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

Among 1819 patients with renal stone disease 44 cases with primary hyperparathyroidism (p.h.p.) were diagnosed. In all cases the diagnosis of php was confirmed by histomorphological examination. In 34 patients with php solitary adenoma was found, in 5 patients an adenoma with concomitant hyperplasia of the parathyroid glands, in 2 patients hyperplasia and in 3 patients carcinoma of the parathyroid glands. Hypercalcemia was found in 86% of patients, while elevated plasma levels of PTH in 90% of patients with php. Not in all patients PTH secretion was entirely autonomous. No significant correlation was found between plasma levels of PTH and kind of pathology of the parathyroid glands as well as clinical feature of php respectively.
Pol Arch Med Wewn 1992 Jan
PMID:[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. II. Primary hyperparathyroidism]. 164 64

The primary hyperparathyroidism (PHP) is a complex of nosological symptoms associated with disturbances of calcium-phosphate equilibrium and bone metabolism, caused by excessive secretion of parathormone. In the past regarded as a rare entity, today it is arousing great interest due to ever more frequent diagnosis of it in the stage of subtle changes or in the asymptomatic period. Untreated PHP leads to the development of a number of organ complications, and even to a life-threatening state, that is hypercalcemic crisis. The authors discussed differential diagnostic and localisation difficulties in PHP on example of own observations.
Pol Arch Med Wewn 1996 Apr
PMID:[Diagnostic difficulties in primary hyperparathyroidism based on personal observations]. 875 43

Parathyroid imaging with 99m Tc-MIBI, introduced at the beginning of the 90's seems to be a promising method for parathyroid adenomas localization. The aim of the study was to assess the efficacy of parathyroid imaging with 99m Tc-MIBI for preoperative localization of parathyroid adenomas and to compare that method with the high-resolution ultrasonography. Thirteen patients with primary hyperparathyroidism of duration from 2 to 25 years were included in the study. The presence of parathyroid adenomas was confirmed by histopathology in all patients. The sensitivity for scintigraphy and ultrasonography was 92.8% and 78.5%, the number of false positive results was 0 and 2 and false negative-0 and 1, respectively. Parathyroid imaging with 99m Tc-MIBI is a useful method for parathyroid adenomas localization, and in contrast to ultrasonography its sensitivity does not decrease if a parathyroid adenoma is located ectopically. Nevertheless, because of the greater accessibility, lower costs and its simplicity ultrasonography should be used as a screening modality for parathyroid adenoma localization.
Pol Arch Med Wewn 1996 Jun
PMID:[Primary hyperparathyroidism--diagnostic problems]. 900 22

Hyperparathyroidism, both primary and secondary in chronic renal failure, leads to pathologic changes in the bones. Newly introduced markers of bone metabolism enable to biochemically detect and evaluate these changes. The aim of our studies was to perform determinations of serum osteocalcin as a marker of bone formation, and C-terminal telopeptide of collagen I (ICTP) as a marker of bone resorption in patients with excessive secretion of parathyroid hormone (PTH). Our studies comprised of 15 patients with primary and 24 patients with secondary hyperparathydroidism. In all patients serum PTH, osteocalcin and ICTP were detected by radioimmunoassay; the correlations between PTH and osteocalcin as well as between PTH and ICTP were also performed. Serum PTH was elevated in both, primary and secondary hyperparathyroidism. In primary hyperparathyroidism serum osteocalcin was moderately or definitely elevated, similarly serum ICTP was high. Following surgical removal of a parathyroid adenoma, concomitantly with a drop in serum PTH there was a rapid normalization of serum osteocalcin and ICTP. Secondary hyperparathyroidism in uraemia was characterised by markedly elevated serum osteocalcin and ICTP which surpassed the concentration of these markers in primary hyperparathyroidism. There was a positive correlation between serum PTH and osteocalcin levels, and a lower correlation between PTH and ICTP. From our studies it is concluded that excessive secretion of PTH in primary and secondary hyperparathyroidism stimulates bone formation and to higher degree--bone resorption.
Pol Arch Med Wewn 1998 Apr
PMID:[Markers of bone formation and resorption in primary and secondary hyperparathyroidism]. 976 Aug 16

In children and the youth it is secondary osteoporosis (OP) rather than idiopathic one which occurs more often; its multidirectional pathogenesis is usually ascertainable. Secondary OP, mostly generalised, is diagnosed in the course of such hormonal disturbances as: primary hyperparathyroidism, hyperthyroidism, hyperadrenalocorticalism. Another group of diseases implicating OP are connective tissue pathologies: congenital (osteogenesis imperfecta, collagenopathies) and acquired (juvenile chronic arthritis). A serious problem for a paediatrician is the iatrogenic OP resulting from a long-term use of some medicines (glucocorticosteroids) or long-lasting immobilization for surgical and orthopaedic reasons, or from chronic general diseases. Osteoporosis accompanying pathological states of the skeletal and nervous systems (with paralyses and pareses) is particularly intensive and difficult for treatment. Osteoporosis in developmental age may cause disturbances in natural development of the skeleton, which leads to deformities in the skeletal system and to the formation of faulty postures. Lower body height is a frequent complication resulting from OP in children and the youth. In OP diagnostics the densitometry test is of the basic importance, the most common method is dual energy X-ray absorptiometry (DEXA) and the diagnosis criterion is the decrease of bone mineral density (BMD) greater than 2 SD. It should be taken into account also the X-ray and clinical symptoms, which are similar as those observed in adults. Osteoporosis biochemical markers, however are, less significant in children because for the most of then the reference values are not determined. The OP treatment is indispensable in developmental age and it should include pharmacological therapy and the proper diet and rehabilitation as well.
Pol Merkur Lekarski 1998 Oct
PMID:[Osteoporosis in developmental age: diagnostic and therapeutic problems]. 1010 50

Parathyroid cancer is a rare disease, causing 0.5% to 5.2% of primary hyperparathyroidism cases. Hyperparathyroidism accompanying a cancer is usually more severe with richer clinical symptomatology then hyperparathyroidism in the course of benign lesions. Every palpable neck tumour with high blood plasma calcium level should suggest the presence of parathyroid cancer. Development of cancer is slow but life prognosis depends on the extent of the first surgery. The prognosis is most favourable in case of 'en bloc' resection of tumour during the first surgical procedure. Therefore, diagnosis of cancer before operation is very important. If the surgery fails, the treatment should be aimed at lowering hypercalcaemia, which is the most common cause of the fatal sequel.
Pol Merkur Lekarski 2000 Mar
PMID:[Parathyroid cancer]. 1087 Apr 12

Primary hyperparathyroidism is a systemic disease, more and more frequently recognized-concerning 1 to 3% of the population. Statistically appears in 1 of 1000 adults, with significant advantage of women. In Poland every year about 30 new cases are noticed and incidence increases with an age. In spite of significant advance of the knowledge, it still makes a lot of diagnostic troubles. It appears to be non-specific illness, characterised by just one symptom, mainly urolithiasis, sometimes chronic ulcer disease, chronic pancreatitis, arterial hypertension, disorders of the movement or psychic disorders. Parathyroid adenoma which is the main reason of the disease is usually single and small, multiple and bigger ones are found exceptionally. In about 2% of cases they are localized in mediastinum. In the article the basic symptoms, diagnostic and therapeutic problems were shown, especially concerning surgical treatment which is safe, radical and efficacious method when performed by experienced surgical team and the conduct from choice on primary and secondary hyperparathyroidism.
Pol Merkur Lekarski 2000 Nov
PMID:[Primary hyperparathyroidism treated surgically]. 1120 37

In this study, the biochemical and clinical profile of primary hyperparathyroidism, diagnosed in 155 patients (106 females and 49 males) in the Department of Nephrology of the Silesian University School of Medicine in the years 1972-1998 was analyzed. The mean age of patients was 48.5 +/- 12.8 years. In all cases the diagnosis was confirmed by the pathomorphological examination. In the majority of cases PNP was diagnosed in a phase of advanced organic injuries. The leading clinical finding in these patients was nephrolithiasis. Asymptomatic hypercalcemia was diagnosed only in 9% of cases. In the years 1972-1992 elevated serum total calcium concentration was found in 92.6% while after introduction of routine estimation of ionized calcium concentration in 1993, hypercalcemia was found in all patients. The incidence of hypercalciuria increased significantly in patients diagnosed in the period 1993-1998 while in this same period the incidence of impaired renal function declined significantly. The elevated serum PTH was found in 86% of patients regardless whether C-terminal fragments of PTH or intact PTH-1-84 were assessed. Elevated levels of ionized serum calcium with normal or increased plasma iPTH-1-84 level are the most constant symptoms of primary hyperparathyroidism.
Pol Arch Med Wewn
PMID:[Clinical and biochemical picture of primary hyperparathyroidism based on 155 observed cases]. 1123 60

The frequent association of thyroid and parathyroid disorders has been reported. Most commonly, hyperthyroidism may coexist with hypercalcemia, but the latter is successfully treated when euthyroidism is achieved. However, the concomitant hyperthyroidism with primary hyperparathyroidism is of a rare occurrence. Moreover, it may frequently go unrecognized. In this paper we report a case of a patient with hypercalcemia due to PTH--secreting parathyroid adenoma associated with hyperthyroidism due to toxic nodular goiter. This case demonstrates the dramatic outcome of those two coexisting disorders. We point out that in patients with primary hyperparathyroidism thyroid function test should always be carried out. A proper, first-line treatment of hyperthyroidism will prevent the deterioration of primary hyperparathyroidism course, and thus surgical parathyroid treatment may safely be introduced.
Pol Arch Med Wewn 2003 Feb
PMID:A rare coexistence of primary hyperparathyroidism and hyperthyroidism due to toxic nodular goiter--a case report. 1287 80

MEN 1 syndrome (Multiple Endocrine Neoplasia type 1) is a rare endocrine disorder characterized by the association of tumors in several endocrine glands, mainly in parathyroids, gut and pituitary. At our institution in the years 1982-2004 we have followed 26 patients with MEN 1 syndrome belonging to 19 families. The diagnosis of MEN 1 was based on Gubbio Consensus (JCEM 86: 5658-5671, 2001). Mean age at the diagnosis of MEN 1 was 35 years. Primary hyperparathyroidism was the most frequent pathology, which was diagnosed in 25 of 26 patients (96%). Gut endocrine tumors were found in 20 patients (77%), while pituitary tumors in 18 (70%). Non-functioning gut tumors were most frequent (n=9), followed by insulinoma (n=7) and gastrinoma (n=4). Prolactinoma was the most frequent pituitary tumor found in 12 patients (67%). Three patients died during the observation period - all of them of generalized gut endocrine tumor (gastrinoma in 2 cases and foregut carcinoid in one case). The management of MEN 1 is not easy and careful analysis of clinical picture is necessary in each individual case. Several important observations can be made on the basis of own experience and the literature: 1. In each sporadic pathology, which may be a part of MEN 1, one should consider. the possibility of MEN 1. The individual MEN 1 abnormalities are often diagnosed after 40 and later 2. MEN 1 tumor are usually multiple thus necessitating a different therapeutic approach (more radical surgery) 3. The most valuable screening tests are: Ca++, PP, CgA and prolactin 4. Endoscopic ultrasound is the most specific method for the localization of pancreatic endocrine tumors. 5. The results of surgical treatment of MEN 1 tumors are worse than that of sporadic tumors. 6. Prognosis in MEN 1 is determined by the behaviour of gut neuroendocrine tumor 7. No genotype/phenotype correlation in MEN 1 syndrome was found so far. In summary, it should be underlined that MEN 1 syndrome is an endocrine disorder, in which early diagnosis and optimal treatment may significantly improve the prognosis.
Endokrynol Pol
PMID:[Diagnostic and therapeutic difficulties in MEN 1 syndrome]. 1635 Jul 23


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