Reduced speed of sound in tibial bone of haemodialysed patients: association with serum PTH level

Abstract Purpose To access serum parathyroid hormone (PTH) level in elderly patients with hip fracture in relation to fracture healing outcomes. Methods This study included 90 elderly male patients with hip fracture and they were defined as the hip fracture group, and they were divided into healing effective group and delayed healing group by final fracture healing outcomes, 45 cases in each group; another 45 male patients older than 70 years without established osteoporosis and hip fracture were included as the control group. The levels of serum PTH level were examined in each group. Results Serum PTH level was significantly higher in healing effective group patients at the 7 days and 14 days after fracture than the delayed healing patients. Conclusions Our results show that serum PTH level may be an effective indicator of hip fracture delayed healing risk in the elderly.

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Disorders of plasma calcium

10.1093/med/9780199568741.003.0175 ◽

2018 ◽

Author(s):

Aron Chakera ◽

William G. Herrington ◽

Christopher A. O’Callaghant

Keyword(s):

Vitamin D ◽

Normal Serum ◽

Ion Concentration ◽

Normal Range ◽

Physiological Regulation ◽

Dihydroxyvitamin D ◽

Diagnostic Approaches ◽

Serum Pth ◽

Calcium Ion Concentration ◽

Pth Level

The extracellular calcium ion concentration is tightly regulated through the actions of parathyroid hormone (PTH) and vitamin D (1,25-dihydroxyvitamin D) on bone, kidney, and intestines. Abnormalities in these homeostatic mechanisms may lead to increased or decreased serum calcium concentrations, resulting in hypercalcaemia or hypocalcaemia, respectively. Hypercalcaemic disorders may be further divided into those associated with a high/high-normal serum PTH level, and those associated with a low serum PTH concentration. Hypocalcaemia occurs when abnormalities in the physiological regulation of PTH and vitamin D results in calcium levels lower than the desired normal range. Failure of release of calcium from bone, and increased binding of calcium in the circulation, are other factors causing hypocalcaemia. This chapter discusses hypercalcaemia and hypocalcaemia, exploring definitions of the diseases, their etiologies, typical and uncommon symptoms, demographics, natural history, complications, diagnostic approaches, other diagnoses that should be considered, prognosis, and treatment.

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Hypercalcemia as a Cause of Kidney Failure: Case Report

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2016.044 ◽

2016 ◽

Vol 4 (2) ◽

pp. 283-286

Author(s):

Olivera Stojceva-Taneva ◽

Borjanka Taneva ◽

Gjulsen Selim

Keyword(s):

Renal Failure ◽

Primary Hyperparathyroidism ◽

Epigastric Pain ◽

History Of ◽

St Elevation ◽

Multiple Myelomas ◽

Serum Pth ◽

Reduced Kidney Function ◽

Common Manifestation ◽

Pth Level

BACKGROUND: Hypercalcemia is a common manifestation in clinical practice and occurs as a result of primary hyperparathyroidism, malignancy, milk-alkali syndrome, hyper or hypothyroidism, sarcoidosis and other known and unknown causes. Patients with milk-alkali syndrome typically are presented with renal failure, hypercalcemia, and metabolic alkalosis caused by the ingestion of calcium and absorbable alkali. This syndrome is caused by high intake of milk and sodium bicarbonate.CASE PRESENTATION: We present a 28-year old male admitted to hospital with a one-month history of nausea, vomiting, epigastric pain, increased blood pressure and worsening of renal function with hypercalcemia. His serum PTH level was almost undetectable; he had mild alkalosis, renal failure with eGFR of 42 ml/min, anemia, hypertension and abnormal ECG with shortened QT interval and ST elevation in V1-V4. He had a positive medical history for calcium-containing antacids intake and after ruling out primary hyperparathyroidism, malignancy, multiple myelomas, sarcoidosis, and thyroid dysfunction, it seemed plausible to diagnose him as having the milk-alkali syndrome.CONCLUSION: Although milk-alkali syndrome currently may be more probably a result of calcium and vitamin D intake in postmenopausal women, or in elderly men with reduced kidney function taking calcium-containing medications, one should not exclude the possibility of its appearance in younger patients taking calcium-containing medications and consider it a serious condition taking into account its possibility of inducing renal insufficiency.

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Pretransplant Parathyroid Hormone Level Has No Correlation with Platelet Recovery After Stem Cell

Blood ◽

10.1182/blood.v120.21.4495.4495 ◽

2012 ◽

Vol 120 (21) ◽

pp. 4495-4495

Author(s):

Soo-Jeong Kim ◽

Yundeok Kim ◽

Shin-Young Hyun ◽

Ji-Eun Jang ◽

Doh Yu Hwang ◽

...

Keyword(s):

Stem Cell ◽

Platelet Count ◽

Stem Cell Niche ◽

Chronic Gvhd ◽

Platelet Recovery ◽

Allogeneic Hsct ◽

Post Transplant ◽

Cell Niche ◽

Serum Pth ◽

Pth Level

Abstract Abstract 4495 Background Stem cell fate is influenced by specialized microenvironments called as stem cell niche. Osteoblasts are considerd to play very important role in stem cell niche. They are activated by parathyroid hormone (PTH) or PTH related protein through PTH/PTHrP receptor and produce hematopoietic growth factors. In few large animal studies PTH treatment after hematopoietic stem cell transplantation (HSCT) improved post-transplant platelet count and CD4 lymphocyte count. Effect of PTH on cord blood stem cell transplantation to improve engraftment is under clinical trial. Therefore, authors investigated on correlation between pre-transplant serum PTH level and platelet recovery after allogeneic HSCT. Methods From January 2008 to December 2009, we measured pre-transplant serum PTH, ferritin of 28 patients who underwent allogeneic HSCT. Post-transplant platelet was checked at the point of post-transplant 14 days, 30 days, 60 days, 90 days and 180days. Surveillance of cytomegalovirus was done by weekly or biweekly CMV-PCR assay. Acute graft-versus-host disease (GVHD) was graded by IBMTR classification and chronic GVHD by NIH scoring system. Results Five patients received graft from partially matched donors and the others from fully matched donors, 15 from unrelated and 13 from related donors. Nineteen patients were in high risk at diagnosis. Nonmyeloablative conditioning was applied to 7 patients. Only 1 patient used bone marrow as stem cell source. Median dose of infused stem cell was 5.7×10∧6/kg (range 1.68 – 12.74). All patients were successfully engrafted. Acute GVHD more than grade 2 occurred in 15, and chronic GVHD more than moderate degree in 7. Five patients relapsed and 15 patients died of relapse or treatment related mortality. Pre-transplant serum PTH had no correlation with platelet count recovery. There was no correlation with pre-HSCT PTH and acute or chronic GVHD. However patient with lower PTH level had tendency to more frequent CMV reactivation (P=0.098). Conclusion Our hypothesis was that higher pre-transplant PTH would be related to better platelet recovery but failed to find correlation between two of them. There are various factors which affect engraftment and graft function. Role of PTH for engraftment should be evaluated in larger number of cases. Disclosures: No relevant conflicts of interest to declare.

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Does compensatory hyperparathyroidism predispose to ischemic stroke? [RETRACTED]

Neurology ◽

10.1212/01.wnl.0000047345.05818.8b ◽

2003 ◽

Vol 60 (4) ◽

pp. 626-629 ◽

Cited By ~ 14

Author(s):

Y. Sato ◽

M. Kaji ◽

N. Metoki ◽

K. Satoh ◽

J. Iwamoto

Keyword(s):

Ischemic Stroke ◽

Elderly Women ◽

High Serum ◽

Control Group ◽

Compensatory Mechanism ◽

Mineral Density ◽

Stroke Patients ◽

Control Subjects ◽

Serum Pth ◽

Pth Level

Background: Parathyroid hormone (PTH) is vasoactive, and the endothelium is one of the target tissues of this hormone. Hyperparathyroidism is frequently associated with hypertension.Objective: To determine if hyperparathyroidism, which develops particularly in elderly women as a compensatory mechanism to osteoporosis, may be a risk factor for ischemic stroke.Methods: Serum PTH levels and bone mineral density (BMD) in 107 elderly patients with ischemic stroke (≥65 years old) were assessed on the day of onset. The control group consisted of 107 healthy volunteers matched for age and sex.Results: BMD was significantly lower and serum PTH higher in female stroke patients than in control subjects; there was a negative correlation between these two measurements. One-third of the female stroke patients had a serum PTH level higher than the mean + 2 SD of the control subjects (high PTH group), and the interval between menopause and the stroke was significantly longer in the high PTH group than in the normal PTH group. Multiple logistic analyses revealed hypertension and ischemic heart disease were more prevalent in the high PTH group. BMD and PTH were normal in male stroke patients.Conclusion: High serum PTH level may be associated with high incidence of ischemic stroke in women, possibly through the increased incidence of hypertension.

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Relationship between Parathyroid Hormone Level and Early Remodeling Heart Failure after Acute Myocardial Infarction

Journal of Pharmaceutical Care ◽

10.18502/jpc.v8i1.2741 ◽

2020 ◽

Author(s):

Zohreh Firouzi ◽

Saeideh Mahdizadeh Sajjadieh ◽

Maryam Mousavi ◽

Zahra Erfanian ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Vitamin D ◽

Parathyroid Hormone ◽

Serum Vitamin ◽

Current Evidence ◽

Serum Vitamin D ◽

Serum Pth ◽

Pth Level

Background: Previous studies have indicated that parathyroid hormone (PTH) has been linked to post-myocardial infarction (MI) development. The aim of this cross-sectional study was to evaluate the relationship between PTH level and heart failure due to post infarction remodeling during the first 72 hours of hospitalization. Methods: Seventy patients with a diagnosis of acute MI (age ≥18 years, 22 females and 48 males) were enrolled. Patients were admitted to the Imam Raza Educational, Research and Treatment Center, Mashhad University of Medical Sciences, Iran between July 2014 to September 2015. We measured PTH and vitamin D level. Blood samples were taken after 24 hours and 72 hours. Results: During the first 72 hours, the PTH level significantly increased in patients with Post-MI heart failure. 68% of the subjects had an inappropriate vitamin D level at the time of admission. Mean levels of vitamin D and PTH increased compared with the baselines (95% CI, 0.15 to 10.03, P: 0.044), (95% CI, 6.5 to 24.8, P:0.001) respectively. Conclusion: Acute elevations of serum PTH levels increased early remodeling heart failure after MI. Serum vitamin D status was independent of high serum PTH level. Based on the current evidence, PTH excess may be a risk factor for heart failure, so early treatment and omitting risk factors are the most effective strategies for the patients with acute myocardial infarction. J Pharm Care 2020; 8(1): 11-15.

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Intraoperative serum parathyroid hormone level is an indicator of hypocalcaemia in total thyroidectomy patients

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v38i3.14331 ◽

2013 ◽

Vol 38 (3) ◽

pp. 84-89 ◽

Cited By ~ 2

Author(s):

MS Islam ◽

T Sultana ◽

D Paul ◽

AHMZ Huq ◽

AA Chowdhury ◽

...

Keyword(s):

Parathyroid Hormone ◽

Total Thyroidectomy ◽

Predictive Value ◽

Clinical Pathology ◽

High Sensitivity ◽

Intraoperative Pth ◽

Serum Pth ◽

Sensitivity Specificity ◽

Postoperative Hypocalcaemia ◽

Pth Level

Postoperative hypocalcaemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose or to predict hypocalcaemia immediately after total thyroidectomy for minimizing complications. A prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Microbiology & Immunology, Department of Surgery, Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Otolaryngology, Dhaka Medical College & Hospital (DMC&H), Dhaka, during the period of September 2010 to August 2011 to evaluate intraoperative (20 minutes after total thyroidectomy) parathyroid hormone (PTH) measurement as a predictor of post thyroidectomy hypocalcaemia. Total 65 patients were enrolled in this study those came for total thyroidectomy. Postoperative hypocalcaemia developed in 25 cases. Intraoperative PTH was assessed and significant correlation was found between intraoperative PTH level and development of hypocalcaemia. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative serum PTH for prediction of post total thyroidectomy hypocalcaemia were 84.0%, 85.0%, 84.6%, 77.8%, and 89.5% respectively. Because of the high sensitivity, specificity and accuracy of intraoperative serum PTH of this study, the early prediction of hypocalcaemia could be made by single assay of intraoperative serum PTH level at 20 minutes after total thyroidectomy. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14331 Bangladesh Med Res Counc Bull 2012; 38(3): 84-89 (December)

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Application of Tissue Aspirate Parathyroid Hormone Assay for Imaging Suspicious Neck Lesions in Patients with Complicated Recurrent or Persistent Renal Hyperparathyroidism

Journal of Clinical Medicine ◽

10.3390/jcm10020329 ◽

2021 ◽

Vol 10 (2) ◽

pp. 329

Author(s):

Chien-Ling Hung ◽

Yu-Chen Hsu ◽

Shih-Ming Huang ◽

Chung-Jye Hung

Keyword(s):

Parathyroid Hormone ◽

Final Diagnosis ◽

Imaging Studies ◽

Renal Hyperparathyroidism ◽

Operative Surgery ◽

Parathyroid Hormone Assay ◽

Serum Pth ◽

Pth Level ◽

Suspicious Lesions

Background: Comprehensive pre-reoperative localization is essential in complicated persistent or recurrent renal hyperparathyroidism. The widely used imaging studies sometimes lead to ambiguous results. Our study aimed to clarify the role of tissue aspirate parathyroid hormone (PTH) assay with a new positive assay definition for imaging suspicious neck lesions in these challenging scenarios. Methods: All patients with complicated recurrent or persistent renal hyperparathyroidism underwent parathyroid sonography and scintigraphy. Echo-guided tissue aspirate PTH assay was performed in suspicious lesions revealed by localization imaging studies. The tissue aspirate PTH level was determined by an immunoradiometric assay. We proposed a newly-developed definition for positive assay as a washout level higher than one-thirtieth of the serum PTH level obtained at the same time. The final diagnosis after re-operation was confirmed by the pathologists. Results: In total, 50 tissue aspirate PTH assays were performed in 32 patients with imaging suspicious neck lesions, including discrepant results between scintigraphy and sonography in 47 lesions (94%), unusual locations in 19 lesions (38%), multiple foci in 28 lesions (56%), and locations over previously explored areas in 31 lesions (62%). Among 39 assay-positive lesions, 13 lesions (33.3%) were not identified by parathyroid scintigraphy, and 28 lesions (71.8%) had uncertain parathyroid sonography findings. The final pathology in patients who underwent re-operative surgery proved the tissue aspirate PTH assays had a 100% positive predictive value. Conclusions: Our findings suggest tissue aspirate PTH assay with this new positive assay definition is beneficial to clarify the nature of imaging suspicious lesions in patients with complicated persistent or recurrent renal hyperparathyroidism.

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Comparison the level of parathyroid gland hormone and body mass index normal in Iraqi population in age between (4-20) year with their reference values: مقارنة مستويات هرمون الغدة جنب الدرقية مع وزن كتلة الجسم الطبيعية في المجتمع العراقي بالنسبة للعمر بين (4- 20) سنة مع القيم المرجعية

Journal of medical and pharmaceutical sciences - مجلة العلوم الطبية و الصيدلانية ◽

10.26389/ajsrp.s160918 ◽

2019 ◽

Vol 3 (2) ◽

Author(s):

SAFFANA MAEN ABD AL-HUSSEIN

Keyword(s):

Body Mass Index ◽

Parathyroid Gland ◽

Body Mass ◽

Reference Values ◽

Important Lesson ◽

Ordinary Life ◽

Descriptive Approach ◽

Serum Pth ◽

Pth Level ◽

Research Analysis

This study aimed to compare between PTH level and BMI in female and male separately then the results were compared between female and male. The aim of this study is to know the cause of differences in hormone elevation and weight in female compared with male for the same age (4 – 20) year old in Iraqi society and the effect of stress, physiological change on these results. A descriptive approach has been used in this study to research analysis, two variables were used: PTH, BMI. The conclusion of this study is that: there is an elevation in female serum PTH level with elevation in their weights in ages (4 – 9), (10 -14), (15 – 20) year, when these results compared with the results from male in the same age it's clear that they were higher, so; the handling of this issue by interesting in sport in ordinary life and in school and consideredit an important lesson Based on direction of education ministry.

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Effect of Oral Calcium Supplementation on Insulin Sensitivity in Patients With Metabolic Syndrome

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.956 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A468-A468

Author(s):

Ye Myint ◽

Mya Thanda Sein ◽

Khin Saw Than ◽

Ko Ko ◽

Tint Swe Latt

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Insulin Sensitivity ◽

Calcium Supplementation ◽

Control Group ◽

Oral Calcium ◽

Supplement Group ◽

Serum Pth ◽

Elemental Calcium ◽

Pth Level

Abstract Background: Evidence from epidemiological research suggests that dietary calcium may protect against metabolic abnormality in populations at high risk. Observational studies show the relationship between dietary calcium intake and metabolic syndrome. However evidence for beneficial effect of elemental calcium supplementation on metabolic syndrome is limited. Aims: Present studydetermined whether oral calcium supplementation reduced insulin resistance in patients with metabolic syndrome or not. Methods; Hundred patients who have metabolic syndrome without diabetes mellitus, parathyroid disease, chronic renal failure, pregnancy and lactationwere randomly allocated to the group receiving 1500 mg/ day of elemental calcium as calcium carbonate for 8 weeks and the control group. The primary outcome was change in insulin resistance as measured by homeostasis model assessment of insulin resistance (HOMA-IR). Other outcomes were changes of serum free ionized calcium (FiCa) level with accompanying serum parathyroid hormone (PTH) level. Fasting serum glucose was measured by glucose oxidase method. Serum insulin and PTH level were measured by enzyme linked immunoassay. Total serum ionized calcium was analyzed by Atomic Absorption Spectrophotometry. Serum FiCa(mg/dl) level was calculated by using following formula = [6Ca-(K/3)]/(K+6). Results: Mean age of participants was 47.38±13.2 years in calcium supplement group (n = 50) and 49.46±12.9 years in control group (n=50). Mean body mass index was not significant different between two groups (30.91 ±4.23 vs 30.37 ± 4.62 kg/m2). More female were involved in both group, 72% vs 62% respectively. Baseline biochemical parameters of the participants between two groups were not significantly different. After 8 week intervention period, mean serum FiCa increased significantly from 2.64±1.19 mg/dl to 5.82± 5.59 mg/dl, p<0.0001, serum PTH decreased significantly from 57.88 ±17.05 pg/ml to 35.7±23.12 pg/ml, p<0.0001, HOMA-IR decreased significantly from 5.14 ± 3.71 to 2.94±1.51, p<0.0001. None of these parameters were significantly affected in control group. By comparing biochemical changes of calcium supplement group to control group, Mean (SEM) of paired difference changes were observed in serum FiCa level [3.18(0.81) vs 0.81(0.25)mg/dl, p<0.05], serum PTH level [22.18(3.24) vs 3.58(1.99)pg/ml, p<0.0001] and HOMA-IR [2.19(0.45) vs 0.43(0.21), p<0.05]. It indicated that elemental calcium supplementation not only reduced insulin resistance but also decompensated the higher level of PTH to normal range by replenishing FiCa significantly. Conclusion: Eight-week oral elemental calcium supplementation of 1500mg/day showed beneficial effect on insulin sensitivity in patients with metabolic syndrome.

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