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

Eleven patients with primary hyperparathyroidism confirmed by histologic examination were subjected to a comparative study of the results of quantitative determination of parathormone and of quantitative bone biopsy. Quantitative radioimmunologic determination of parathormone was carried out with the aid of an N-terminal specific anti serum, while the histologic features studied were the periosteocytic and osteoclastic absorption surfaces. On the basis of a combination of the results of these two techniques, the diagnosis could be made in all the cases studied. A statistically significant correlation was observed between the results of quantitative determination of parathormone and those of histologic examination of the surfaces of periosteocytic lacunae (r = 0.63; p = 0.05).
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PMID:[Correlation of parathormone determination and bone biopsy in primary hyperparathyroidism]. 88 15

Eleven cases with histologically confirmed primary hyperparathyroidism have been studied. Although histologically, bone turnover increased in all but 1 patient, urinary hydroxyproline excretion and serum alkaline phosphatase in patients with renal stones were within the upper normal limits of slightly elevated (27.5 mg/24 h, concentration 19.5 microgram/ml, alkaline phosphatase 35.0 IU/l). On the contrary, 3 cases without renal stones exhibited an increased urinary hydroxyproline excretion (129 mg/24 h, concentration 95.6 microgram/ml) and elevated serum alkaline phosphatase (99.9IU/l). Serum total hydroxyproline was elevated in both groups (renal stones, 2.00 mg%; no renal stones, 3.16 mg%; p = 0.006). Hydroxyproline was determined under conditions of a very low proline diet and 1.5 liters of daily fluid intake. There were no statistically significant differences between serum calcium, phosphorus, and parathormone between urinary excretion of calcium and phosphorus. Creatinine clearance was within normal limits in all patients. The possible relevance of urinary hydroxyproline for stone formation is discussed.
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PMID:Urinary hydroxyproline concentration in primary hyperparathyroidism with and without renal stones. 91 50

An unusual case of primary hyperparathyroidism involving six parathyroid glands is reported. Despite markedly elevated parathormone levels, neoplastic features were not found. This patient also had ovarian dysgenesis and hypertrophy and clear cell appearance of the salivary glands.
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PMID:Water clear cell hyperplasia of parathyroid: autopsy report of a case with supernumerary glands. 99 Oct 85

The basis for the radioimmunoassay of parathormone (PTH) as a routine method is a new sheep antiserum and a labelled PTH stabilised by a modification of the purification technique. The antiserum is obtained by immunisation with pig and cattle parathormone, it is C-terminal specific and is used in the assay in a final dilution of 1:35000. The affinity to human PTH is markedly greater than of the antisera used up to now. Two purification steps of 125J labelled bovine PTH lead to a tracer with a nonspecific binding of approximately 5% which increases to approximately 10% within 6 weeks. All normal sera investigated so far were measurable quantitatively (normal range 0.7 to 2.5 mul/equiv.). The lower sensitivity range was at 0.3 mul/equiv. All patients with chronic renal insufficiency and dialysis patients have an increased PTH concentration (3.9 to greater than 20 mul/equiv.). This also applies to patients with primary hyperparathyroidism (2.9 to greater than 20 mul/equiv.).
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PMID:[A highly sensitive C-terminal specific radioimmunoassay for human parathormone as a routine method (author's transl)]. 99 60

Multisite cervico-mediastinal venous blood samples were collected fort the estimation of parathormone before operation in twenty four patients subsequently confirmed at surgery to have primary hyperparathyroidism. The examination made it possible to lateralise a single (single adenoma: 18 cases) or predominant lesion (multiple adenomas or hyperplasia: 6 cases), in 15 of them (62%). In patients with a single adenoma, exact lateralisation was obtained in 12 out of 18 cases (9 had selective samples with 7 accurate lateralisations). This lengthy and costly examination is essentially of value in localisation and should be used essentially in patients with virtually definite primary hyperparathyroidism and in whom the responsible lesion has not been discovered at exploratory operation.
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PMID:[Multisite cervico-mediastinal venous samples for radioimmunologic determination of parathormone in primary hyperparathyroidism. Results in 24 surgically confirmed cases]. 100 76

In examining a group of 90 hypercalcaemic patients (37 with primary hyperparathyroidism), a comparison was made of the diagnostic reliability of: 1) tests commonly used for diagnosis of primary hyperparathyroidism; 2) radioimmunoassay of plasma parathormone; 3) a recently introduced model of multivariate statistical analysis. The results indicate that, at present, the model of multivariate statistical analysis used is of higher diagnostic reliability in the diagnosis of primary hyperparathyroidism than renal phosphate excretion tests and the radioimmunoassay of PTH itself.
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PMID:Primary hyperparathyroidism: diagnostic value of a model of multivariate statistical analysis. 102 48

The seventh case in the world literature of primary hyperparathyroidism in a neonate is reported. This is the fifth case in which an autopsy was performed. The clinical and anatomic findings in all seven cases are reviewed and compared. Neonates with primary hyperparathyroidism show diffuse hyperplasia of the parathyroid glands. The bones show disturbed osteogenesis, bone resorption, and widespread fibrosis of the marrow cavities. Bony cysts are not appreciated. Pathologic fractures are common. Marked hypercalciuria or hyperphosphaturia is usually not observed, perhaps because the immature renal tubules fail to respond to the influence of excess parathormone. Aminoaciduria and anemia are commonly observed. The prognosis is grave, and the etiology of this syndrome remains unexplained.
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PMID:Primary neonatal hyperparathyroidism. Report of a case and review of the literature. 110 78

Serum ionized calcium was shown to be significantly elevated in a group of twenty-eight subjects with idiopathic hypercalciuria in whom the mean total serum calcium concentration was within normal limits. Measurement of parathyroid hormone levels confirmed that elevated values are suppressible by infusion of calcium. Ten subjects with simultaneous elevation of serum ionized calcium and parathormone levels above 3 S.D. of normal were referred for neck exploration, and a parathyroid adenoma was found and removed in nine. Significant decreases to normal values of serum ionized calcium and parathormone levels of urine and calcium excretion were documented some weeks following operation. The results conflict with both the alimentary calcium hyperabsorption theory and the renal calcium leak theory of the aetiology of idiopathic hypercalciuria, and support the possibility that idiopathic hypercalciuria in many cases represents an early or mild form of 'normocalcaemic' primary hyperparathyroidism.
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PMID:Serum ionized calcium and parathyroid hormone in renal stone disease. 125 1

Using a sensitive two-site immunoradiometric assay which detects intact parathormone (iPTH), we studied the decrease in peripheric and jugular plasmatic iPTH during surgical removal of abnormal parathyroid (s). In the next future, results of intact parathormone (iPTH) assay will be given in 45 minutes. In a prospective study of 33 patients operated on for hyperparathyroidism or for cold thyroid nodule, the serum levels of intact PTH was measured intraoperatively in peripheric and in jugular blood. The preoperative mean serum iPTH concentration was 119.23 +/- 172.48 pg/ml and fell to 34.5 +/- 32.21 pg/ml after surgery in 14 cases of primary hyperparathyroidism (p < 0.001). Thirteen out of 14 patients had serum iPTH values less than 65 pg/ml within 15 minutes after parathyroidectomy. The preoperative mean serum iPTH concentration in the 5 secondary hyperparathyroidism was 781.2 +/- 403.19 pg/ml. This value fell to 124 +/- 66.91 pg/ml after parathyroidectomy (p < 0.04). No significant decrease was observed in the mean serum concentration of the 14 patients operated on for cold thyroid nodule. Patients suffering from single parathyroid adenoma presented a significant gradient in jugular plasmatic PTH concentration between the adenoma side and the contralateral one. This gradient decreased during effective parathyroid adenomectomy (309.7 +/- 313.3 pg/ml to 3.7 +/- 35.1 pg/ml). Intraoperative serum iPTH concentration will provide a valuable tool to appreciate the effectiveness of surgical removal of parathyroid glands and to detect the location of parathyroid adenoma when the surgical research is negative.
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PMID:[Contribution of intra-operative measurement of intact parathormone in surgery for primary hyperparathyroidism]. 129 31

We have developed a sensitive, specific solid-phase immunoradiometric assay (IRMA) of parathyroid hormone-related protein (PTH-RP) with use of affinity-purified polyclonal immunoglobulins. Antibodies recognizing PTH-RP(37-74) are immobilized to a polystyrene bead to "capture" analytes from the sample; antibodies to epitopes within the 1-36 amino acid region of PTH-RP are labeled with 125I. This IRMA recognizes PTH-RP(1-74) and PTH-RP(1-86) equivalently, but does not detect N-terminal or C-terminal fragments of PTH-RP, intact human parathyrin (PTH), or fragments of PTH. PTH-RP is not stable in plasma at 3-5 degrees C or room temperature, but a mixture of aprotinin (500 kallikrein units/L) and leupeptin (2.5 mg/L) improves PTH-RP stability in blood samples. In plasma collected in the presence of these protease inhibitors from normal volunteers and patients with various disorders of calcium metabolism, PTH-RP concentrations were above normal (greater than 1.5 pmol/L) in 91% (42 of 46) of patients with hypercalcemia associated with nonhematological malignancy. In plasma from patients with other hypercalcemic conditions (e.g., primary hyperparathyroidism, sarcoidosis, and vitamin D excess), PTH-RP was undetectable. Above-normal concentrations of PTH-RP and total calcium decreased to normal in a patient with an ovarian cyst adenocarcinoma after surgical removal of the tumor. We conclude that PTH-RP is related to and probably the causative agent of hypercalcemia in most patients with cancer, and that measurements of PTH-RP are useful in the diagnosis and management of patients with tumor-associated hypercalcemia.
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PMID:Modified immunoradiometric assay of parathyroid hormone-related protein: clinical application in the differential diagnosis of hypercalcemia. 154 Sep 98


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