Physiologic Actions of PTH I

Goltzman, David

doi:10.1016/b978-0-12-397166-1.00009-6

Cited by 3 publications

(1 citation statement)

References 170 publications

(152 reference statements)

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“…PTH is a central regulator of bone homeostasis, through its action on bone-forming osteoblasts, osteocytes and bone-resorbing osteoclasts 39 . The final effect of PTH on bone mass is either anabolic or catabolic and will depend on the dose and periodicity of PTH signalling 40 . In healthy individuals, PTH is released both with circadian dynamics and in a pulsatile manner, such that its dual anabolic and catabolic actions are well balanced.…”

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

Primary hyperparathyroidism

Bilezikian

Cusano

Khan

et al. 2016

Nat Rev Dis Primers

209

166

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Primary hyperparathyroidism (PHPT) is a common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of the four parathyroid glands. A single benign parathyroid adenoma is the cause in most people. However, multiglandular disease is not rare and is typically seen in familial PHPT syndromes. The genetics of PHPT is usually monoclonal when a single gland is involved and polyclonal when multiglandular disease is present. The genes that have been implicated in PHPT include proto-oncogenes and tumour-suppressor genes. Hypercalcaemia is the biochemical hallmark of PHPT. Usually, the concentration of PTH is frankly increased but can remain within the normal range, which is abnormal in the setting of hypercalcaemia. Normocalcaemic PHPT, a variant in which the serum calcium level is persistently normal but PTH levels are increased in the absence of an obvious inciting stimulus, is now recognized. The clinical presentation of PHPT varies from asymptomatic disease (seen in countries where biochemical screening is routine) to classic symptomatic disease in which renal and/or skeletal complications are observed. Management guidelines have recently been revised to help the clinician to decide on the merits of a parathyroidectomy or a non-surgical course. This Primer covers these areas with particular attention to the epidemiology, clinical presentations, genetics, evaluation and guidelines for the management of PHPT.

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Section: Mechanisms/pathophysiologymentioning

confidence: 99%