Case-control study on symptoms and signs of “asymptomatic” primary hyperparathyroidism

BackgroundNormocalcemic primary hyperparathyroidism (PHPT-N) is a condition that may have similar long-term implications to primary hyperparathyroidism (PHPT); however, differential diagnosis and treatment for parathyroid disorders are not clearly defined. We investigated the effect of an oral peptone and an oral calcium load on calcium-regulating hormones in PHPT-N compared with PHPT and healthy controls to provide a new potential diagnostic tool.DesignCase–control study.MethodsWe evaluated serum gastrin, PTH, ionized calcium, and phosphate responses to oral calcium (1 g) and peptone (10 g) load in 22 PHPT and 20 PHPT-N patients matched for PTH serum values. Moreover, 30 healthy subjects were enrolled as controls. In 12 patients for each group, we also performed the oral peptone test adding aluminum hydroxide (AH) to suppress phosphate absorption.ResultsIn PHPT patients, PTH increased significantly 30 min after the oral peptone load, while no significant increase was found in PHPT-N and controls. After oral calcium load, PTH remained stable in PHPT while it decreased dramatically in PHPT-N patients, and ionized calcium increased significantly in each of the three groups. Peptones plus AH induced a blunted PTH increase in the three groups.ConclusionsConsidering the marked difference in PTH response elicited by peptones in PHPT compared with PHPT-N, we suggest that the oral peptone test could be added to the diagnostic evaluation of PHPT patients. In case of absent response to peptones, patients should have their serum calcium levels assessed twice a year in accordance with recent guidelines.

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Breast cancer associated with primary hyperparathyroidism: A nested case control study

Clinical Epidemiology ◽

10.2147/clep.s17298 ◽

2011 ◽

pp. 103 ◽

Cited By ~ 8

Author(s):

Norenstedt ◽

Fredrik Granath ◽

Anders Ekbom ◽

Berg ◽

Lambe ◽

...

Keyword(s):

Breast Cancer ◽

Primary Hyperparathyroidism ◽

Case Control Study ◽

Case Control ◽

Nested Case Control ◽

Control Study

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Cardiovascular dysfunction in symptomatic primary hyperparathyroidism and its reversal after curative parathyroidectomy: Results of a prospective case control study

Surgery ◽

10.1016/j.surg.2013.06.047 ◽

2013 ◽

Vol 154 (6) ◽

pp. 1394-1404 ◽

Cited By ~ 21

Author(s):

Gaurav Agarwal ◽

Gitika Nanda ◽

Aditya Kapoor ◽

Kul Ranjan Singh ◽

Gyan Chand ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Case Control Study ◽

Case Control ◽

Cardiovascular Dysfunction ◽

Control Study ◽

Prospective Case Control Study

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Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT

Journal of Bone and Mineral Research ◽

10.1002/jbmr.98 ◽

2010 ◽

Vol 25 (9) ◽

pp. 1941-1947 ◽

Cited By ~ 81

Author(s):

Stinus Hansen ◽

Jens-Erik Beck Jensen ◽

Lars Rasmussen ◽

Ellen M Hauge ◽

Kim Brixen

Keyword(s):

Primary Hyperparathyroidism ◽

Distal Radius ◽

Case Control Study ◽

Bone Geometry ◽

Case Control ◽

Control Study

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Predictors of Renal Function and Calcifications in Primary Hyperparathyroidism: A Nested Case-Control Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-00923 ◽

2018 ◽

Vol 103 (9) ◽

pp. 3574-3583 ◽

Cited By ~ 5

Author(s):

Henriette Ejlsmark-Svensson ◽

Lise Sofie Bislev ◽

Lars Rolighed ◽

Tanja Sikjaer ◽

Lars Rejnmark

Keyword(s):

Renal Function ◽

Primary Hyperparathyroidism ◽

Ct Scan ◽

Impaired Renal Function ◽

Case Control Study ◽

Case Control ◽

University Hospital ◽

Calcium Excretion ◽

Nested Case Control ◽

Control Study

Abstract Context Some patients with primary hyperparathyroidism (PHPT) develop renal calcifications. Investigation of urinary and nonurinary risk factors are essential. Objective We aimed to study the prevalence and potential biochemical predictors of renal calcifications. Design Nested case-control study. Setting University hospital. Participants We identified 792 patients with PHPT from 2005 to 2015. We used biochemical data to validate the diagnosis of PHPT. Main Outcome Measures The prevalence of renal calcifications defined as nephrolithiasis or nephrocalcinosis assessed by a routine CT scan at the time of diagnosis. Results A total of 792 patients with PHPT were identified among whom 617 patients (78%) had a CT scan preformed. We found a prevalence of renal calcifications of 23%, equally frequent between sexes. A total of 76 patients (12%) had nephrolithiasis and 75 patients (12%) had nephrocalcinosis where 7 patients (1%) had both nephrolithiasis and nephrocalcinosis. Compared with patients without renal calcifications, patients with renal calcifications had significantly higher levels of ionized calcium, parathyroid hormone, and 24-hour calcium excretion (Pall < 0.01). Patients with nephrocalcinosis had higher plasma levels of phosphate and a higher calcium-phosphate product compared with patients with nephrolithiasis (Pall < 0.05). Impaired renal function (estimated glomerular filtration rate <60 mL/min) was observed in 12% of patients. However, no differences in renal function were observed between those with and without renal calcifications. Conclusion Renal calcifications are frequent in patients with PHPT and are associated with the severity of the disease. Impaired renal function is also common in PHPT, but renal function was not associated with renal calcifications.

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COVID-19 symptoms: a case–control study, Portugal, March–April 2020

Epidemiology and Infection ◽

10.1017/s095026882100042x ◽

2021 ◽

Vol 149 ◽

Author(s):

M. Perez Duque ◽

H. Lucaccioni ◽

C. Costa ◽

R. Marques ◽

D. Antunes ◽

...

Keyword(s):

Case Control Study ◽

Gastrointestinal Symptoms ◽

Respiratory Illness ◽

Case Control ◽

Case Definition ◽

Clinical Criteria ◽

Negative Case ◽

Best Fit ◽

Symptoms And Signs ◽

Control Study

Abstract COVID-19, although a respiratory illness, has been clinically associated with non-respiratory symptoms. We conducted a negative case–control study to identify the symptoms associated with SARS-CoV-2-positive results in Portugal. Twelve symptoms and signs included in the clinical notification of COVID-19 were selected as predictors, and the dependent variable was the RT-PCR test result. The χ2 tests were used to compare notified cases on sex, age group, health region and presence of comorbidities. The best-fit prediction model was selected using a backward stepwise method with an unconditional logistic regression. General and gastrointestinal symptoms were strongly associated with a positive test (P < 0.001). In this sense, the inclusion of general symptoms such as myalgia, headache and fatigue, as well as diarrhoea, together with actual clinical criteria for suspected cases, already updated and included in COVID-19 case definition, can lead to increased identification of cases and represent an effective strength for transmission control.

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