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)

Psychiatric symptoms are well recognized as a feature of patients with primary hyperparathyroidism. We have applied a standardized psychiatric interview to 15 patients before and after surgery. Thirteen had a lower 'psychiatric score' (less psychiatric morbidity) after surgery and improvements were particularly seen in symptoms of fatigue, depression, irritability, sleep disturbance and lack of concentration. The levels of intellectual impairment and of anxiety were unchanged after surgery. The 'psychiatric scores' in an additional group of 21 hyperparathyroid patients, in whom a decision to treat conservatively had been made independently, were similar to those in the surgically treated patients after surgery. Among all the untreated patients no relationship was found between overall 'psychiatric score' and serum levels of calcium or parathyrin.
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PMID:Psychiatric morbidity in primary hyperparathyroidism. 260 90

A 67-year-old woman was admitted to our department because of 5 years' duration of proximal muscle weakness. Serum CK was high, and EMG showed myogenic pattern, and muscle biopsy revealed remarkable inflammatory cells infiltrating around the destroyed muscle fibers. Her muscle weakness and hyperCKemia markedly improved by corticosteroid therapy, suggesting that the diagnosis was compatible with polymyositis (PM). In addition, serum calcium was high and phosphate was low. Serum parathormone level significantly elevated. The findings of diagnostic imaging procedures including echography, scintigraphy, and computed tomography of the parathyroid glands suggested presence of parathyroid adenoma with cystic degeneration in the thyroid tissue. There was only one case report of PM associated with primary hyperparathyroidism (PHP) as the literature referred. In this case, we could not prove direct relationship between PM and PHP. The association might have been coincidental. However, PHP might have played some role in the pathogenesis of muscular involvement, or there might be a similar immunological mechanism as seen between PM and malignancy. It is possible that association of PM and PHP is more frequent than generally considered. It may be necessary to pay more attention to find out the association of PM and PHP.
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PMID:[A case with polymyositis associated with primary hyperparathyroidism]. 261 6

The prevalence of peptic ulcer disease was retrospectively analysed in 35 patients affected by primary hyperparathyroidism consecutively observed from 1977 through 1987. Eight of the examined patients (22.8%) had peptic ulcer (7 duodenal and 1 gastric ulcer), that in five cases (14%) represented the first clinical manifestation of the endocrine disease. A Zollinger-Ellison syndrome was demonstrated in three cases (8.5% of the total series, 37% of the patients with ulcer). There was no difference in calcium, gastrin and parathormone serum level between patients with and without ulcer, excluding patients with Zollinger-Ellison syndrome. These data confirm the high prevalence of peptic ulcer disease in hyperparathyroidism, but the mechanism causing this association remains to be elucidated.
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PMID:[Primary hyperparathyroidism and peptic ulcer]. 262 74

For this two-site immunochemiluminometric assay of intact human parathyrin (hPTH), the luminescent tracer was synthetic hPTH(53-84), conjugated via succinimide linkage to (aminobutyl)ethyl-isoluminol hemisuccinimide (abei-h). Purification of the labeled hPTH(53-84) by reversed-phase high-performance liquid chromatography allowed isolation of the conjugate having the highest incorporation of abei-h, 1.6 mol per mole of hPTH(53-84). The solid-phase antibody directed against the N-terminal part of hPTH was immobilized by adsorption onto the polystyrene surface of the assay tube and extracted the intact hPTH and N-terminal fragments. Another antibody against synthetic hPTH(53-84), which bound to the C-terminal part of intact hPTH, was indirectly labeled at its second free binding site with the abei-h-labeled hPTH(53-84). The assay has a detection limit of 0.5 pmol/L; it is accurate, precise, and reliable; and it shows a linear response for samples containing up to 100 pmol of hPTH per liter. The normal reference interval ranged from 1.8 to 5.9 pmol/L; 56 patients with primary hyperparathyroidism had concentrations ranging from 5.9 to 113 pmol/L. The concentrations detected in patients with idiopathic hypoparathyroidism were below the normal reference interval.
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PMID:Two-site immunochemiluminometric assay of intact human parathyrin in serum with use of a tracer peptide purified by reversed-phase high-performance liquid chromatography. 264 57

In a chance observation, a 74-year-old woman was found to have hypercalcaemia (3.0 mmol/l) and multiple skeletal osteolyses. A diagnosis of multiple myeloma was made after the demonstration of paraproteins in serum (IgG-kappa) and a 10% proportion of plasma cells in a pelvic crest biopsy. Oral chemotherapy with melphalan and prednisone failed to alter the calcium level. Simultaneous increase in alkaline phosphatase and reduction in serum phosphate concentration led to further tests: determination of peripheral venous parathormone concentration, ultrasound examination of the neck, thallium-technetium subtraction scintigraphy and selective venous parathormone measurements. The results demonstrated the coexistence of primary hyperparathyroidism. The calcium level became normal after surgical removal of a parathyroid adenoma.
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PMID:[Hypercalcemia in coexistent parathyroid adenoma and multiple myeloma. Problems of differential diagnosis]. 266 81

We studied the effects of acute modifications in plasma calcium on parathormone (PTH) secretion in 23 patients with primary hyperparathyroidism (PHPT). In 12 patients, PTH hypersecretion was autonomous, and basal plasma calcium concentration was positively correlated with maximal serum PTH(1-84) reached during Na2EDTA infusions. In 11 patients, PTH hypersecretion remained suppressible, but with elevated set point value, and basal plasma calcium concentration was positively correlated with set point. Thus, the degree of hypercalcemia seems mainly determined by the magnitude of maximal PTH secretion and set point error in autonomous and suppressible PHPT, respectively. We have previously suggested that high serum calcitriol levels might chronically inhibit PTH hypersecretion in PHPT. We showed that hyperparathyroid patients with renal stone presentation exhibited an abnormally high value of circulating calcitriol and a moderately elevated PTH activity, while patients with severe bone disease presentation displayed a low to normal calcitriol value and a dramatically increased PTH activity. The hypothesis was supported by a recent study from our Unit in one hyperparathyroid patient with severe bone disease and normal serum calcitriol level. Increment of serum calcitriol after daily intravenous Rocaltrol for 5 days directly suppressed PTH hypersecretion without change in plasma ionized calcium.
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PMID:Determinants of parathormone secretion in primary hyperparathyroidism. 269 19

In the submitted review the author pays attention to mechanisms of control of insulin secretion and the mutual interaction of other messengers (cAMP, calcium and inisitol triphosphate) with special attention to the calcium signal which plays a most important role in the stimulation of the excitable B cell. The trigger of the two-stage insulin secretion is cyclic accumulation of calcium in the cytosol of the B cell and the mutual harmony between calcium of the intra- and extracellular compartment. In the early stage of insulin secretion in particular the intracellular compartment is the source of calcium; from there the ion is released due to the action of inositol triphosphate (IP3) activated by phospholipase C. Calcium of the extracellular compartment is mobilized also in the early secretory stage by opening of the depolarization-dependent calcium channels, it plays, however, a more important part during the second stage. Activation of the other messengers, incl. the calcium signal, depends on the type of secretagogue stimulus. During systemic changes of calcium homeostasis in vivo the calcium signal of the B cell is activated or inhibited in different ways. In the course of hypercalcaemia, in particular if acute, the direct influence of calcium ions on insulin secretion is modulated by further factors, e.g. somatostatin, calcitonin, cholecystokinin, glucagon, adrenocortical hormones, opioids and other substances released into the blood stream. In chronic hypercalcaemia which is the result of primary hyperparathyroidism or vitamin D intoxication the action of calcium on the metabolic and hormonal response is enhanced by the ionophoretic action of parathormone or active vitamin D metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The calcium signal in the regulation of insulin secretion]. 269 62

Primary hyperparathyroidism is a pathological entity due to excessive secretion of parathormone from a single or multiple parathyroid glands. The biochemical hallmark of this disorder is an elevated serum calcium. The relationship of the parathyroid glands with the thymus gland in fetal development accounts for the occasional aberrant location of the parathyroids. By utilizing computed tomography or nuclear scanning or both preoperatively, the surgeon can isolate the hyperfunctioning adenoma and resect it, thus minimizing potential complications.
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PMID:Primary hyperparathyroidism. 276 6

The "N-tact" immunoradiometric assay (IRMA) from INCSTAR for parathyrin (PTH) in serum involves a 125I-labeled affinity-purified antiserum to PTH 1-34 and an affinity-purified antiserum to PTH 39-84, the latter bound to a polystyrene bead. The mean detection limit, determined in six consecutive assays, was 4 ng/L. The within-batch CV was less than 7% in the range 15 to 2135 ng/L. The between-batch CV was 11.7% and 5.3% at 30 and 371 ng/L, respectively. Serum PTH in 14 proven cases of primary hyperparathyroidism was 49-808 (median 111) ng/L, undetectable (less than 5 ng/L) in 10 cases of primary hypoparathyroidism and in 10 cases of hypercalcemia associated with malignancy, compared with 7-39 ng/L in 45 normal subjects. PTH was 9 to 19 ng/L in four patients with familial benign hypercalcemia. In 39 patients with renal failure, apparent concentrations were 14 to 857 (median 133) ng/L, but sera from these patients pre-diluted with zero standard did not parallel dilutions of the standard, PTH 1-84. PTH concentrations were not significantly decreased in blood or serum kept at 20 degrees C for up to 6 h. After successful removal of a parathyroid adenoma, the mean half-time for disappearance of PTH in vivo in five hyperparathyroid patients was 3.3 min.
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PMID:Performance and diagnostic application of a two-site immunoradiometric assay for parathyrin in serum. 277 25

Forty-nine patients with primary hyperparathyroidism were examined preoperatively and three months after parathyroid operation for their serum vitamin D metabolites and routine laboratory samples related to calcium metabolism. The preoperative serum 24,25-dihydroxyvitamin D level, mean (SE) was 1.86 (0.22) nmol/l and the postoperative level 5.35 (0.63) nmol/l, the difference being highly significant (P less than 0.001). Serum 1,25-dihydroxyvitamin D levels fell significantly (P less than 0.001) from a preoperative level of 175.5 (17.9) pmol/l to 102.8 (10.1) pmol/l postoperatively. The preoperative 25-hydroxyvitamin D level did not change significantly after surgery. The preoperative serum 24,25-dihydroxyvitamin D level was very low, especially in patients with bone disease while serum parathormone was significantly higher than in patients without bone disease.
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PMID:Serum vitamin D metabolite concentrations in primary hyperparathyroidism. 278 97


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