removed. Because the existence of severe hyperparathyroidism had been firmly established based on biochemical and radiological evidence, the diagnosis of primary hyperparathyroidism due to an ectopic adenoma became obvious. Digital angiography and computerized tomography were then carried out. The results of angiography were inconclusive but computerized tomography revealed and precisely localized a mediastinal adenoma which was subsequently removed via sternotomy. The existence of a hypoparathyroid state was confirmed over the following two months. Reimplantation of parathyroid fragments which had been cryopreserved during the first operation, was then performed with success.
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PMID:[Diagnostic and therapeutic problems in a severe case of hyperparathyroidism with renal insufficiency]. 396 Feb 60


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