Evaluation of preoperative serum concentrations of ionized calcium and parathyroid hormone as predictors of hypocalcemia following parathyroidectomy in dogs with primary hyperparathyroidism: 17 cases (2001–2009)

2012 ◽  
Vol 241 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Melissa Arbaugh ◽  
Daniel Smeak ◽  
Eric Monnet
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Ionized Calcium ◽  
Serum Concentrations ◽  
Preoperative Serum

scholarly journals The cardiovascular system in patients with symptomatic and mild primary hyperparathyroidism

2009 ◽  
Vol 55 (3) ◽  
pp. 25-29 ◽  
Author(s):  
I V Voronenko ◽  
N G Mokrysheva ◽  
L Ya Rozhinskaya ◽  
A L Syrkin
Keyword(s):  
Parathyroid Hormone ◽  
Left Ventricular Hypertrophy ◽  
Primary Hyperparathyroidism ◽  
Cardiovascular System ◽  
Qt Interval ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ionized Calcium ◽  
Mild Primary Hyperparathyroidism

The cardiovascular system was analyzed in patients with symptomatic (n = 31) and mild primary hyperparathyroidism (n = 34) whose mean age was 54.6 years; 95% females). In the patients with symptomatic primary hyperparathyroidism, the PQ interval was longer and the QT interval was significantly shorter than those in patients with mild hyperparathyroidism. Left ventricular hypertrophy was noted in 45.2% of patients with symptomatic and in 15.2% of those with mild hyperparathyroidism (p = 0.013). Left ventricular diastolic dysfunction was also more common in the group of symptomatic hyperparathyroidism. There was a statistically significant correlation between the levels of parathyroid hormone, total and ionized calcium and the duration of QT interval and the determinants of diastolic function and left ventricular hypertrophy. The revealed cardiovascular disorders in patients with primary hyperparathyroidism are presumed to depend on the increase rate of parathyroid hormone and total and ionized calcium.

Treatment with cimetidine in patients with primary hyperparathyroidism

1982 ◽  
Vol 99 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Sverker Ljunghall ◽  
Göran Åkerström ◽  
Claes Rudberg ◽  
Orjan Selking ◽  
Henry Johansson ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Serum Concentrations ◽  
Pre Treatment

Abstract. Treatment with cimetidine (1000 mg daily in four divided doses) was given for 3–20 weeks to 10 patients with primary hyperparathyoidism (HPT). All patients had hypercalcaemia and raised serum concentrations of parathyroid hormone (PTH). During treatment no consistent effects were noted on either serum calcium or PTH and normalization did not occur in any case. Hypergastrinaemia was demonstrated in 6 patients and was also unaffected by therapy while in the 4 patients with normal pre-treatment gastrin values a slight increase was seen. This study does not support the view that cimetidine can be of use for the treatment of primary HPT.

Preoperative Serum Osteocalcin may Predict Postoperative Elevated Parathyroid Hormone in Patients with Primary Hyperparathyroidism

2012 ◽  
Vol 36 (6) ◽  
pp. 1320-1326 ◽  
Author(s):  
Nahid Rianon ◽  
Gillian Alex ◽  
Glenda Callender ◽  
Camilo Jimenez ◽  
Mimi Hu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Serum Osteocalcin ◽  
Preoperative Serum

Acute effects of intravenous 1α-hydroxycholecalciferol on parathyroid hormone, osteocalcin and calcitriol in man

1994 ◽  
Vol 130 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Stephen J Gallacher ◽  
Robert A Cowan ◽  
William D Fraser ◽  
Fraser C Logue ◽  
Andrew Jenkins ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Royal Infirmary ◽  
Serum Concentrations ◽  
Acute Effects ◽  
Treatment Groups ◽  
Basal Serum ◽  
University Department ◽  
Normal Males ◽  
Primary Hyperparathyroid

Gallacher SJ, Cowan RA, Fraser WD, Logue FC, Jenkins A. Boyle IT. Acute effects of intravenous 1α-hydroxycholecalciferol on parathyroid hormone, osteocalcin and calcitriol in man. Eur J Endocrinol 1994;130:141–5. ISSN 0804–4643 The acute effects of a single intravenous injection of 2 μg of 1α-hydroxycholecalciferol (alfacalcidol) were studied for a 24-h period in six normal males (mean age 33 years), six women with primary hyperparathyroidism (mean age 72 years) and six women with established osteoporosis (mean age 63 years). In all three groups, serum calcitriol levels rose to a peak 2–3 h after administration of alfacalcidol. Basal levels were highest in the primary hyperparathyroidism group at (mean ±sem) 81±2 vs 62±12 (normal males) (p<0.05) and 56±5 pmol/l (osteoporosis) (p<0.01). Highest peak levels were found also in the primary hyperparathyroidism group at 150±15 vs 114±15 (normal males) (p<0.05) and 127 ± 1 5 pmol/l (osteoporosis) (p<0.01). The rise in calcitriol was higher in the primary hyperparathyroidism group than either the normal males or osteoporotic patients (p<0.05). No significant differences were evident in basal serum calcidiol concentrations among the three treatment groups. As might be expected, highest basal concentrations of parathyroid hormone (PTH). serum calcium and serum osteocalcin were noted in the primary hyperparathyroid group (PTH: 17.1±7.7 vs 1.9±0.5 (normal males) (p<0.01) and 2.1±0.3 pmol/l (osteoporosis) (p<0.01): calcium: 3.06±0.08 vs 2.50±0.02 (normal males) (p<0.01) and 2.43±0.02 mmol/l (osteoporosis) (p<0.01): osteocalcin: 1.10±0.08 vs 0.56±0.16 (normal males) (p<0.05) and 0.53±0.21 nmol/l (osteoporosis) (p<0.05). Following treatment with alfacalcidol, no significant change was observed in PTH, calcium or osteocalcin serum concentrations in any group. These results show that maximal conversion of alfacalcidol to calcitriol occurs within a few hours of administration of alfacalcidol in normal males and patients with primary hyperparathyroidism and osteoporosis. Whilst this may reflect differences in activity of the enzyme 2 5-hydroxylase among these groups, other explanations, such as differences in calcitriol clearance, cannot be excluded. SJ Gallacher, University Department of Medicine, Queen Elizabeth Building, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK

scholarly journals Acute and long-term kidney function after parathyroidectomy for primary hyperparathyroidism

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244162
Author(s):  
Marcelo Belli ◽  
Regina Matsunaga Martin ◽  
Marília D’Elboux Guimarães Brescia ◽  
Climério Pereira Nascimento ◽  
Ledo Mazzei Massoni Neto ◽  
...  
Keyword(s):  
Renal Function ◽  
Primary Hyperparathyroidism ◽  
Serum Creatinine ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Ionized Calcium ◽  
Hydroxyvitamin D ◽  
Preoperative Serum ◽  
Permanent Reduction ◽  
Preoperative Creatinine

Background In kidney transplant patients, parathyroidectomy is associated with an acute decrease in renal function. Acute and chronic effects of parathyroidectomy on renal function have not been extensively studied in primary hyperparathyroidism (PHPT). Methods This retrospective cohort study included 494 patients undergoing parathyroidectomy for PHPT. Acute renal changes were evaluated daily until day 4 post-parathyroidectomy and were stratified according to acute kidney injury (AKI) criteria. Biochemical assessment included serum creatinine, total and ionized calcium, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25OHD). The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. We compared preoperative and postoperative renal function up to 5 years of follow-up. Results A total of 391 (79.1%) patients were female, and 422 (85.4%) were non-African American. The median age was 58 years old. The median (first and third quartiles) preoperative serum creatinine, PTH and total calcium levels were 0.81 mg/dL (0.68–1.01), 154.5 pg/mL (106–238.5), and 10.9 mg/dL (10.3–11.5), respectively. The median (first and third quartiles) preoperative eGFR was 86 mL/min/1.73 m2 (65–101.3). After surgery, the median acute decrease in the eGFR was 21 mL/min/1.73 m2 (p<0.0001). Acutely, 41.1% of patients developed stage 1 AKI, 5.9% developed stage 2 AKI, and 1.8% developed stage 3 AKI. The acute eGFR decrease (%) was correlated with age and PTH, calcium and preoperative creatinine levels in univariate analysis. Multivariate analysis showed that the acute change was related to age and preoperative values of ionized calcium, phosphorus and creatinine. The change at 12 months was related to sex, preoperative creatinine and 25OHD. Permanent reduction in the eGFR occurred in 60.7% of patients after an acute episode. Conclusion There was significant acute impairment in renal function after parathyroidectomy for PHPT, and almost half of the patients met the criteria for AKI. Significant eGFR recovery was observed during the first month after surgery, but a small permanent reduction may occur. Patients treated for PHPT seemed to present with prominent renal dysfunction compared to patients who underwent thyroidectomy.

scholarly journals Urine Calcium and Serum Ionized Calcium, Total Calcium and Parathyroid Hormone Concentrations in the Diagnosis of Primary Hyperparathyroidism and Familial Benign Hypercalcaemia

1992 ◽  
Vol 29 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Ian R Gunn ◽  
James R Wallace
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Load Test ◽  
Ionized Calcium ◽  
Calcium Excretion ◽  
Fasting Serum ◽  
Urine Calcium ◽  
Glomerular Filtrate ◽  
Calcium Load ◽  
Serum Pth

A relationship between serum concentrations of ionized calcium and parathyroid hormone (PTH) in persons without parathyroid overactivity was defined by performing an oral calcium load test. As a result, a serum PTH concentration greater than 2·6 pmol/L in a hypercalcaemic patient was regarded as suggestive of hyperparathyroidism. Fasting serum PTH concentrations in 58 patients with surgically and histologically proven primary hyperparathyroidism (PHPT) were all above 2·7 pmol/L (range 3·2–84·5). Thirteen of 20 patients with familial benign hypercalcaemia (FBH) had fasting serum PTH concentrations greater than 2·6 pmol/L (range 1·6–6·1). There was a significant correlation between serum PTH and age in the FBH patients only. Fasting urine calcium excretion (CaE) ranged from 14 to 222 μmol/L of glomerular filtrate in PHPT and 3–34 μmol/L of glomerular filtrate in FBH. The best biochemical discriminant between patients with PHPT and FBH was a plot of fasting serum PTH against CaE. A plot of post-calcium load PTH against post-load CaE showed no further significant advantage in discriminating between the two conditions.

Relations between diurnal variations in serum osteocalcin, cortisol, parathyroid hormone, and ionized calcium in normal individuals

1991 ◽  
Vol 124 (4) ◽  
pp. 391-398 ◽  
Author(s):  
Henning Kaspersen Nielsen ◽  
Peter Laurberg ◽  
Kim Brixen ◽  
Leif Mosekilde
Keyword(s):  
Parathyroid Hormone ◽  
Diurnal Rhythm ◽  
Time Course ◽  
Serum Cortisol ◽  
Early Morning ◽  
Ionized Calcium ◽  
Serum Osteocalcin ◽  
Serum Concentrations ◽  
Normal Individuals ◽  
Serum Pth

Abstract. Serum osteocalcin varies in a diurnal rhythm, with peak values during the night and minimum levels before noon, but the factors controlling this rhythm are unknown. In this study, we evaluated the temporal relations between the osteocalcin rhythm and variations in serum concentrations of cortisol, intact parathyroid hormone (PTH(1-84)), and ionized calcium (Ca2+) in 15 normal volunteers, aged 22-46 years. Serum cortisol varied in a typical way preceding inverse changes in serum osteocalcin by about 4 h (r=0.78, p<0.0001). Changes in serum osteocalcin following the early morning increase in serum cortisol were statistically indistinguishable from the changes seen after oral administration of 2.5 or 10 mg of prednisone. Serum PTH (1-84) showed a diurnal rhythm (p<0.01) with peak values (4.06±0.42 pmol/l) at 20.30 h and nadir (2.81±0.10 pmol/l) around 10.30 h, preceding changes in serum osteocalcin in the same direction by 5 h (r=0.55, p<0.02). Prednisone at a dose of 10 mg did not change the time course significantly. Serum Ca2+ varied in an almost bi-phasic pattern (p<0.01) with maximal mean levels around 16.30 and 09.30 h and minimal levels around 05.30 and 14.30 h. Serum Ca2+ correlated inversely with PTH (1-84) (r=0.53, p<0.01), and serum osteocalcin was inversely related to Ca2+ at concurrent time points (r=0.59, p<0.005). Prednisone caused a 2-3 h lasting increase in serum Ca2+ 3-5 h after ingestion (p<0.001). In conclusion, our results suggest that cortisol is strongly associated to the diurnal rhythm in serum osteocalcin. The biological relevance of the reported relation between serum osteocalcin and PTH (1-84) and serum Ca2+ is uncertain.

scholarly journals OCCULT PRIMARY HYPERPARATHYROIDISM: A CASE REPORT AND REVIEW OF PARATHYROID ULTRASONOGRAPHY

2020 ◽  
Vol 6 (3) ◽  
pp. e127-e131
Author(s):  
Matthew C. Moccia ◽  
Eli E. Miller ◽  
Cherie L. Vaz
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Reference Range ◽  
Relevant Literature ◽  
Hashimoto Thyroiditis ◽  
Neck Mass ◽  
Ionized Calcium ◽  
Total Serum ◽  
Radiologic Evaluation ◽  
Total Serum Calcium

Objective: To discuss the diagnosis and management of occult primary hyperparathyroidism. Methods: We present the biochemical and radiologic evaluation, treatment, and outcome of a woman with occult primary hyperparathyroidism which presented as an unusual neck mass on ultrasound. We also present a relevant literature review. Results: A 52-year-old female presented with Hashimoto thyroiditis and a 1.2-cm, hypoechoic oval nodule in the left upper lateral portion of the thyroid. She returned a decade later with a 2.2-cm, hypervascular mass on ultrasound. Parathyroid hormone was mildly elevated at 90 pg/mL (reference range is 15 to 65 pg/mL), but she had persistently normal levels of total serum calcium at 9.9 mg/dL (reference range is 8.7 to 10.3 mg/dL), phosphorus at 3.5 mg/dL (reference range is 2.1 to 4.5 mg/dL), and albumin at 4.4 g/dL (reference range is 3.6 to 4.8 g/dL). She had elevated ionized calcium of 5.9 mg/dL (reference range is 4.5 to 5.6 mg/dL). Computed tomography with contrast of the neck revealed an enhancing oval lesion abutting the superior pole of the left thyroid with attenuation characteristics similar though slightly different from the thyroid. 99mTc-Sestamibi scan showed increased uptake posterior to the superior aspect of the left thyroid. Bone densitometry showed osteoporosis of the left distal radius and osteopenia of the left femoral neck. Minimally invasive radio-guided parathyroidectomy was performed with normalization of parathyroid hormone. Pathology confirmed a 1.715-g parathyroid adenoma. Conclusion: Despite normal total calcium levels, clinically significant primary hyperparathyroidism may present as a large adenoma which could appear as a hypervascular neck mass on ultrasound. A high index of suspicion based on ultrasound features and measurement of ionized calcium may be helpful in diagnosing occult, but clinically relevant primary hyperparathyroidism.

Sign in / Sign up

Export Citation Format

Share Document