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

The rarity of primary hyperparathyroidism (PHPT) in multiple endocrine neoplasia type 2A (MEN 2A) led us to study clinical findings, surgical therapy and outcome in 67 patients in order to evaluate our therapeutic strategy. The retrospective study was based on cases registered by the EUROMEN study group (nine participating centres) from 1972 to 1993. Characteristics of PHPT in 67 patients (41 females, 26 males) with MEN 2A were reviewed. All patients underwent exploratory neck surgery; PHPT was confirmed histologically and/or biochemically. The median age at diagnosis of PHPT was 38 years. In 75% of the patients, PHPT and medullary thyroid carcinoma were diagnosed synchronously, while in 4%. PHT was diagnosed earlier. In 18% of the patients, PHPT was diagnosed after thyroidectomy, and in 3%, after discovery of pheochromocytoma. Primary hyperparathyroidism was asymptomatic in 84% of the patients; 15% suffered from renal stones. Serum calcium was slightly elevated in 69% (2.9 +/- 0.2 mmol-1) and normal in 16% of subjects. A single adenomectomy was performed in 42% of the patients, subtotal parathyroidectomy in 31% and total parathyroidectomy with autotransplantation in 16%. Independent from the extent of resection, cure was achieved in 94% of the patients, including 13% with hypoparathyroidism; hypercalcaemia persisted in 3% and no information was available in 3%. In an 8-year follow-up, hypercalcaemia recurred in 12% of the patients, although half had undergone parathyroidectomy totally or subtotally. CONCLUSION. MEN 2A-related PHPT is characterized by a mild hypercalcemia which is mostly asymptomatic and can be cured by simple resection of an enlarged parathyroid gland in most cases.
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PMID:Primary hyperparathyroidism in multiple endocrine neoplasia type 2A. 759 74

Flow cytometric DNA analysis was performed in 21 cases of primary hyperparathyroidism (19 adenomas in 19 cases and 5 glands with primary hyperplasia) and 24 glands with secondary hyperplasia. Tissue intact-PTH concentration was measured in another 41 glands with secondary hyperplasia. Glands with adenoma had a higher proliferative index than normal glands or glands with secondary hyperplasia. In the adenoma group, there was a negative correlation between proliferative index and age, an indicator of the tumorous nature of adenomas. Daily urinary calcium excretion in case of adenoma and tissue intact-PHT concentration in glands with secondary hyperplasia also showed correlations with proliferative index, which demonstrates a close relationship between cellular proliferation and endocrine activity. Gland weight and proliferative index had no significant correlation in both groups. Therefore, another mechanism besides cellular proliferation and endocrine activity, such as number of non-functional parathyroid cells, should be considered.
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PMID:[Study on the cellular proliferation and endocrine activity of the parathyroid gland in hyperparathyroidism]. 841 3