Hyperparathroid

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High doses of oral calcium or long-term calcium infusions are recommended to correct the hypocalcemia and secondary hyperparathyroidism in patients with hereditary 1,25 dihydroxyvitamin D3-resistant rickets (HVDRR). Preliminary studies revealed that calcimimetics may be a safe and effective therapeutic choice in children with secondary hyperparathyroidism. Our aim was to observe the efficacy of cinacalcet in the normalization of secondary hyperparathyroidism and hypophosphatemia in two siblings aged 2.5 years and 6 months with HVDRR who did not respond to traditional treatment regimes...

BACKGROUND: Secondary hyperparathyroidism is a common acquired disorder seen in chronic renal failure. It may result in potentially serious complications including metabolic bone diseases, severe atherosclerosis and undesirable cardiovascular events. Parathyroidectomy is required in about 20% of patients after 3-10 years of dialysis and in up to 40% after 20 years. AIMS: The aim of the current study was to evaluate the short-term and long-term outcomes of patients with secondary hyperparathyroidism who had undergone total parathyroidectomy with autotransplantation and thymectomy or subtotal parathyroidectomy with thymectomy by the same surgical team during the study period...

BACKGROUND: A growing number of patients with primary hyperparathyroidism (PHPT) are diagnosed in the absence of symptoms following routine biochemical screening. However, in some countries, overt manifestations and osteitis fibrosa cystica (OFC) still dominate the clinical profile of PHPT patients. METHODS: We retrospectively studied clinical and biochemical manifestations of 47 consecutive patients with primary hyperparathyroidism who were treated with parathyroidectomy from October 1993 to June 2005...

Pathogenesis of parathyroid diseases has been recently elucidated at molecular levels. In uremic hyperparathroidism, it has been revealed that down regulation of vitamin D receptor and calcium sensing receptor plays major roles. In future, correction of such abnormalities of parathyroid cells may become possible by in vivo or ex vivo gene transfer. For this purpose, culture system of physiologically viable parathyroid cells and appropriate vectors need to be established.

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The bone disease associated with chronic renal impairment is complex and multifactorial, and has changed over past decades. Whereas originally features of vitamin D deficiency (rickets/osteomalacia) and secondary hyperparathroidism (erosions, osteosclerosis, brown cysts) predominated, improvement in management and therapy have resulted in such readiographic features being present in a minority of patients. Metastatic calcification and "adynamic" bone develop as a complication of disease (phosphate retention) and treatment (phosphate binders)...

From 1960 to 1990, one hundred twenty eight (128) subjects with primary hyperparathyroidism were operated in the University Hospital. The medical records were reviewed. Serum and urine chemistries were done by conventional methods, serum PTH was done by RIA's (N-, C-, and midregion) and intact by IRMA and 1,25 dihydroxycholecalciferol by a non equilibrium receptor assay from calf thymus and preceded by double Sep-Pak chromatography. The distal third of the radius (nondominant arm) was used to evaluate radial bone density (RBD), using single photon absorptiometry (Norland) and the lumbar bone density (LBD) was measured by dual energy X Ray absorptiometry (DEXA)...

This paper describes some of the earlier experiences of parathyroid disease in Birmingham. It goes on to describe the experience of the disease in patients with and without renal failure treated by one surgeon over the past decade. It should be read in conjunction with a previous publication in the Annals (3). A careful neck exploration by a surgeon experienced in parathyroidectomy gives a high (92.3%) cure of all comers with primary hyperparathyroidism. The majority of failures are cases with familial disease...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Two monoclonal antibodies reacting with surface structures on exclusively parathyroid cells and proximal kidney tubule cells were evaluated in the microscopic diagnosis of parathyroid disease. Immunostained cryosections of adenomatous and hyperplastic parathyroid glands from 30 hypercalcemic patients with primary or uremic hyperparathroidism (HPT) showed a reduced and heterogeneous staining with the antibodies. This contrasted with the intense and even staining of normal and suppressed human parathyroid glands, as well as lymph node metastases of parathyroid carcinoma...

Maintenance hemodialysis, while capable of prolonging life, is an incomplete substitute for the patient's native functioning kidneys. Recently, it has become clear with time that long-term survivors of hemodialysis develop an osteoarthropathy differing from classic secondary hyperparathyroidism. The radiographic appearance includes erosive or destructive changes of articular surfaces, bone cysts, osteopenia, and periarticular calcific deposits. The most important clinical factor related to the development of the disease is increasing duration of hemodialysis...

Under observation were 66 (50.3%) of 130 patients with an ossific form of hyperparathyroidism. Fourty five patients showed the classical picture of Recklinghausen disease, and 21-only diffuse osteoporosis. The correct diagnosis would be established 4-5 years following the onset of the disease. During the period of most distinct manifestations pains in bones were noted in 93 per cent of cases. Two thirds of patients showed marked atonia and fatigue. Pathological fractures were multiple and were observed in 45 of 66 patients (totally 125 fractures)...

A case of total, dense dural calcification in an adult female patient with secondary hyperparathroidism is presented. The often reported feature in the skull is that of a combination of osteopenia and osteosclerosis giving a granular bone texture described sometimes as "grains of sand" or "salt and pepper" appearance [6]. Extensive dural calcification with this condition has very rarely been reported [2, 3]. The purpose of this paper is to document the existence of the latter in a patient followed up for 19 years...

Case report of a female neonate with hypocalcemia and spasms. The cause was parathyroid insufficiency due to hyperparathroidism of the mother. The hypocalcemia was treated with a massive dose of Vitamin D; this led to a sharp rise of 25-OH-vitamin D levels in serum. The mother had kidney stones. There was hypercalcemia and a raised parathormone level. Diagnosis was confirmed by surgery. An adenoma weighing 7 g was removed.