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 long-standing, asymptomatic, primary hyperparathyroidism developed pain in the anterior neck area, with cough, dysphagia and increasing shortness of breath. This led to respiratory insufficiency, which required endotracheal intubation and respirator assistance. During the ensuing hours the patient developed an area of ecchymosis on the anterior chest. Chest x-ray showed widening of the superior mediastinum, and CT scan showed a large mass with a fluid level. Surgery revealed a large hematoma originating from a mediastinal parathyroid adenoma with a hemorrhagic infarct. Serum calcium, previously elevated, decreased to normal with the onset of neck pain, and the patient remains normocalcemic. Previous reported cases of this rare complication of parathyroid adenomas are reviewed. Hemorrhagic infarct of a parathyroid adenoma may present with a rapidly enlarging mediastinal mass, and/or hypercalcemic crisis. Surgical removal of the infarcted adenoma can return the serum calcium to normal.
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PMID:Spontaneous hematoma of a parathyroid adenoma. 265 47

Subclinical infarction of abnormal parathyroid tissue likely occurs relatively frequently, but remission of primary hyperparathyroidism due to spontaneous massive infarction of a parathyroid adenoma is a rare occurrence. We describe a patient who was unique in that spontaneous remission was accompanied by disappearance of the parathyroid adenoma on serial parathyroid scans. We identified 11 other patients in the literature with sufficient documentation of clinical remission of primary hyperparathyroidism due to spontaneous massive infarction of a parathyroid adenoma and review their clinical features as well. Manifestations varied according to the delay in diagnosis, alteration in serum calcium, location, and degree of associated hemorrhage. Ages ranged from 19 to 73 years, and both sexes were affected. Preceding symptoms suggestive of hypercalcemia and/or prior documentation of hypercalcemia were present in 10 cases. Neck pain was present at the time of infarction in 6/12 patients, and a neck mass in 7/12. Only 1 patient died. The initial calcium level done postinfarction was "normal" in 7/12 patients, low in 3/12, and high in 2/12. The parathyroid adenoma was 2 cm or larger in 8/12 patients. In all patients who had parathyroidectomy, histopathology confirmed extensive infarction (bland or hemorrhagic) of the adenoma. The clinical scenarios encountered were 3 hypocalcemic crises, 2 hypercalcemic crises ("acute parathyroid intoxication"), 1 respiratory arrest secondary to a mediastinal hematoma, 2 patients with neck pain as the major complaint, and 4 with no symptoms apart from the premorbid symptoms of hypercalcemia.
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PMID:Remission of primary hyperparathyroidism due to spontaneous infarction of a parathyroid adenoma. Case report and review of the literature. 985 3

We report a 39-yr-old woman with spontaneous short-term remission of primary hyperparathyroidism (PHPT). She was referred to our Department for PHPT with bilateral kidney stones diagnosed elsewhere; at the time of our observation she had developed anterior neck pain associated with swelling and tenderness. Biochemical data (serum ionized calcium and PTH) suggested a remission of the PHPT. The local symptoms gradually improved and disappeared over the next several days without therapy. Serum ionized calcium and PTH levels remained normal for up to 11 months. Subsequently, the patient had a recurrence of PHPT with mild hypercalcemia and elevated PTH levels. The patient underwent surgery and pathological examination revealing a 1.0 x 1.2 cm parathyroid adenoma with areas of necrosis with hemosiderinladen macrophages. In conclusion, we describe a case of spontaneous short-term remission of PHPT due to infarction of parathyroid adenoma.
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PMID:Spontaneous short-term remission of primary hyperparathyroidism from infarction of a parathyroid adenoma. 1550 96

Most cases of primary hyperparathyroidism (80 to 90%) are caused by a parathyroid adenoma; most of the rest are caused by either parathyroid gland hyperplasia or multiple adenomas. Parathyroid carcinoma can be the cause of primary hyperparathyroidism in 1 to 5% of patients. When the appropriate clinical scenario is presented, it must be considered in the differential diagnosis. We describe the case of a 72-year-old woman with a long history of hypercalcemia and arthritic shoulder and neck pain who was admitted with an elevated calcium level and acute renal failure secondary to bilateral obstructing ureteral calculi. A sestamibi scan and magnetic resonance imaging detected the presence of what appeared to be a right inferior parathyroid adenoma. Her intact parathyroid hormone (PTH) level was 2,257 pg/ml. Following placement of bilateral ureteral stents and adequate hydration, the patient was taken to the operating room for a neck exploration and removal of a parathyroid adenoma with rapid intraoperative PTH monitoring. A 4 x 2.5-cm, 10-g mass was removed from the right inferior pole of the thyroid gland. Following excision, her intraoperative PTH level dropped from 1,103 to 110 pg/ml. Her ionized calcium levels fell from a high of 8.4 mg/dl preoperatively to 4.7 mg/dl. On final pathologic examination, the mass was confirmed to be a parathyroid carcinoma.
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PMID:Parathyroid carcinoma: a rare cause of primary hyperparathyroidism. 1975 Apr 62