Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary hyperparathyroidism becomes increasingly common with age and affects females four times more commonly than males. We now know that the majority of patients are asymptomatic of the disease and the commonest symptoms are fatigue and lethargy. Because of these facts, it is now appropriate to consider conservative management of primary hyperparathyroidism in the older patient who is asymptomatic or who has only mild symptoms. Further studies are indicated to ascertain whether such a conservative policy is correct.
 ...
PMID:Primary hyperparathyroidism. Clinical presentation and factors influencing clinical management. 267 66

The muscle contraction of the anterior tibial muscle was investigated by measurements of electrically stimulated and computer-analyzed muscle twitches in 18 unselected patients with primary hyperparathyroidism (HPT) and in 20 healthy control persons. The HPT patients had a lower muscle twitch tension (TT) at single stimulation, compared with the control group [76 +/- 24 N (SD) and 99 +/- 33 N respectively, P less than 0.05]. At high-frequency stimulation the difference in muscle force increased, and at 20 Hz stimulation the force in the HPT patients was 73% of that in the controls (P less than 0.01). There were no differences between the HPT patients and the control persons in neither contraction time nor half relaxation time at single muscle twitch nor in twitch potentiation after 20 and 90 seconds maximal voluntary contraction. The results indicate that patients with primary HPT have an impaired muscle function of probable importance for their symptoms of weakness and generalized fatigue.
 ...
PMID:Muscle function in patients with primary hyperparathyroidism. 271 Jan 53

Primary hyperparathyroidism (HPT) is associated with symptoms of generalized fatigue and muscle weakness. The purpose of this study was to investigate muscular function in HPT quantitatively and to evaluate the effect of parathyroid surgery in this respect. The maximal isokinetic muscle strength (peak torque) of knee extension and flexion was measured with a Cybex-II dynamometer in 16 patients with primary HPT (mean serum calcium 2.81 +/- 0.14 mmol/l), four of whom had subjective impairment of strength, and in nine control patients submitted to hemithyroidectomy due to atoxic thyroid adenoma. Before surgery there was no significant difference in muscle strength between the two groups, neither was there any consistent relationship between the subjective feeling of muscular weakness and the measured peak torque. Seven months after surgery the HPT patients had increased their muscle strength by 8 per cent (P less than 0.05). The improvement was correlated with the pre-operative serum calcium levels (r = 0.56, P = 0.02) and was particularly seen in patients with pre-operative subjective muscular weakness. Patients with only slightly raised calcium values and without subjective muscular symptoms did not benefit clearly from surgery, compared with the controls. The study demonstrates that HPT patients, especially those with neuromuscular symptoms, can improve their muscle strength after parathyroid surgery.
 ...
PMID:Maximal isokinetic muscle strength in patients with primary hyperparathyroidism before and after parathyroid surgery. 333 59

In a consecutive series of 100 neck explorations for primary hyperparathyroidism, 42 patients were 60 years of age or older; in this group of elderly patients the surgical cure rate was 100%. These patients were reviewed retrospectively by means of a structure interview. Twenty-one patients had had preoperative neuromuscular symptoms that ranged from coma to subjective muscular weakness. These patients had significantly-higher preoperative serum calcium and parathyroid hormone levels than did 21 patients without neuromuscular symptoms (P = 0.003 and P = 0.046, respectively). Most of the neuromuscular symptoms improved in the postoperative period. In particular, 15 of 17 patients with muscle weakness reported a significant improvement, while 14 of 15 patients who suffered from fatigue and lethargy reported an improvement. An improvement also occurred in the level of day-to-day function in eight patients. While surgery for primary hyperparathyroidism generally is undertaken for a specific indication, such as severe hypercalcaemia or renal stones, it appears from this study that neuromuscular symptoms also may improve, particularly in elderly patients.
 ...
PMID:Neuromuscular symptoms in elderly patients with hyperparathyroidism: improvement with parathyroid surgery. 339 14

This study comprised 100 white patients with primary hyperparathyroidism treated between 1975 and 1984. Of these, 75 attended Johannesburg Hospital and 25 were managed by private practitioners. The mean age was 56.4 +/- 1.4 years at the time of diagnosis. There were almost twice as many women as men. In patients attending Johannesburg Hospital there was a progressive increase in the detection rate after 1979, which corresponded with the introduction of automated multichannel serum analysis. The commonest major complications were renal stones (54%), renal insufficiency (27%), a history of skeletal fractures (12%), radiographic evidence of osteopenia (38%) and peptic ulcers (20%). Bone disease was particularly common in postmenopausal women (64%). Other notable features were the frequency of weakness and fatigue (40%) and hypertension (45%). Coincidental thyroid abnormalities were frequent (18%). Ninety-three patients were treated surgically; 76 (81.7%) had a single adenoma. Our findings are compared with those of other large series. This study indicates the need for a greater awareness of this condition and earlier diagnosis to forestall the development of its harmful complications, and for the collection of additional information from a prospective study.
 ...
PMID:Primary hyperparathyroidism. A study of 100 patients in Johannesburg. 394 58

Two hundred and eighty-nine patients operated on for primary hyperparathyroidism (PHPT) in the years 1956-79 have been followed up for a mean period of 5 years. The aim of the study was to investigate the symptomatology of PHPT and the disappearance of the symptoms after operative treatment. Of the presenting symptoms hypercalcaemic crisis and cystic bone changes were cured, and none of the patients with pancreatitis as presenting symptom had a recurrence. In the renal stone group, 10% of the patients had recurring stones during the follow-up period. The presenting symptom disappeared in 84% of the patients. Thirty-five% of the patients had no presenting symptom and were classified as "asymptomatic", though, on questioning, most of them had various symptoms which disappeared postoperatively. Malaise, fatigue and muscular weakness disappeared in 79% of the patients, upper abdominal pains in 66%, constipation in 63%, pains in the extremities in 51% depression in 65%. Hypertension increased by 28% during the follow-up period; only three of the 90 patients with hypertension has discontinued antihypertensive treatment postoperatively. During the follow-up study, 6% of the patients were hypercalcaemic, though the serum calcium was only slightly elevated in almost all of these patients (mean +/- SD 2.75 +/- 0.09 mmol/l) and most of them had the multiglandular form of PHPT. The renal function did not deteriorate as much as was expected on the basis of earlier reports; only two patients had a serum creatinine over 500 mumol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Long-term effect of surgical treatment on the symptoms of primary hyperparathyroidism. 407 2

The aim of this study was to examine the development of the clinical appearance of primary hyperparathyroidism in a material of 334 patients operated on for PHPT in the years 1956-79. The material was divided into three parts: 72 patients from the years 1956-70, 102 patients from the years 1971-75 and 160 patients from the years 1976-79. A marked change was observed in the structure of the material: the mean age of both men and women increased, and the group of women over 50 years became dominating. Symptoms such as renal stones, cystic bone changes and hypercalcaemic crisis proportionally decreased, and nonspecific symptoms as malaise, fatigue and various pains increased. The number of asymptomatic patients also steadily increased. The preoperative serum calcium values were lower in the consecutive groups. The number of small adenomas increased but, on the other hand, the number of big adenomas remained the same. The ratio between single adenomas and multiglandular disease remained unchanged in the three periods. In our material, the general development of the clinical appearance of PHPT seems to have taken only one decade. In the latest period PHPT has been diagnosed considerably more often than before, and the disease has usually been treated at an earlier stage. However, the severe forms of the disease have been diagnosed as frequently in all of the periods.
 ...
PMID:The changing picture of primary hyperparathyroidism in the years 1956-1979. 652 34

The treatment of 11 elderly patients with primary hyperparathyroidism is described. All the patients underwent exploration of the neck and removal of a parathyroid adenoma, and the operation was well tolerated. After surgery, serum Ca concentrations returned to normal. The commonest symptoms in these elderly patients before operation included extreme fatigue, muscle weakness, mental disturbances, personality changes, severe depression, psychosomatic retardation and mild-to-severe dementia; all improved dramatically.
 ...
PMID:Surgical treatment of primary hyperparathyroidism in the elderly patient. 684 Oct 38

An unusual clinical presentation of moderate hypercalcemia as a result of primary hyperparathyroidism is described. The patient complained of fatigue, depression, thirst, polyuria, and focal neurologic symptoms including amaurosis fugax, anomia, right upper-extremity dysesthesias, and a left cerebral transient ischemic attack. No structural central nervous system abnormality could be documented. Signs and symptoms disappeared when serum calcium levels were reduced from 13.2 to 9.8 mg/100 ml. They have not recurred in 30 months of follow-up. The association of focal neurologic disease and hypercalcemia is uncommon. Although the precise pathophysiologic mechanism is unclear, this patient's symptoms suggest a vascular etiology.
 ...
PMID:Focal neurologic symptoms in hypercalcemia. 718 1

A 41-year-old woman was referred to our hospital with complaints of general fatigue, appetite loss, nausea and vomiting. Blood examination revealed high serum calcium level (21.6 mg/dl) and high serum parathyroid hormone level. Although enlarged parathyroid glands could not be clearly detected via ultrasonography, computed tomography and scintigraphy, we diagnosed her with hypercalcemic crisis due to primary hyperparathyroidism and performed parathyroidectomy after conservative therapy. A parathyroid tumor measuring 1.9 x 1.1 x 1.0 cm, and weighing 1,100 mg was found at the upper right pole of the thyroid gland, and three thyroid tumors were found in the bilateral lobes of the thyroid gland. Histological diagnosis was adenoma of the parathyroid gland and follicular adenomas of the thyroid gland. Following removal of the parathyroid tumor, the serum calcium level rapidly dropped and the symptoms rapidly improved. Hypercalcemic crisis has a high mortality, and the only treatment is surgical removal. Therefore, in patients with hypercalcemic crisis due to primary hyperparathyroidism, surgical removal should be done immediately, unless the serum calcium level has dropped and symptoms of crisis have disappeared after conservative treatment.
 ...
PMID:[A case of primary hyperparathyroidism associated with marked hypercalcemic crisis]. 794 74


<< Previous 1 2 3 4 5 6 7 8 Next >>