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)

A patient with metastatic islet cell carcinoma of the pancreas, recurrent peptic ulcer disease, and hypergastrinemia (Zollinger-Ellison syndrome) developed symptomatic hypercalcemia and renal insufficiency; she was treated with streptozotocin after parathyroidectomy failed to control her hypercalcemia. Shortly after somewhat less than the usual recommended dose of streptozotocin was administered, the serum calcium concentration fell to near normal with complete resolution of symptoms. Seven months after therapy, mild hypocalcemia, consistent with her degree of renal impairment was noted. However, mild hypercalcemia recurred 13 months after therapy. Shortly after streptozotocin therapy, the mean serum gastrin concentration fell to near normal with radiographic disappearance of the anastomotic ulcer. At 7 and 13 months after therapy, serum gastrin levels were normal. Streptozotocin therapy was accomplished without major complications; specifically, without a detrimental effect on the creatinine clearance. Thus, although hypercalcemia in patients with pancreatic islet cell tumors is often due to associated primary hyperparathyroidism, in some patients it may be due to secretion of a hypercalcemic substance from the tumor and may respond to streptozotocin. Similarly, hypergastrinemia in patients with islet cell tumors may also respond to streptozotocin.
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PMID:Pancreatic islet cell carcinoma with hypercalcemia and hypergastrinemia: response to streptozotocin. 13 70

A 45-yr-old man who presented with hypercalcemia was found to have an abdominal mass that was a pancreatic islet cell carcinoma. Although clinical features were suggestive of primary hyperparathyroidism, his parathyroid hormone level was not elevated. The patient underwent a radical resection of the pancreatic neoplasm which was situated in the tail of the gland. After surgery, the serum calcium fell within the normal range, suggesting that the tumor was responsible for production of a parathyroid hormone-like substance. Because of malignant histologic features of the lesion, a chemotherapeutic regimen including 5-fluorouracil and streptozotocin was indicated. Five years later, the tumor has remained in total remission.
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PMID:Pancreatic islet cell carcinoma with hypercalcemia: complete remission 5 years after surgical excision and chemotherapy. 185 92

A 60-year-old woman presented with hypercalcemia and was found to have metastatic pancreatic islet cell carcinoma. Although clinical features were very suggestive of hyperparathyroidism, her parathyroid hormone levels were not elevated and no abnormal parathyroid tissue was detected by thallium-technetium or computed tomographic scanning techniques. Her hypercalcemia appeared to be due to a humoral factor--distinct from parathyroid hormone--that mimics the action of parathyroid hormone almost exactly. The various tools that may be used to differentiate primary hyperparathyroidism from the humoral hypercalcemia of malignancy are reviewed.
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PMID:Pancreatic islet cell carcinoma with hypercalcemia. Primary hyperparathyroidism or humoral hypercalcemia of malignancy. 298 60