Hyperparathyroidsm

Mild or asymptomatic disease is now the dominating presentation of primary hyperparathyroidism (PHPT). However, bone involvement with decreased bone mineral density (BMD) and an increased risk of fractures has been demonstrated. Indications for parathyroidectomy (PTX) in mild PHPT have been debated for years. There is a need of long-term randomized studies comparing PTX with observation without intervention (OBS). Here, we present bone health data from the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH), a randomized controlled trial, comparing PTX to OBS...

Primary hyperparathyroidism (PHPT) is mainly caused by parathyroid adenoma, which produces excess parathyroid hormones. Its pathogenic mechanisms have not yet been fully understood. To investigate the mechanism in the pathogenesis of PHPT, the transcriptome and genome-wide DNA methylation profiles of parathyroid adenoma were analyzed. The candidate genes that may be involved in the PHPT were verified via qRT-PCR, immunohistochemistry, western blot, and methylation-specific PCR. A total of 1650 differentially expressed genes and 2373 differentially methylated regions were identified...

The calcium sensing receptor (CASR) is expressed most abundantly in the parathyroid glands and the kidney. CASR regulates calcium homeostasis through its ability to modulate parathormone secretion and renal calcium reabsorption. Inactivating mutations in the CASR gene may result in disorders of calcium homeostasis manifesting as familial benign hypocalciuric hypercalcemia (FBHH) and neonatal severe hyperparathyroidsm (NSHPT). Two cases were referred with severe hypercalcemia in the neonatal period. Laboratory evaluation revealed severe hypercalcemia and elevated PTH...

OBJECTIVE: To differentiate between benign and malignant hyperparathyroidism on the basis of excretion of HCG and its malignant isoforms in urine. MATERIALS AND METHODS: This hospital based study was carried out using data retrieved from the register maintained in Manipal Teaching Hospital from 1st January, 2008 and 31st August, 2012. The variables collected were urinary HCG and HCG malignant isoform, calcium and parathyroid hormone. Preceding the study, approval was obtained from the institutional research ethical committee...

Brown tumor is an extreme form of severe hyperparathyroid bone disease in end-stage renal disease patients. The evolution of the tumor after renal transplantation and under conservative treatment is still unclear. Herein, we report a 22-yr-old girl with parathyroid glandular hyperplasia because of an inadequate compliance and control of the mineral metabolism and subsequently developed Brown tumor of the ribs. A gradual improvement in bone and parathyroid gland status was observed within three yr following successful kidney transplantation and treatment with pulses of oral calcitriol...

BACKGROUND: Secondary hyperparathyroidsm (2HPT) is a common complication in hemodialysis patients associated with morbidity and sometimes mortality. The majority of patients with 2HPT can be managed by medical treatment. However, medical treatment does not always provide control of parathyroid disorder. Some patients require surgical treatment, parathyroidectomy (PTx). Successful surgical treatment often results in dramatic drop of the parathyroid hormone (PTH) levels, relieves the patients from clinical symptoms, and reduces mortality...

BACKGROUND: Secondary hyperparathyroidsm is frequently observed in patients with chronic renal failure, and clinical treatment guidelines have been published. Despite this, a large proportion of patients do not reach the target levels for calcium, phosphorus, calcium x phosphorus product, or intact parathyroid hormone. The use of albumin-corrected calcium is recommended as calcium measurement, but it is the concentration of ionized calcium that is biologically active. We hypothesized that in clinical practice, the use of ionized calcium rather than albumin-corrected calcium would influence the calcium classification of the individual patient...

We report the case of a 76-year-old woman with a diagnosis of Primary Hyperparathyroidsm and Systemic Amyloidosis, in whom subsequent investigations revealed the presence of Multiple Myeloma. We discuss the relationship between these conditions and the implications for management.

AIMS: Renal osteodystrophy is the major complication in patients with end-stage renal failure. Oral or intravenous vitamin D3 (D3) is given to these patients, but severe hypercalcaemia sometimes interrupts this therapy. This study was undertaken to determine whether the effectiveness and safety of D3 also depend on its dosing time during a repeated treatment. METHODS: A higher dose (3 micro g) was given orally to 13 haemodialysis patients at 08.00 h or 20.00 h for 12 months by a randomized, cross-over design...

The secretory response of abnormal parathyroid glands obtained surgically from eleven patients with primary and secondary hyperparathyroidsm was tested in vitro. Short term flask studies were used to measure release of parathyroid hormone (PTH) at high (3.0 mM) and low (0.5 mM) calcium. Of eight adenomas, all but one showed increased release of hormone when exposed to low calcium ("responsive to calcium"), the degree of stimulation at three hours ranging from 15 to 209%. By comparison, two normal human glands were stimulated an average of 180%...