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)

In two patients primary hyperparathyroidism developed in association with myotonic dystrophy (MyD). Both patients had solitary adenoma, and the adenomas were surgically removed. After the operation, subjective improvement of muscle weakness was found in one patient. Because parathyroid hormone secretion is regulated by extracellular calcium concentration and because abnormalities in transmembrane calcium transport are thought to play a role in the pathogenesis of MyD, the concurrence of these rather rare disorders in two patients raises the possibility that abnormalities in transmembrane calcium transport may underlie the development of primary hyperparathyroidism in patients with MyD. Although further studies are needed to clarify the possible link between these two disorders, the present study emphasizes the importance of evaluation of parathyroid function in patients with MyD.
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PMID:Association of primary hyperparathyroidism with myotonic dystrophy in two patients. 382 66

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.
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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)
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PMID:Long-term effect of surgical treatment on the symptoms of primary hyperparathyroidism. 407 2

A patient with many symptoms and signs of primary hyperparathyroidism had hypocalcaemia when first seen. Bone section histology showed osteomalacia and osteitis fibrosa, and the hyperparathyroidism at this stage was considered to be secondary to osteomalacia with postgastrectomy steatorrhoea. On treatment with vitamin D (with disappearance of her bone pains and weakness) she developed hypercalcaemia. She regained her health after removal of a 6-g. parathyroid adenoma. Normal histology was shown in another parathyroid gland.We believe that the initial hypocalcaemia was due to vitamin-D deficiency, which produced ineffective hyperparathyroidism until it was corrected. A review of the few reports of patients with autonomous hyperparathyroidism with steatorrhoea and osteomalacia does not support the argument that these patients had "tertiary" disease. It suggests that most of them, like our patient, had primary hyperparathyroidism.
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PMID:Hypocalcaemic primary hyperparathyroidism. 541 47

Primary hyperparathyroidism was diagnosed in two German shepherd pups from a litter of four females. Clinical signs were apparent by two weeks of age and included stunted growth, muscular weakness, and polydipsia/polyuria. Radiography revealed diffuse reduction in bone density. Both pups had marked hypercalcemia, hypophosphatemia, increased plasma immunoreactive parathyroid hormone concentrations and increased fractional clearance of inorganic phosphate in the urine. Intravenous infusion of one affected pup with calcium gluconate failed to suppress the plasma concentration of immunoreactive parathyroid hormone, suggesting autonomous secretion of parathyroid hormone. Necropsy of the other pup at eight weeks of age revealed diffuse hyperplasia of parathyroid chief cells, nodular hyperplasia of thyroid C-cells, skeletal alterations consistent with fibrous osteodystrophy, hypercalcemic nephropathy, and extensive mineralization of the lungs and gastric mucosa. The dam and sire were half sibs. One male pup from a previous litter of six had developed similar clinical signs and radiographic lesions, suggesting autosomal recessive inheritance. This is the first report of hereditary primary hyperparathyroidism in domestic animals, a disease which may be analogous to hereditary neonatal primary hyperparathyroidism in children.
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PMID:Primary hyperparathyroidism in German shepherd dogs: a disorder of probable genetic origin. 646 98

Sixteen consecutive patients with primary hyperparathyroidism (HPT) were examined by a combination of electrophysiological, morphological and biochemical measurements. Six patients had, preoperatively, subjective impairment of neuromuscular function. Three of them were improved by the normalization of parathyroid function after surgery. In the other patients, who either had vague symptoms or appeared to be asymptomatic, the operation did not cause subjective changes in their neuromuscular function during a 3-month follow-up period. Altogether seven patients, three of whom had symptoms, had impairment of the neuromuscular transmission as evaluated by the single-fibre EMG technique. The changes were of slight degree and unlikely to be of clinical importance. Two patients had a slightly reduced nerve conduction velocity and in two cases moderate abnormalities were found in muscle biopsy specimens. In conclusion, the muscular weakness reported by HPT patients did not seem to be caused by disturbance of neuromuscular transmission. HPT patients who preoperatively were apparently asymptomatic did not have defects of their neuromuscular transmission that were of clinical significance.
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PMID:Neuromuscular involvement in primary hyperparathyroidism. 652 Jun 19

Two patients, one with ataxia, internuclear ophthalmoplegia, muscle weakness, atrophy, fasciculations, and bilateral Babinski's signs, the other with dysarthria, dysphagia, muscle weakness, atrophy, fasciculations, and hyperreflexia, had elevated serum calcium and parathyroid hormone levels, establishing the diagnosis of primary hyperparathyroidism (HPT). Removal of a parathyroid adenoma in one patient and three hyperplastic parathyroid glands in the other resulted in remission of the hyperparathyroidism but left both patients with residual neurological damage. Postmortem examination of the second patient showed typical features of amyotrophic lateral sclerosis. The findings in these patients show that hyperparathyroidism may be associated with signs of severe central nervous system disease and that patients with unexplained neurological signs or symptoms should be checked for hyperparathyroidism.
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PMID:Severe neurological disease associated with hyperparathyroidism. 673 92

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.
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PMID:Surgical treatment of primary hyperparathyroidism in the elderly patient. 684 Oct 38

Twelve patients aged over 70 with primary hyperparathyroidism (persistent hypercalcaemia and raised serum parathyroid hormone concentrations) underwent parathyroidectomy, which was well tolerated by all. After operation serum calcium concentrations returned to normal and the commonest symptoms before operation (muscle weakness, malaise, and mild to severe dementia), although not related in severity to the degree of hypercalcaemia, improved. Mental function was greatly improved. The findings suggest that primary hyperparathyroidism should be sought in any elderly patient with hypercalcaemia and that more such patients with the diagnosis should be considered for parathyroidectomy irrespective of age.
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PMID:Surgical treatment of primary hyperparathyroidism in the elderly. 742 33

It is important to localize the site of abnormal parathyroid glands in treatment of primary hyperparathyroidism. Selective venous sampling with parathyroid hormone assay is one of the methods for localization of adenoma or hyperplasia in primary hyperparathyroidism. Since Reitz first described it in 1969, it has been improved during the last two decades and there is a high sensitivity (70-80%). Especially in those cases, localization is unknown in imaging methods, the first operation fails or the patients has previously been explored in the neck, venous sampling becomes a very useful method. How to perform, indication, performance, strengths and weakness of selective venous sampling is described here.
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PMID:[Parathyroid selective venous sampling]. 775 76


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