TITLE

Preoperative Normal Level of Parathyroid Hormone Signifies an Early and Mild Form of Primary Hyperparathyroidism World J. Surg. Vol 27, No 4, April 2003

AUTHOR(S)
Bergenfelz, Anders; Lindblom, Pia; Lindergård, Birger; Valdemarsson, Stig; Westerdahl, Johan
PUB. DATE
April 2003
SOURCE
World Journal of Surgery;Apr2003, Vol. 27 Issue 4, p481
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Contemporary patients are often diagnosed with mild or intermittent hypercalcemia. In addition, most studies demonstrate patients with parathyroid (PTH) levels in the upper normal range. The aim of the present investigation was to define subgroups of patients with mild primary hyperparathyroidism (pHPT), which could be of importance in the decision for or against surgical treatment. Two-hundred and eleven patients, operated for pHPT were investigated with biochemical variables known to reflect PTH activity, renal function, and bone mineral content. The preoperative diagnosis of pHPT was based on the presence of hypercalcemia combined with an inappropriate serum concentration of PTH. The mean age of the patients was 64 ± 14 years and the mean serum level of calcium was 2.78 ± 0.19 mmol/L. One hundred and sixty-two patients (77%) had raised levels of calcium and PTH the day before surgery (overt pHPT), 25 patients (12%) had a normal level of calcium and a raised PTH level (normal calcium group), and 20 patients (9%) had a raised level of calcium and a normal level of PTH (normal PTH group). In four patients the level of calcium and PTH was normal. Between-group analysis demonstrated no major difference in symptom and signs of pHPT. Except for lower adenoma weight, patients in the normal calcium group did not essentially differ from the patients in the overt pHPT group. However, patients in the normal PTH group were a decade younger, and had better renal function, lower bone turnover, and a preserved bone density compared with patients in the overt pHPT group. In conclusion, the data from the present investigation show that pHPT patients with a preoperative normal PTH level have an early and mild form of the disease. Furthermore, the serum calcium concentration does not reflect disease severity in pHPT.
ACCESSION #
16820802

 

Related Articles

  • Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results-New Philosophy or Expensive Selection without Improvement of Surgical Results? Mortier, Pierre-E.; Mozzon, Marta M.; Fouquet, Olivier P.; Soudan, Benoit C.; Huglo, Damien G.; Cussac, Jean-F.; Proye, Charles A.G. // World Journal of Surgery;Dec2004, Vol. 28 Issue 12, p1298 

    We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal99mtc-MIBI scan was required for the unilateral approach...

  • Pseudo-pseudohypercalcaemia, apparent primary hyperparathyroidism and Waldenström's macroglobulinaemia. Elfatih, A.; Anderson, N. R.; Fahie-Wilson, M. N.; Gama, R. // Journal of Clinical Pathology;Apr2007, Vol. 60 Issue 4, p436 

    An apparent primary hyperparathyroidism was reported due to pseudo-pseudohypercalcaemia in a 74-year-old man with Waldenström's macroglobulinaemia. It is important to recognise artificially elevated serum calcium levels so as to avoid erroneous diagnosis, unnecessary investigations and...

  • Severe Acute Pancreatitis As A First Symptom Of Primary Hyperparathyroidism: A Rare Case Report. Michalopoulos, A.; Papadopoulos, V.; Apostolidis, S.; Paramythiotis, D.; Zatagias, A.; Harlaftis, N. // Internet Journal of Surgery;2007, Vol. 9 Issue 1, p28 

    A case of severe acute pancreatitis with normal values of serum calcium in a 59 year old woman is presented. The patient was operated for chololithiasis and choledocholithiasis because of misleading ultrasonography. No stones were found during the duct exploration. Parathyroid adenoma was...

  • Parathyroidectomies Using Intraoperative Parathormone Monitoring: When Should We Stop Measuring Intraoperative Parathormone Levels? Gupta, Aditya; Unawane, Amruta; Subhas, Gokulakkrishna; Herschman, Barry R.; Silapaswan, Sumet; Kolachalam, Ramachandra; Kestenberg, William; Ferguson, Lorenzo; Jacobs, Michael J.; Mittal, Vijay K. // American Surgeon;Aug2012, Vol. 78 Issue 8, p844 

    Intraoperative parathyroid hormone monitoring (IOPM), in use for the last 15 years, has facilitated focused parathyroidectomy. We undertook this study to determine if a drop in IOPT hormone levels below 50 per cent of baseline were sufficient to terminate the procedure. We conducted a...

  • Hypotensive Effects of Nifedipine in Patients with Primary Hyperparathyroidism: Case Reports. Takata, Yutaka; Takishita, Shuichi; Koga, Tokushi; Nakao, Yae; Okamura, Ken; Yao, Takashi; Takemura, Ken; Fujishima, Masatoshi // Angiology;Dec1989, Vol. 40 Issue 12, p1079 

    Nifedipine was administered orally to 2 patients with primary hyperparathy- roidism before and after parathyroidectomy. The operation lowered serum calcium concentration and parathyroid hormone but did not alter plasma renin activity, plasma aldosterone concentration, and serum magnesium. The...

  • Direct maxacalcitol injection into hyperplastic parathyroids improves skeletal changes in secondary hyperparathyroidism. Shiizaki, K.; Hatamura, I.; Negi, S.; Sakaguchi, T.; Saji, F.; Kunimoto, K.; Okamoto, M.; Imazeki, I.; Muragaki, Y.; Akizawa, T. // Kidney International;Aug2006, Vol. 70 Issue 3, p486 

    Direct maxacalcitol (OCT) injection into a parathyroid gland (PTG) ameliorates several important etiologic factors of resistance to medical treatments for secondary hyperparathyroidism (s-HPT): the upregulations of vitamin D receptor (VDR) and Ca-sensing receptor (CaSR) in PTGs and the...

  • The Outcome of Cervical Exploration for Asymptomatic and Symptomatic Patients with Primary Hyperparathyroidism. Abbas, Jaber S.; Hashem, Suzan I.; Faraj, Walid G.; Khalifeh, Mohammad J.; Horani, Mukbil H.; Salti, Ibrahim S. // World Journal of Surgery;Jan2006, Vol. 30 Issue 1, p69 

    This study examined the success and safety of cervical exploration in patients with primary hyperparathyroidism (HPT). The presentation, pathologic findings, and outcome of patients with asymptomatic primary HPT were compared with those with symptomatic disease. Records of patients undergoing...

  • Non-suppressible parathyroid hormone secretion is related to gland size in uremic secondary hyperparathyroidism. Indridason, Olafur S.; Heath III, Hunter; Khosla, Sundeep; Yohay, Daniel A.; Quarles, L. Darryl // Kidney International;Nov1996, Vol. 50 Issue 5, p1663 

    To determine the relative importance of parathyroid gland enlargement and alterations in calcium sensing (set-point changes) in the pathogenesis of uremic secondary hyperparathyroidism (2°HPT), we investigated the relationship between estimates of parathyroid gland size and calcium-mediated...

  • Long-Term Outcome in Patients with Primary Hyperparathyroidism who Underwent Minimally Invasive Parathyroidectomy. Venkat, Raghunandan; Kouniavsky, Guennadi; Tufano, Ralph; Schneider, Eric; Dackiw, Alan; Zeiger, Martha // World Journal of Surgery;Jan2012, Vol. 36 Issue 1, p55 

    Background: Minimally invasive parathyroidectomy (MIP) has become a well-accepted treatment for selected patients with primary hyperparathyroidism (PHPT). However, few studies have evaluated long-term outcomes for this operative approach. We therefore chose to examine both the long-term symptom...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics