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

Hypercalcaemia would seem to be rare during immobilisation, whilst osteoporosis and hypercalciuria are constant. In fact, it often goes unnoticed. The case presented here confirms its predominance in the adolescent male. The reason for immobilisation seems to be irrelevant. The clinical symptoms are very variable: polydipsia, nausea, headache, apathy, anorexia. Blood calcium levels are raised, up to 14 mg%. This hypercalcaemia is due to very marked bone loss in adolescents, secondary to hyper-resorption and a temporary stoppage in osseous formation. The differential diagnosis from primary hyperparathyroidism is sometimes difficult but is aided by laboratory and histological findings. The essential is to consider the possibility of immobilisation hypercalcaemia in the presence of any suggestive symptoms in an immobilised adolescent. Treatment includes a return to weight bearing, adequate water intake and the administration of phosphorus, calcitonin, furosemide, and corticosteroids.
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PMID:[Immobilisation hypercalcaemia (author's transl)]. 59 68

Intrauterine hyperparathyroidism is a self-limited condition seen in the neonate born of a mother with poorly controlled hypoparathyroidism. In this report, we describe the histologic findings in bone and parathyroids in twin infants with this condition who died from other causes. The skeleton showed osteopenia with evidence of increased bone turnover and defective mineralization, and there was parathyroid gland hyperplasia of the water-clear cell type. One twin died at birth, and the histologic findings were indistinguishable from those of infantile primary hyperparathyroidism; but the second twin, dying at 3 months of age, demonstrated noticeable improvement in the bone and parathyroid abnormalities.
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PMID:Intrauterine hyperparathyroidism. Postmortem findings in two cases. 76 May 15

Eight cases of primary hyperplasia of the parathyroid are reported among 322 cases of primary hyperparathyroidism. Preoperatively, all had high serum calcium. Six cases were water-clear, one chief cell, and one mixed hyperplasia. The case of chief cell hyperplasia was misdiagnosed primarily as adenoma. Its exact nature was recognised retrospectively. Identification and biopsy with frozen section of all the parathyroid glands is stressed. This is essential to rule out the presence of multiple adenoma or adenomatous formation in hyperplasia. When hyperplasia was proved, total parathyroidectomy and autotransplantation of parathyroid tissue equivalent to 1/2 or one normal-sized parathyroid gland was done in 7 cases. Although one patient had hyperplastic tissue in situ, the results of this management are considered to be satisfactory. On to six years postoperatively, all surviving patients are without symptoms of hyperparathyroidism and have normal serum calcium. Two patients required a small dose of Vit D-2 to sustain a normal calcium level. Total parathyroidectomy and autotransplantation of parathyroid tissue (PTA) is preferred to subtotal parathyroidectomy in cases of primary hyperplasia. There is a good primary result and reoperation can be easily done if there is recurrence of hyperparathyroidism.
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PMID:Primary hyperplasia of the parathyroids. 112 19

Almost all functioning parathyroid adenomas are composed of chief or water-clear cells. In contrast, most oxyphil cell adenomas of this organ remain clinically silent. To date only occasional parathyroid adenomas consisting of oxyphil cells only have been found associated with primary hyperparathyroidism. The two additional examples described in this report confirm observations by others indicating that the parathyroid oxyphil cell can play an active metabolic role.
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PMID:[Oxyphil cell adenomas associated with primary hyperparathyroidism (author's transl)]. 112

Immunohistochemical and ultrastructural studies were performed on cases with hyperparathyroidism. The relationship between histology and cell activity in hyperfunctioning parathyroid glands was studied. Furthermore, the synthesis-secretion process of parathyroid hormone (PTH), which has been more or less elucidated biochemically, was studies by a morphological means. The subjects employed in the present study were 23 cases of primary hyperparathyroidism (PHPT) and 31 cases of secondary hyperparathyroidism (SHPT). Based on the results of the immunohistochemical study using anti-PTH antibody, the histology of the parathyroid gland was classified into 4 types: type A; sporadic cells showing intense yellowish brown staining in their cytoplasm, type B; glandular cells showing intense yellowish brown staining specifically in their cytoplasm, type C; as a whole the cells were weakly stained, but intensely stained cells were absent, and type D; only the cytoplasm of large cells showed uniform and intense yellowish brown staining. In both PHPT and SHPT, type C constituted about 80%. On the other hand, all water clear cell hyperplasia in SHPT showed type D staining. Electron microscopic studies performed on the hyperparathyroidism revealed that the rough endoplasmic reticulum and Golgi apparatus, which are related to the synthesis of PTH, were well developed. Immunoelectron microscopy revealed that only the secretory granules were specifically stained with the anti-PTH antibody. This finding suggests that PTH becomes active once it reaches the secretory granule.
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PMID:[Immunohistochemical classification and ultrastructural study of hyperparathyroidism]. 147 49

Relations between histopathological characteristics and clinical data were retrospectively investigated in patients with sporadic primary hyperparathyroidism due to hyperplasia. The study comprised 100 patients with chief cell hyperplasia and nine with hyperplasia of the water-clear cell type operated on during the period of 1959-1989. The chief cell hyperplasia was associated with a renal stone disorder as the predominant symptom in 41 patients, psychiatric/neuromuscular manifestations in 26 patients, while 23 patients were apparently asymptomatic. The remaining ten patients had miscellaneous symptoms. Patients with renal stones were more frequently of the male sex and generally had lower serum calcium values and less marked increments in total parathyroid glandular weights than patients with other symptoms or those who were overtly asymptomatic. Two main morphological patterns, diffuse and nodular hyperplasia, were encountered in chief cell hyperplasia. Diffuse hyperplasia was usually found in moderately enlarged glands, with a less variable size and morphology. It was also more prevalent among young patients having moderate hypercalcaemia and either recurrent renal stones or neuromuscular/psychiatric symptoms. The glands affected by nodular hyperplasia were asymmetric in size with a variable cellular arrangement and a high proportion of oxyphil cells. Nodular hyperplasia was irrespective of symptoms more frequent in the elderly patients. Water-clear cell hyperplasia was not encountered during the last decade of the study and until then it was an occasional finding in patients with marked hypercalcaemia. In this histological entity the glands were greatly and asymmetrically enlarged.
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PMID:Histological and clinical features of non-familial primary parathyroid hyperplasia. 159 79

Ultrasonography is a direct method of representation, giving various advantages over other methods in the examination of parathyroid glands: it is rapid, non-radiation and economically undemanding. Dynamic examination by means of the linear electronic transducer of 3.5 MHz and the use of water path was used in 37 patients. In 7 patients with primary hyperparathyroidism was the examination rapid and the pictures of the adenomas were persuasive. In 30 patients with secondary hyperparathyroidism were found characteristic pictures, if the glands were enlarged to 8 mm or more. For the diagnosis of smaller glands a high resolution transducer will be necessary. Histological finding was available in 21 patients undergoing operation, and easily available method and it is therefore the procedure of the first choice.
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PMID:[Ultrasonography in the diagnosis of hyperparathyroidism]. 218 81

Until recently, nonfunctioning parathyroid cysts were usually identified at operation for a presumed thyroid mass. Thyroid needle biopsy now allows their preoperative diagnosis and potential definitive treatment. This study reviews four patients with nonfunctioning parathyroid cysts treated during a two-year period. Three women and one man range in age from 28 to 70 years. Each presented with an asymptomatic thyroid mass ranging from 3 to 5 cm in length. None had symptoms of primary hyperparathyroidism. Serum calciums were from 9.2 to 10.7 mg/dl and serum phosphoruses were 3.2 to 4.4 mg/dl. Needle aspiration revealed 5 to 85 cc of water-clear fluid. C-terminal parathyroid hormone in three patients was 12,600, 6,500 and 61,200 pg/ml and N-terminal PTH was 1,700 pg/ml in one. All four had normal serum calcium and phosphorus on follow-up ranging from six months to two years. Two patients had resolution of their cysts with a single aspiration. One patient had recurrence but has no evidence of recurrence six months after injection with tetracycline. Another patient had a recurrence but remains well one year following reaspiration. Nonfunctioning parathyroid cysts present as a thyroid mass. Needle aspiration of water-clear fluid high in parathormone is diagnostic and, in most patients, is the therapeutic modality of choice.
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PMID:Needle aspiration of nonfunctioning parathyroid cysts. 236 85

We found that a few patients with urolithiasis had normal parathyroid hormone levels but high cyclic AMP excretion. The purpose of this paper was to study the endocrinological mechanism. Male rats were given intraperitoneally dibutyryl cyclic AMP (DBcAMP), a derivative of cyclic AMP, per 100 gm of body weight for 50 days. Feed and water were supplied ad libitum. Crystal formation or calcification in mainly the dystal tubules and collecting system were found in 3 out of 10 rats, and renal calcium stones in 2 rats. The cyclic AMP of the renal parenchyma, especially the renal medulla, was elevated by more than 100 times after DBcAMP administration. Serum calcium levels, urinary calcium and phosphate excretion, and the adrenaline levels of the renal parenchyma were significantly increased. Serum parathyroid hormone was slightly enhanced, but vitamin D and the noradrenaline levels of the renal parenchyma were not changed. Based on these findings, it is suspected that stone formation in rats injected DBcAMP occurs through the action of DBcAMP on the renal tubules to increase urinary calcium excretion and to make renal stones as a form of primary hyperparathyroidism.
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PMID:[Studies on the endocrinological metabolism of the parathyroid. I. The production of renal calcinosis by cyclic AMP injection in rat]. 300 37

There are a variety of water and electrolyte disorders in patients with cancer. These disorders occur during the growth of tumors, generally as a consequence of inadequate intake and absorption of electrolytes, renal failure secondary to tumor or rapid tumor destruction and production of metabolically active substances by the tumor. In this paper, the electrolyte abnormalities associated with cancer were reviewed. Hyponatremia is one of the most common clinical electrolyte abnormalities in advanced cancer. Some patients may have hyponatremia, in spite of increased total body sodium and absence of a defect in water diuresis. This status is designated as "sick cell syndrome" or "essential hyponatremia". In addition, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in association with various tumors has been described. This syndrome is principally due to water retention, but can also be due to continuous urinary loss of sodium, and hypo-osmolality. Hypercalcemia is associated with coexistent primary hyperparathyroidism, prostaglandin (PGE2) or osteoclast-activating factor. It now seems likely that ectopic PTH is rarely the cause of hypercalcemia in nonparathyroid cancer. There are no data supporting the ectopic production of vitamin D-like substance as an important factor in the hypercalcemia of cancer. There are three general categories in which patients with hypercalcemia and cancer may be placed: those with bone metastases, those without bone metastases of solid tumors and those with hematologic malignancies. Hypokalemia is associated with ectopic ACTH- and insulin--producing tumors, and is often found in patients with mucin-secreting, potassium-losing adenocarcinoma of the colon.
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PMID:[Electrolyte abnormalities associated with cancer: a review]. 352 93


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