scholarly journals Modern problems of hyper- and hypoparathyroidism

2021 ◽  
Vol 93 (10) ◽  
pp. 1149-1154
Author(s):  
Natalia G. Mokrysheva ◽  
Anna K. Eremkina ◽  
Elena V. Kovaleva ◽  
Julia A. Krupinova ◽  
Olga K. Vikulova
Keyword(s):  
Primary Hyperparathyroidism ◽  
Mineral Metabolism ◽  
Parathyroid Glands ◽  
Endocrine Gland ◽  
Phosphorus Metabolism ◽  
Tertiary Hyperparathyroidism ◽  
The World ◽  
Calcium Phosphorus ◽  
Epidemiological Trends

The parathyroid glands are the most important regulators of mineral metabolism. The parathyroid glands were first discovered only in 1880 and their function went the long way unrecognized. Even the term "parathyroid gland" itself speaks of the initial misconception of it as an underdeveloped part of the thyroid. To date, there is a large amount of data regarding the role of this endocrine gland in the human body and the significant changes associated with their dysfunction, including such widespread diseases such primary, secondary and tertiary hyperparathyroidism, hypoparathyroidism. This review covers the problem of the main disturbances in calcium-phosphorus metabolism, presents the results of databases of patients with primary hyperparathyroidism and hypoparathyroidism, as well as current epidemiological trends in Russia and in the world.

scholarly journals The History of the Discovery of Parathyroid Glands, and Their Role in the Body

2019 ◽  
Vol 74 (1) ◽  
pp. 35-43
Author(s):  
Natalia G. Mokrysheva ◽  
Julia A. Krupinova
Keyword(s):  
Modern Medicine ◽  
The Body ◽  
Parathyroid Glands ◽  
Main Role ◽  
Phosphorus Metabolism ◽  
Pathological Conditions ◽  
Long Time ◽  
Calcium Phosphorus ◽  
History Of

Currently, the parathyroid glands (PG) are admited as vital organs in humans. At the same time, the way to this acknowledgment was long and difficult, and the establishment of a link between the pathological conditions of the PG and their complications passed through many mistakes and errors. Understanding the regulation of calcium-phosphorus metabolism in the body and recognition of the main role of parathyroid hormone (PTH) in it was slow, throughout the XIX − early XX centuries. Despite the increasing number of observations confirming the development of complications because of hyperfunction of the PG or development of tetany due to their removal, the main link of this relationship remained unidentified for a long time. In view of the unique anatomical features of the PG, they were the last of the endocrine glands found, which the main obstacle was in the rapid study of their functional characteristics. Today, the structure and functions of the PG are described in detail, the manifestations of their various pathological conditions are well studied, and the capabilities of modern medicine allow timely diagnosis and treatment of diseases. The review describes the history of the discovery of the PG, highlights the main stages in the study of their role in calcium-phosphorus metabolism in particular and in the body as a whole, and discusses the prospects for further development in this direction. We analyzed the work devoted to the evolution in the notions of anatomical, physiological, pathological features of the PG.

Observations on the mineral metabolism of pullets. II

1936 ◽  
Vol 26 (1) ◽  
pp. 85-100 ◽  
Author(s):  
R. H. Common
Keyword(s):  
Calcium Carbonate ◽  
Egg Production ◽  
Mineral Metabolism ◽  
Ammonium Phosphate ◽  
Ammonia Nitrogen ◽  
Egg Laying ◽  
Phosphorus Metabolism ◽  
Phosphorus Excretion ◽  
Calcium Phosphorus ◽  
Digestible Protein

1. Where heavy phosphorus excretion accompanies egg laying in the pullet the excretion of ammonia nitrogen is simultaneously increased. It is probable that this indicates an excretion of excess phosphate in the urine as ammonium phosphate.2. It is shown that heavy phosphorus excretion does not accompany egg laying provided the calcium carbonate intake is sufficiently high.3. The origin of the excess of phosphorus excretion is discussed in relation to calcium-phosphorus metabolism.4. Pullets on a ration containing 5 per cent, calcium carbonate laid eggs containing a higher percentage of P2O5 than pullets receiving a similar ration but from which the calcium carbonate supplement was omitted.5. Some evidence is put forward in support of the view that current standards pitch the requirements of digestible protein for egg production at too high a level.

Effects of Parathyroidectomy on Normocalcemic Primary Hyperparathyroidism and the Role of Intraoperative PTH Measurement

2021 ◽  
pp. 000313482110488
Author(s):  
Ehab Alameer ◽  
Mahmoud Omar ◽  
Marcus Hoof ◽  
Hosam Shalaby ◽  
Mohamed Abdelgawad ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Cure Rate ◽  
Tertiary Hyperparathyroidism ◽  
Intraoperative Pth ◽  
Intraoperative Parathyroid Hormone ◽  
Cure Rates ◽  
Current Guidelines ◽  
Normocalcemic Hyperparathyroidism

Background Normocalcemic primary hyperparathyroidism (NCpHPT) and normohormonal primary hyperparathyroidism (NHpHPT) are recently recognized variants of primary hyperparathyroidism. Current guidelines for the management hyperparathyroidism recognize NCpHPT as one of the areas that are recommended for more research due to limited available data. Methods A retrospective review of patients who had parathyroidectomy between 2014 and 2019. We excluded patients with multiple endocrine neoplasia syndromes and secondary and tertiary hyperparathyroidism. Included patients were classified based on the biochemical profile into classic or normocalcemic hyperparathyroidism group. Collected data included demographics, preoperative localizing imaging, intraoperative parathyroid hormone levels, and postoperative cure rates. Results 261 patients were included: 160 patients in the classic and 101 patients in the normocalcemic group. Patients in the normocalcemic group had significantly more negative sestamibi scans (n = 58 [8.2%] vs 78 [51.3%], P = <.01), smaller parathyroid glands (mean weight 436.0 ± 593.0 vs 742.4 ± 1109.0 mg, P = .02), higher parathyroid hyperplasia rates (n = 51 [50.5%] vs 69 [43.1%]), and significantly higher intraoperative parathyroid hormone at 10 minutes (78.1 ± 194.6 vs 43.9 ± 62.4 1, P = .04). Positive predictive value of both intraoperative parathyroid hormone and cure rate was lower in the normocalcemic group (84.2% vs 95.7%) and (80.5% vs 95%), respectively. Conclusion Normocalcemic hyperparathyroidism is a challenging disease. Surgeons should be aware of the lower cure rate in this group, interpret intraoperative parathyroid hormone with caution, and have a lower threshold for bilateral neck exploration and 4 glands visualization.

scholarly journals Analysis of the calcium-phosphorus metabolism and function of the parathyroid glands in patients with type 1 diabetes mellitus

2013 ◽  
Vol 16 (4) ◽  
pp. 33-37 ◽  
Author(s):  
Ekaterina Alexandrovna Khantakova ◽  
Larisa Yur'evna Khamnueva ◽  
Galina Mikhailovna Orlova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Secondary Hyperparathyroidism ◽  
Calcium Metabolism ◽  
Parathyroid Glands ◽  
Phosphorus Metabolism ◽  
Target Values ◽  
Calcium Phosphorus

Objective. To analyze the calcium-phosphorus metabolism in patients with diabetes mellitus (DM) type 1 depending on the functional state of the kidneys. Materials and Methods. The study involved 235 patients with type 1 diabetic (males). One hundred and thirty-four patients entered the group without diabetic nephropathy (DN) and 101 patients entered the group with DN. To study the phosphorous-calcium metabolism in patients with type 1 diabetes there were studied the following parameters in blood plasma: the level of intact parathyroid hormone (PTH), total calcium (Ca), ionized calcium (Ca2+), serum phosphorus (P), as well as calculated CaxP product. Results.  In patients with type 1 diabetes in the progression of DN the increase of P was observed from stage 4 CKD and reduction of Ca ? from CKD stage 5. The increase of the level of PTH was observed from the stage of CKD 3, although isolated cases of secondary hyperparathyroidism were registered in patients with stage CKD 2. At the same time in a large group of the patients with type 1 diabetes there was observed level of PTH below the target values of the stages CKD 3, 4, 5. The deterioration of glycemic control in patients with type 1 diabetes is associated with decreased level of PTH. In patients with type 1 diabetes without DN and with DN there was observed inverse relationship between the level of glycated hemoglobin (HbA. 1c). Conclusion. In patients with type 1 diabetes the progression of DN leads to various disorders of phosphorus-calcium metabolism: reduction of Ca, higher level of P, alter the function of the parathyroid glands (secondary hyperparathyroidism and reduction of PTH below the target value). Deterioration of glycemic control in patients with type 1 diabetes is associated with a reduction of PTH.

The Parathyroids

2017 ◽  
Author(s):  
Courtney J. Balentine ◽  
C Taylor Geraldson
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Calcium Homeostasis ◽  
Multiple Endocrine Neoplasia ◽  
Laryngeal Nerve ◽  
Parathyroid Glands ◽  
Tertiary Hyperparathyroidism ◽  
Endocrine Neoplasia ◽  
And Function

Successful surgery of the parathyroid glands depends on a thorough knowledge of their anatomic and developmental relations. This knowledge is crucial for locating ectopic parathyroids or preventing injury to the recurrent laryngeal nerve. In addition, the surgeon should understand the physiology and function of these glands. Unlike other conditions a surgeon might treat, physiology, and not anatomy alone, often dictates the timing and course of parathyroid procedures. This surgeon-oriented, focused review covers the development, histology, anatomy, physiology, and pathophysiology of the parathyroid. Figures show the location and frequencies of ectopic upper and lower parathyroid glands, and regulation of calcium homeostasis. This review contains 2 highly rendered figures, and 16 references Key words: calcitonin; hypercalcemia; hyperparathyroidism; multiple endocrine neoplasia; parathyroid; parathyroid hormone; primary hyperparathyroidism; secondary hyperparathyroidism; tertiary hyperparathyroidism

Analysis of the association of polymorphisms CASR and VDR with the development of nephrolithiasis in patients with primary hyperparathyroidism

2016 ◽  
Vol 61 (5) ◽  
pp. 4-8 ◽  
Author(s):  
Elena Viktorovna Peretokina ◽  
Ekaterina Aleksandrovna Pigarova ◽  
Natal'ya Georgievna Mokrysheva ◽  
Lyudmila Yakovlevna Rozhinskaya ◽  
Galina Viktorovna Baydakova ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gene Polymorphisms ◽  
Restriction Analysis ◽  
Phosphorus Metabolism ◽  
Chain Reaction ◽  
Calcium Phosphorus ◽  
Polymerase Chain ◽  
Relationship Of ◽  
The Relationship

Pathogenesis of nephrolithiasis (NL) at PHPT is not fully understood. Meanwhile, the detection of NL patients with PHPT is an absolute indication for parathyroidectomy. Conducted various studies aimed at finding a predictor of NL patients with PHPT. Actively study the role of genetic markers, particularly genes that regulate calcium-phosphorus metabolism.Objective — to assess the relationship of polymorphisms CASR and VDR with the development of the NL at PHPТ.Material and methods. A study to include 203 patients with confirmed PHPT, out of which 114 patients had the NL and 87 patients without NL. All patients were studied indicators calcium-phosphorus metabolism, the study of the level of PTH, vitamin D, the filtration function of the kidneys. All patients were studied indicators calcium-phosphorus metabolism, the level of PTH, vitamin D, the filtration function of the kidneys. The study of gene polymorphisms VDR (FokI, TaqI, BsmI, ApaI, Cdx2) was performed in 169 patients (113 with NL, 56 without NL) by polymerase chain reaction followed by restriction analysis; Study 3 polymorphisms CASR (A986S, R990G, Q1011E) was performed in 187 patients (110 with NL, 77 without NL), by direct sequencing.Results. No significant differences in the frequency of genotypes and alleles studied genes between the two groups has been received. According to logistic regression analysis, the only predictor of NL is the level of ionized calcium.Conclusions. The studied genes can not be used as predictors of the NL. May need to investigate other genes.

scholarly journals Regulation of plasma fibroblast growth factor 23 by calcium in primary hyperparathyroidism

2006 ◽  
Vol 154 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Keisuke Kobayashi ◽  
Yasuo Imanishi ◽  
Akimitsu Miyauchi ◽  
Naoyoshi Onoda ◽  
Takehisa Kawata ◽  
...  
Keyword(s):  
Vitamin D ◽  
Growth Factor ◽  
Primary Hyperparathyroidism ◽  
Creatinine Clearance ◽  
Fibroblast Growth Factor ◽  
Time Course ◽  
Parathyroid Glands ◽  
Fibroblast Growth ◽  
Fgf 23

Objective: While the importance of fibroblast growth factor (FGF)-23 is established in phosphate-wasting disorders, little is known about the mechanisms regulating its circulating level. To investigate the role of parathyroid hormone (PTH) and calcium in FGF-23 metabolism, we examined plasma FGF-23 levels in patients with primary hyperparathyroidism (PHPT). Patients and methods: Fifty patients with PHPT and 52 controls were employed in this study. Plasma was obtained from 18 PHPT patients who underwent parathyroidectomy (PTX) on the first postoperative morning without vitamin D administration. Time-course samples were also obtained from 5 of 18 PTX patients without vitamin D analogs or calcium administration. The expression of Fgf23 on resected parathyroid glands was analyzed by reverse transcription (RT)–PCR and immunohistochemistry. Results: FGF-23 was significantly elevated in PHPT patients compared with controls. FGF-23 levels were significantly correlated positively with serum corrected calcium and intact PTH levels, and negatively with creatinine clearance and inorganic phosphate, among which creatinine clearance and corrected calcium were independently associated factors. In 18 PTX patients, postoperative FGF-23 levels were significantly decreased compared with preoperative levels. Corrected-calcium levels were significantly decreased 1 h after PTX, and this was followed by a reduction in plasma FGF-23 levels in time-course study. In addition, postoperative FGF-23 levels in 18 PTX patients were significantly correlated with corrected calcium, consistent with a role of serum calcium as one of the major regulators of FGF-23. The absence of Fgf23 expression in parathyroid glands indicated that the parathyroid glands were not major sources of circulating FGF-23. Conclusions: Serum calcium may regulate circulating FGF-23 levels in PHPT.

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