scholarly journals Challenges in differential diagnosis between primary and secondary forms of hyperparathyroidism

2017 ◽  
Vol 14 (3) ◽  
pp. 48-53
Author(s):  
Natalia G. Mokrysheva ◽  
Anna K. Eremkina ◽  
Svetlana S. Mirnaya ◽  
Elena V. Kovaleva
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Clinical Laboratory ◽  
Hypovitaminosis D ◽  
Parathyroid Glands ◽  
Vitamin D Receptors ◽  
Calcium Sensing ◽  
Calcium Exchange ◽  
Excessive Secretion

Hyperparathyroidism is a disease characterized by excessive secretion of parathyroid hormone (PTH) in the chief cells of parathyroid glands. There are three types of hyperparathyroidism: primary, secondary, and tertiary depending on the cause of this disease. By the secondary hyperparathyroidism calcium-sensing receptors (CaSR) and vitamin D receptors (VDR) lead to disturbance of phosphorus-calcium exchange and to development of a parathyroid glands hyperplasia. Treatment of secondary hyperparathyroidism with vitamin D showed the efficiency not only in normalization of clinical laboratory indicators but also in involution of changes in parathyroid glands. We represent the clinical case of a patient with secondary hyperparathyroidism caused by hypovitaminosis D, parathyroid hyperplasia more than 1 cm. The long-term oral therapy with active vitamin D led to the positive dynamics of PTH levels, as well as complete reduction of parathyroid lesion.

The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism

2005 ◽  
Vol 288 (2) ◽  
pp. F253-F264 ◽  
Author(s):  
Mariano Rodriguez ◽  
Edward Nemeth ◽  
David Martin
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Positive Impact ◽  
Mineral Metabolism ◽  
Current Treatment ◽  
Phosphate Binders ◽  
Parathyroid Cell ◽  
Calcium Sensing Receptor ◽  
Vitamin D Receptors ◽  
Calcium Sensing

Serum calcium levels are regulated by the action of parathyroid hormone (PTH). Major drivers of PTH hypersecretion and parathyroid cell proliferation are the hypocalcemia and hyperphosphatemia that develop in chronic kidney disease patients with secondary hyperparathyroidism (SHPT) as a result of low calcitriol levels and decreased kidney function. Increased PTH production in response to systemic hypocalcemia is mediated by the calcium-sensing receptor (CaR). Furthermore, as SHPT progresses, reduced expression of CaRs and vitamin D receptors (VDRs) in hyperplastic parathyroid glands may limit the ability of calcium and calcitriol to regulate PTH secretion. Current treatment for SHPT includes the administration of vitamin D sterols and phosphate binders. Treatment with vitamin D is initially effective, but efficacy often wanes with further disease progression. The actions of vitamin D sterols are undermined by reduced expression of VDRs in the parathyroid gland. Furthermore, the calcemic and phosphatemic actions of vitamin D mean that it has the potential to exacerbate abnormal mineral metabolism, resulting in the formation of vascular calcifications. Effective new treatments for SHPT that have a positive impact on mineral metabolism are clearly needed. Recent research shows that drugs that selectively target the CaR, calcimimetics, have the potential to meet these requirements.

scholarly journals Vitamin D Deficiency in Testicular Cancer Survivors: A Systematic Review

2021 ◽  
Vol 22 (10) ◽  
pp. 5145
Author(s):  
Giuseppe Schepisi ◽  
Caterina Gianni ◽  
Sara Bleve ◽  
Silvia De Padova ◽  
Cecilia Menna ◽  
...  
Keyword(s):  
Vitamin D ◽  
Testicular Cancer ◽  
Vitamin D Deficiency ◽  
Molecular Mechanisms ◽  
Hypovitaminosis D ◽  
Young Males ◽  
Report Data ◽  
Testicular Cancer Survivors ◽  
Patients Experience

Testicular cancer (TC) is the most frequent tumor in young males. In the vast majority of cases, it is a curable disease; therefore, very often patients experience a long survival, also due to their young age at diagnosis. In the last decades, the role of the vitamin D deficiency related to orchiectomy has become an increasingly debated topic. Indeed, vitamin D is essential in bone metabolism and many other metabolic pathways, so its deficiency could lead to various metabolic disorders especially in long-term TC survivors. In our article, we report data from studies that evaluated the incidence of hypovitaminosis D in TC survivors compared with cohorts of healthy peers and we discuss molecular mechanisms and clinical implications.

scholarly journals Relationship between parathyroid calcium-sensing receptor expression and potency of the calcimimetic, cinacalcet, in suppressing parathyroid hormone secretion in an in vivo murine model of primary hyperparathyroidism

2005 ◽  
Vol 153 (4) ◽  
pp. 587-594 ◽  
Author(s):  
Takehisa Kawata ◽  
Yasuo Imanishi ◽  
Keisuke Kobayashi ◽  
Takao Kenko ◽  
Michihito Wada ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Murine Model ◽  
Hormone Secretion ◽  
Suppressive Effect ◽  
Receptor Expression ◽  
Parathyroid Glands ◽  
Calcium Sensing Receptor ◽  
Calcium Sensing

Cinacalcet HCl, an allosteric modulator of the calcium-sensing receptor (CaR), has recently been approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis, due to its suppressive effect on parathyroid hormone (PTH) secretion. Although cinacalcet’s effects in patients with primary and secondary hyperparathyroidism have been reported, the crucial relationship between the effect of calcimimetics and CaR expression on the parathyroid glands requires better understanding. To investigate its suppressive effect on PTH secretion in primary hyperparathyroidism, in which hypercalcemia may already have stimulated considerable CaR activity, we investigated the effect of cinacalcet HCl on PTH-cyclin D1 transgenic mice (PC2 mice), a model of primary hyperparathyroidism with hypo-expression of CaR on their parathyroid glands. A single administration of 30 mg/kg body weight (BW) of cinacalcet HCl significantly suppressed serum calcium (Ca) levels 2 h after administration in 65- to 85-week-old PC2 mice with chronic biochemical hyperparathyroidism. The percentage reduction in serum PTH was significantly correlated with CaR hypo-expression in the parathyroid glands. In older PC2 mice (93–99 weeks old) with advanced hyperparathyroidism, serum Ca and PTH levels were not suppressed by 30 mg cinacalcet HCl/kg. However, serum Ca and PTH levels were significantly suppressed by 100 mg/kg of cinacalcet HCl, suggesting that higher doses of this compound could overcome severe hyperparathyroidism. To conclude, cinacalcet HCl demonstrated potency in a murine model of primary hyperparathyroidism in spite of any presumed endogenous CaR activation by hypercalcemia and hypo-expression of CaR in the parathyroid glands.

Vitamin D Receptors and Parathyroid Glands

2011 ◽  
Vol 17 (Supplement 1) ◽  
pp. 63-68 ◽  
Author(s):  
Christine Landry ◽  
Mary Ruppe ◽  
Elizabeth Grubbs
Keyword(s):  
Vitamin D ◽  
Parathyroid Glands ◽  
Vitamin D Receptors

Long-term hypovitaminosis D and secondary hyperparathyroidism outcomes of the Roux-en-Y gastric bypass: a systematic review

2017 ◽  
Vol 18 (5) ◽  
pp. 560-566 ◽  
Author(s):  
N. J. Switzer ◽  
G. Marcil ◽  
S. Prasad ◽  
E. Debru ◽  
N. Church ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Bypass ◽  
Secondary Hyperparathyroidism ◽  
Hypovitaminosis D

scholarly journals Long-term control of secondary hyperparathyroidism by combination therapy with cinacalcet hydrochloride and intravenous active vitamin D

2012 ◽  
Vol 45 (5) ◽  
pp. 393-399
Author(s):  
Kazumichi Ohta ◽  
Hiroyuki Yamamoto ◽  
Kazunobu Kattou ◽  
Mika Ikebe ◽  
Norisato Ikebe ◽  
...  
Keyword(s):  
Vitamin D ◽  
Combination Therapy ◽  
Secondary Hyperparathyroidism ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Cinacalcet Hydrochloride

scholarly journals An Updated Mini Review of Vitamin D and Obesity: Adipogenesis and Inflammation State

2016 ◽  
Vol 4 (3) ◽  
pp. 526-532 ◽  
Author(s):  
Zujaja-Tul-Noor Hamid Mehmood ◽  
Dimitrios Papandreou
Keyword(s):  
Vitamin D ◽  
Adipose Tissue ◽  
Hypovitaminosis D ◽  
The Body ◽  
Positive Energy ◽  
Vitamin D Receptors ◽  
The Past ◽  
Positive Energy Balance ◽  
Relationship Of

Vitamin D related research continues to expand and theorise regarding its involvement in obesity, as both hypovitaminosis D and obesity strike in pandemic proportions. Vitamin D plays an important role in immune system through Vitamin D Receptors (VDR), which are transcription factors located abundantly in the body. Due to this characteristic, it is potentially linked to obesity, which is a state of inflammation involving the release of cytokines from adipose tissue, and exerting stress on other organs in a state of positive energy balance. Research trials in the past couple of years and systematic reviews from SCOPUS and MEDLINE will be discussed. The role of Vitamin D throughout the lifespan (from fetal imprinting until older age), and in various other obesity mediated chronic conditions shall be highlighted. Various mechanisms attributed to the inverse relationship of Vitamin D and obesity are discussed with research gaps identified, particularly the role of adipokines, epigenetics, calcium and type of adipose tissue.

Practical use of parenteral calcimimetics for severe secondary hyperparathyroidism. A case report

2021 ◽  
Vol 2 (3(5)) ◽  
pp. 58-62
Author(s):  
S.E. Khoroshilov ◽  
◽  
S.V. Besedin ◽  
A.V. Nikulin ◽  
◽  
...  
Keyword(s):  
Clinical Trials ◽  
Case Report ◽  
Secondary Hyperparathyroidism ◽  
Cardiovascular Complications ◽  
Treatment Session ◽  
Dialysis Patients ◽  
Calcium Sensing Receptor ◽  
Serum Parathyroid Hormone ◽  
Calcium Sensing

Secondary hyperparathyroidism (SHPT) leads to bone disorders and cardiovascular complications in long-term dialysis patients. SHPT is caused by hyperphosphatemia. Abnormalities of calcium-sensing receptor (CaSR) are associated with the pathogenesis of SHPT. Clinical trials have shown that calcimimetics significantly reduce the risks of parathyroidectomy, bone fracture and cardiovascular hospitalization among long-term dialysis patients with SHPT. Etelcalcetide, a novel calcimimetic compound, acts as a direct CaSR agonist, restores the sensitivity of the CaSR in parathyroid cells, and decreases serum parathyroid hormone without inducing hypercalcemia or hyperphosphatemia. Etelcalcetide's properties allow it to be administered intravenously thrice weekly at the end of a hemodialysis treatment session improving medication adherence.

Bone Density and Cortical Thickness in Nutritional Vitamin D Deficiency: Effect of Secondary Hyperparathyroidism

1988 ◽  
Vol 25 (3) ◽  
pp. 271-274 ◽  
Author(s):  
V Fonseca ◽  
J E Agnew ◽  
D Nag ◽  
P Dandona
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Cortical Thickness ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Plasma Calcium ◽  
Hydroxyvitamin D ◽  
Asymptomatic Patients ◽  
25 Hydroxyvitamin D ◽  
Nutritional Vitamin

Measurements of bone mineral index, mean metacarpal cortical thickness, plasma calcium, alkaline phosphatase and serum 25-hydroxyvitamin D and parathyroid hormone concentrations were carried out in 39 Asian vegetarian patients with hypovitaminosis D. It was concluded that PTH is probably the major determinant of osteopenia in patients with osteomalacia and secondary hyperparathyroidism; and that the presence of secondary hyperparathyroidism in association with hypovitaminosis D should be an absolute indication for vitamin D supplementation even in asymptomatic patients.

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