scholarly journals The severe course of hyperparathyroidism in the elderly: Clinical cases

2009 ◽  
Vol 55 (1) ◽  
pp. 33-35
Author(s):  
N G Mokrysheva ◽  
S S Gulyaeva ◽  
L Ya Rozhinskaya ◽  
V N Smorshchok ◽  
M A Lysenko ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Postmenopausal Women ◽  
Endocrine System ◽  
The Elderly ◽  
Phosphorus Metabolism ◽  
Adequate Treatment ◽  
Calcium And Phosphorus ◽  
Excessive Secretion ◽  
Clinical Cases

Primary hyperparathyroidism (PHPT) is a disease of the endocrine system caused by excessive secretion of parathyroid hormone (PTH) and is characterized by a pronounced violation of calcium and phosphorus metabolism. More recently, in Russia, PHPT was detected extremely rarely and often hid under the mask of recurrent urolithiasis, generalized osteoporosis and other pathologies. As a result, patients did not receive adequate treatment, which in a certain percentage of cases led to the development of serious complications.The clinical cases of severe PHPT in postmenopausal women are presented in this article.

scholarly journals Normocalcemic primary hyperparathyroidism

2010 ◽  
Vol 54 (2) ◽  
pp. 106-109 ◽  
Author(s):  
John P. Bilezikian ◽  
Shonni J. Silverberg
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Kidney Stones ◽  
Bone Disease ◽  
Clinical Phenotype ◽  
Mineral Metabolism ◽  
Historical View ◽  
History Of ◽  
Excessive Secretion

Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease.

scholarly journals High prevalence of abdominal aortic calcification in patients with primary hyperparathyroidism as evaluated by Kauppila score

2016 ◽  
Vol 175 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Jessica Pepe ◽  
Daniele Diacinti ◽  
Emanuela Fratini ◽  
Italo Nofroni ◽  
Antonella D’Angelo ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Postmenopausal Women ◽  
Aortic Calcification ◽  
Mineral Density ◽  
Abdominal Aortic Calcification ◽  
Lateral Spine ◽  
Abdominal Aortic ◽  
Hormone Effect ◽  
Spine Radiograph

Objective The prevalence of abdominal aortic calcification (AAC) in primary hyperparathyroidism (PHPT) is unknown. We assessed both prevalence and severity of AAC in PHPT postmenopausal women. Methods In this study 70 PHPT postmenopausal women and 70 age- and sex-matched controls were enrolled. Each participant underwent biochemical evaluation, lateral spine radiograph, bone mineral density (BMD) measurement (lumbar, femoral, radial sites), and kidney ultrasound. Lateral lumbar films were analyzed in the region of L1–L4 vertebrae and the Kauppila score (a semi-quantitative grading system) was used to assess the severity of AAC. Results There were no differences regarding demographic and cardiovascular risk factors in the two groups. PHPT patients had higher prevalence of kidney stones (30% vs 7%, P=0.0008) and lower radial BMD values (0.558±0.071 vs 0.588±0.082 g/cm2, P<0.05) compared with controls. PHPT patients showed higher prevalence of AAC (31 vs 18, P=0.03), with more severe calcifications (Kauppila score 7.35±6.1 vs 5.05±3.5, P=0.007). PHPT patients with AAC were older and had been suffering from the disease for a longer period compared with those without ACC. Moreover, PHPT patients with severe AAC had mean higher serum parathyroid hormone levels compared with patients with moderate or mild calcifications. In PHPT patients with AAC, multiple regression analysis, adjusted for age and years since diagnosis, showed that only parathyroid hormone significantly correlated with Kauppila score. Conclusion We found a higher prevalence and severity of AAC in PHPT related to parathyroid hormone effect.

Clinical and Molecular Genetics of Primary Hyperparathyroidism

2020 ◽  
Vol 52 (08) ◽  
pp. 578-587
Author(s):  
William F. Simonds
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Tumor Suppressor Genes ◽  
Calcium Concentration ◽  
Systemic Circulation ◽  
Parathyroid Glands ◽  
Serum Calcium Concentration ◽  
Parathyroid Neoplasia ◽  
Excessive Secretion ◽  
Tumor Dna

AbstractCalcium homeostasis is maintained by the actions of the parathyroid glands, which release parathyroid hormone into the systemic circulation as necessary to maintain the serum calcium concentration within a tight physiologic range. Excessive secretion of parathyroid hormone from one or more neoplastic parathyroid glands, however, causes the metabolic disease primary hyperparathyroidism (HPT) typically associated with hypercalcemia. Although the majority of cases of HPT are sporadic, it can present in the context of a familial syndrome. Mutations in the tumor suppressor genes discovered by the study of such families are now recognized to be pathogenic for many sporadic parathyroid tumors. Inherited and somatic mutations of proto-oncogenes causing parathyroid neoplasia are also known. Future investigation of somatic changes in parathyroid tumor DNA and the study of kindreds with HPT yet lacking germline mutation in the set of genes known to predispose to HPT represent two avenues likely to unmask additional novel genes relevant to parathyroid neoplasia.

Reduction of serum gonadotropin concentrations after parathyroidectomy

1989 ◽  
Vol 120 (3) ◽  
pp. 379-382
Author(s):  
Anders Kristoffersson ◽  
Kjell Grankvist ◽  
Johannes Järhult
Keyword(s):  
Parathyroid Hormone ◽  
Luteinizing Hormone ◽  
Primary Hyperparathyroidism ◽  
Postmenopausal Women ◽  
Serum Calcium ◽  
Significant Alteration ◽  
Serum Lh ◽  
Plasma Estradiol ◽  
Serum Gonadotropin ◽  
Estradiol Concentration

Abstract. Calcium, parathyroid hormone, folliclestimulating hormone, luteinizing hormone, and estradiol were measured in 15 postmenopausal women with primary hyperparathyroidism before and 1 year after parathyroidectomy. Normalization of serum calcium concentrations (from 2.87 to 2.29 mmol/l) was followed by a highly significant fall in serum LH and FSH concentrations. No significant alteration occurred in plasma estradiol concentration.

The Effect of Ethinyloestradiol on Calcium and Phosphorus Metabolism of Post-Menopausal Women with Primary Hyperparathyroidism

1973 ◽  
Vol 45 (6) ◽  
pp. 785-802 ◽  
Author(s):  
J. C. Gallagher ◽  
R. Wilkinson
Keyword(s):  
Bone Resorption ◽  
Primary Hyperparathyroidism ◽  
Calcium Balance ◽  
Phosphorus Metabolism ◽  
Urine Calcium ◽  
Phosphorus Balance ◽  
Fasting Plasma ◽  
Menopausal Women ◽  
Calcium And Phosphorus ◽  
Post Menopausal

1. Eight post-menopausal women with primary hyperparathyroidism were given ethinyloestradiol (0.05 mg daily) and the effects on calcium and phosphorus metabolism were observed. 2. In every patient ethinyloestradiol produced a fall in fasting plasma and urine calcium. Calcium balance improved in seven patients on treatment and there was a significant fall in 24 h urine calcium in all eight patients; however, there was no consistent change in net or true absorption of calcium. 3. Ethinyloestradiol produced a small fall in the fasting plasma inorganic phosphorus and a fall in fasting urine phosphorus in seven cases. There was a decrease in 24 h urine phosphorus in seven of the eight cases, but there was no consistent effect on phosphorus absorption nor on phosphorus balance. 4. Bone mineralization rate and bone resorption rate were determined in seven of the patients. The administration of ethinyloestradiol produced a decrease in both these variables in all seven patients. 5. The 24 h urine hydroxyproline, used as an independent measure of bone resorption, decreased in all eight patients during ethinyloestradiol therapy. 6. It is concluded that ethinyloestradiol produces an improvement in calcium and phosphorus balance and a decrease in plasma calcium and phosphorus in primary hyperparathyroidism by decreasing bone resorption. 7. It is suggested that ethinyloestradiol may be used as a medical treatment for primary hyperparathyroidism in post-menopausal women who are either unsuitable for surgery or on whom operative procedures have failed, or in those cases in whom primary hyperparathyroidism is mild.

The effect of operations of varying severity upon calcium and phosphorus metabolism in the elderly

1964 ◽  
Vol 51 (10) ◽  
pp. 783-790 ◽  
Author(s):  
W. F. Walker ◽  
Arleen Watt ◽  
H. G. Morgan ◽  
Mary A. A. McCowan
Keyword(s):  
The Elderly ◽  
Phosphorus Metabolism ◽  
Calcium And Phosphorus
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