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)

We describe a radioimmunoassay for 1,25-dihydroxycholecalciferol in human serum. We raised antisera in rabbits to 1,25-dihydroxycholecalciferol-3-hemisuccinate coupled to bovine serum albumin, and obtained sensitive, high-titer antibodies. These antibodies had a high affinity for 1,25-dihydroxycholecalciferol and cross reacted mainly with 25-hydroxycholecalciferol and 24,25-dihydroxycholecalciferol. Addition of 1 mL of normal rabbit serum per liter reduced this interference to 5 and 4%, respectively. However, these interfering steroids are present in large excess, so extensive purification of 1,25-dihydroxycholecalciferol from serum is necessary. The steroid was extracted with ethyl acetate/cyclohexane, purified on Sephadex LH-20, and then chromatographed on a column of silicic acid. The radioimmunoassay is sensitive to 5 pg/tube (3 ng/L of serum). The between-assay CV was 14%. The mean concentration of 1,25-dihydroxycholecalciferol in the serum of 54 healthy adults was 38 (SD 12) ng/L, with no sex-related difference. The assay was further validated by the finding of low or undetectable concentrations in patients with chronic renal failure and of increased concentrations in the serum of patients with primary hyperparathyroidism. In comparison with previously described methods, the major advantage of the present assay is the use of stable gamma-globulins, which are available in large amounts, as binding protein.
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PMID:A radioimmunoassay for 1,25-dihydroxycholecalciferol. 689 88

Serum calcium, phosphorus, calcitonin, parathyroid hormone, 25-hydroxyvitamin D (25OHD), and 1,25-dihydroxyvitamin D [1,25-(OH)2D] were measured in 6 women and 2 men with medullary carcinoma of the thyroid, 22 normal subjects, 5 patients with chronic renal failure, and 5 patients with primary hyperparathyroidism. Serum 1,25-(OH)2D levels were significantly higher in patients with primary hyperparathyroidism and lower in patients with chronic renal failure than in normal subjects. In patients with medullary carcinoma of the thyroid, the serum calcitonin levels were elevated, but the parathyroid hormone and 1,25-(OH)2D levels were within normal ranges. The serum 25OHD levels were not significantly different in any group. It is concluded that chronic elevation of serum calcitonin has no effect on the serum 1,25-(OH)2D level.
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PMID:Normal serum 1,25-dihydroxyvitamin D in patients with medullary carcinoma of the thyroid. 697 51

One hundred fourteen nondialyzed azotemic adult patients (creatinine connentration 1.2 to 17.6 mg/dl), 78 stable renal transplant recipients (creatinine less than 1.9 mg/dl), 50 patients with idiopathic nephrolithiasis, 36 patients with surgically proven primary hyperparathyroidism, and 62 normal volunteers were studied with simultaneous serum ionized calcium, total calcium, parathyroid hormone (PTH), phosphorus, and creatinine measurements. Ionized calcium could not be reliably predicted from total calcium. Although in all patient groups values for serum ionized calcium correlated significantly with those for total calcium, the scatter around the regression line was such that a direct interpretation was not precise. With respect to reference values, significant differnces were found between ionized and total calcium in 26% of all studied patients. When compared with total serum calcium, ionized calcium appeared to be a more sensitive index of calcium metabolism. All correlations with ionized calcium had a higher r value compared with those with total serum calcium. Two findings were particularly rewarding. In patients with chronic renal failure, serum PTH showed a negative correlation with serum ionized calcium, indicating that the latter may have been largely responsible for the secondary increase in PTH; in patients after a successful transplant, serum PTH showed a positive correlation with serum ionized calcium, indicating that in the presence of normal kidney function the previously hypertrophied parathyroid glands may be largely responsible for the daily study of a large number of specimens, determinations of serum ionized calcium should be encouraged in all patients suspected of having abnormalities of renal calcium metabolism.
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PMID:Comparative studies of total and ionized serum calcium values in normal subjects and patients with renal disorders. 699 43

Early reports of patients with metabolic bone diseases such as nutritional osteomalacia, Fanconi syndrome, indicated an association with aminoaciduria. This association has since been described in osteomalacia of G. I. or hepatic origin, secondary to anticonvulsant therapy, tumors, and chronic renal failure. Aminoaciduria also occurs in primary hyperparathyroidism. In nutritional osteomalacia, vitamin D deficiency was thought to be responsible for the renal tubular abnormality, since it responded to treatment with vitamin D. However, since the description of aminoaciduria in hyperparathyroidism, the literature has been divided concerning the etiology of aminoacidura in conditions associated with abnormal vitamin D metabolism because secondary hyperparathyroidism often occurs in these conditions. Recently, some cases of Fanconi syndrome and a case of tumor-associated osteomalacia have been described with low or absent plasma 1,25-dihydroxycholecalciferol levels, normal serum PTH, and aminoaciduria. In one of these cases, and more recently in patients with chronic renal failure, it has been demonstrated that treatment with 1,25(OH)2D3 can improve amino acid transport independently from changes in serum PTH levels. 1,25(OH)2D3 therefore normally opposes the aminoaciduric effect of PTH. This is an agreement with observations which demonstrate that 1,25(OH)2D3 also opposes the phosphaturic action of parathyroid hormone.
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PMID:Aminoaciduria--its relationship to vitamin D and parathyroid hormone. 699 53

In order to provide information about the prevalence of hypercalcaemia and its different causes, a retrospective survey was carried out in all hospital in-patients in whom serum calcium was elevated. Six hundred and forty-four cases were seen in two years and eight months, but a number of these were excluded as being spurious measurements leaving 496 cases of genuine hypercalcaemia. Four hundred and sixty-nine records (95 per cent) were successfully traced and analysed. Two hundred and nineteen cases of hypercalcaemia with malignancy were found together with 68 cases with chronic renal failure and 59 cases of primary hyperparathyroidism. In 102 cases no cause was identified.
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PMID:Hypercalcaemia--a hospital survey. 702 40

In 100 patients with various types of endocrine dysfunction, we measured bone mineral density (BMD) at the midradius (greater than 95% cortical bone) and distal radius (75% cortical and 25% trabecular bone) by single photon absorptiometry and at the lumbar spine (greater than 66% trabecular bone) using the new technique of dual photon absorptiometry. BMD in each endocrine disorder deviated in at least one site from the sex-specific age regression of 187 normal subjects. For patients with primary hyperparathyroidism, hypercortisolism, and hyperthyroidism this deviation was negative (suggesting bone loss), whereas for patients with secondary hyperparathyroidism due to chronic renal failure, acromegaly, and postsurgical hypoparathyroidism it was positive (suggesting bone gain). When all six states of endocrine dysfunction were compared concomitantly by multivariate analysis of variance, the profile of the changes in BMD differed significantly (P less than 0.001), indicating a nonuniform response of bone to the various hormonal alterations. When values for BMD at each of the three scanning sites were compared the midradius and distal radius did not differ significantly; either of the radius measurements, however, differed significantly (P less than 0.001) from the lumbar spine. Thus, the BMD of the axial skeleton cannot be reliably predicted from measurements made in the appendicular skeleton. We conclude that the effects of endocrine dysfunction on bone density are complex and are both disease and site specific.
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PMID:Differential effects of endocrine dysfunction on the axial and the appendicular skeleton. 708 76

In a university-affiliated community hospital, medical records of 58 patients on whom the intact parathyroid hormone immunoassay (I-PTH) and 29 patients on whom both the carboxyl terminal PTH(C-PTH) and I-PTH ordered by physicians were reviewed to determine the reasons for requesting these tests. Reasons for ordering the PTH tests include (1) the evaluation of hypercalcemic patients (25/58 I-PTH); (2) the evaluation of hypocalcemic patients (2/58 I-PTH); (3) to rule out primary hyperparathyroidism in normocalcemic stone formers (4/58 I-PTH, 4/29 C-PTH) and in those with abnormal skeletal x-ray (3/48 I-PTH 1/29 C-PTH); (4) to follow patients with chronic renal failure on dialysis (11/58 I-PTH, 9/29 C-PTH); (5) to rule out ectopic hyperparathyroidism in patients with cancer (2/58 I-PTH, 3/29 C-PTH); (6) to satisfy physicians' intellectual curiosity of patients with diabetes mellitus (3/58 I-PTH, 3/29 C-PTH) and obesity (5/58 I-PTH; 6/29 C-PTH); (7) to evaluate acute renal failure (1/29 C-PTH). In 3/58 patients on whom I-PTH tests were ordered, reason(s) could not be determined. The C-PTH was elevated in 9/9 patients with chronic renal failure, 4/6 obese patients, 2/3 patients with cancer, 1/3 diabetic patients, 1/4 stone formers, 2/2 patients with primary hyperparathyroidism. Patients with chronic renal failure had the highest C-PTH. Based on well established indications for ordering the PTH immunoassays, 25 out of 58 (43%) of I-PTH and 9 out of 29 (31%) of C-PTH ordered are inappropriate.
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PMID:Diagnostic utility of carboxyl-terminal and intact parathyroid hormone immunoassays in hospitalized patients. 709 Oct 50

The parathyroids from ten consecutive cases of chronic renal failure coming to operation in a period of seven years were studied by light and electron microscopy. The clinical and biochemical data as well as the levels of immunoreactive parathormone (iPTH) were reviewed. For the sake of comparison adenomata from two cases of primary hyperparathyroidism were studied. In the cases of chronic ;renal failure there were six cases of tertiary hyperparathyroidism with adenoma formation, surrounded by dense fibrous tissue and compression of adjacent parathyroid cell amidst a background of hyperplasia. Two cases showed secondary parathyroid hyperplasia and the remaining two cases were adenomata which clinically affected only one gland. Neither the biochemical data nor levels of iPTH allowed the cases with secondary hyperplasia to be separated from those with tertiary hyperparathyroidism. Similarly electron microscopy showed no distinct differences between these two groups of adenomata from cases of primary hyperparathyroidism. The diagnosis of tertiary hyperparathyroidism is made on a combination of clinical, biochemical and histological features, the histological features being most important. It is concluded that tertiary hyperparathyroidism is part of a histological spectrum in response to chronic renal failure and autonomous glands are related to the mass of parathyroid tissue present.
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PMID:The parathyroid in chronic renal failure-- a light and electron microscopical study. 744 5

The effects of parathyroidectomy on left ventricular muscle volume and mechanical performance were evaluated echocardiographically in 24 patients with secondary hyperparathyroidism due to chronic renal failure and in 7 with primary hyperparathyroidism. Intraventricular septum and posterior wall thickness, left ventricular end-diastolic diameters, shortening fraction, ejection fraction, and left ventricular mass index were measured by M mode recording by the parasternal short axis view prior to parathyroidectomy as baseline and repeated 12 months after parathyroidectomy. Serum basal carboxyterminal parathyroid hormone levels in patients with secondary hyperparathyroidism (34.4 +/- 13.7 ng/ml) were significantly higher than in those with primary hyperparathyroidism (3.4 +/- 5.1 ng/ml; p < 0.0001). At 12 months after parathyroidectomy, intraventricular septum and posterior wall thickness, left ventricular end-diastolic diameter and left ventricular mass index were reduced from 11.8 +/- 3.1 mm, 10.9 +/- 1.7 mm, 53.8 +/- 6.3 mm, 200.8 +/- 57.1 g/m2 to 10.0 +/- 2.1 mm (p < 0.05), 9.8 +/- 1.9 mm (p < 0.05), 50.7 +/- 7.2 mm (p < 0.05), 149.6 +/- 38.7 g/m2 (p < 0.0001), in patients with secondary hyperparathyroidism. In patients with primary hyperparathyroidism, all echocardiographic parameters remained in the normal range and did not show any significant changes before or after parathyroidectomy. From this study, parathyroid hormone at extremely high concentrations as seen in secondary hyperparathyroidism appears to be a cardiotoxic substance. Therefore, all patients with secondary hyperthyroidism should be examined by echocardiography and parathyroidectomy should be considered if myocardial hypertrophy is present.
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PMID:Effects of parathyroidectomy on left ventricular mass in patients with hyperparathyroidism. 756 65

The case of an 81-year-old woman with persistent post-traumatic pain of the knee linked to tophaceous gout of the patella is presented. This gout was associated with adenomatous primary hyperparathyroidism. The relationship between hyperuricemia, hyperparathyroidism and chronic renal failure is discussed.
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PMID:Tophaceous gout of the patella with primary hyperparathyroidism. 765 76


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