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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parathyroid hormone is mainly regulated by the serum calcium concentration and not by another hormone which is usually the case for other hormones. We examined whether the parathyroid hormone could also be regulated by a hormone such as adrenocorticotropic hormone (ACTH). Experiment I: A two-hour urine sample was collected from 6 AM to 8 AM. At 8 AM one mg of synthetic ACTH was injected intramuscularly. Blood and urine was collected two hours after the injection for determination of the concentration of serum calcium, phosphate, parathyroid hormone and cortisol. Experiment II: Adenoma tissue was obtained during operation from patients with primary hyperparathyroidism. The adenoma was digested with trypsin. Eagle MEM containing 100 ml fetal calf serum per 500 ml medium was used as the culture medium. The specimens were incubated in an atmosphere of 95% air and 5% CO2. Several days later, 25 micrograms of ACTH was added to the medium which was then incubated for 2 hours. The parathyroid hormone in the medium was measured by radioimmunoassay. Experiment III:ACTH was injected intraperitoneally into control male rats and parathyroidectomized rats. Two hours later, serum calcium and parathyroid hormone levels were measured. After ACTH injection, a remarkable increase in serum calcium level was seen in the patients with primary hyperparathyroidism, but in the other groups, no increase in the serum calcium was observed. Parathyroid hormone was increased after ACTH injection in most subjects in all groups. Serum cortisol levels increased markedly after ACTH injection in all groups. The parathyroid concentration in the culture medium was slightly increased after ACTH addition.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endocrinological characteristic of primary hyperparathyroidism]. 609 27

A 46-year-old woman presented with hypertension and renal disease. Investigations showed severe hypercalcaemia due to primary hyperparathyroidism. Imaging demonstrated renal calculi and an incidental left adrenal lesion. Additional biochemistry confirmed adrenocorticotropic hormone-independent hypercortisolism. Ultrasound and sestamibi scan found an enlarged right-sided parathyroid gland and a suspicious right thyroid nodule, biopsy of which suggested papillary carcinoma. The right parathyroid mass, right thyroid lobe and right central compartment tissue along with a segment of the right recurrent laryngeal nerve was resected en-bloc Completion thyroidectomy and left adrenalectomy were performed 6 months later. Histology showed parathyroid cancer, multifocal papillary thyroid cancer and adrenal clear cell cortical adenoma. Genetic tests were normal. There was no evidence of recurrence at 12 months follow-up. Parathyroid cancer should be suspected in the presence of significant hypercalcaemia, very high parathyroid hormone and end organ damage. Suspicious thyroid nodules on imaging should be appropriately investigated.
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PMID:Simultaneous presentation of parathyroid carcinoma, papillary thyroid cancer and ACTH-independent hypercortisolism due to benign cortical adenoma. 3149 30