Primary hyperparathyroidism: Epidemiology, diagnosis and clinical picture

Ljunghall, Sverker; Hellman, Per; Rastad, Jonas; Åkerström, Göran

doi:10.1007/bf01665300

Cited by 58 publications

(30 citation statements)

References 59 publications

(94 reference statements)

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“…However, as almost all of the 26 above-mentioned MEN 1 patients with gastric tumours exhibited also pHPT, the neoplasms of the stomach might have a humoral as well as genetic pathogenesis [64,76]. The hypothesis that the pHPT induced hypercalcaemia in association with hypergastrinaemia could play a promoter role [51] is supported by a study of more than 4,000 pHPT patients which revealed a 50% increased risk of developing malignant endocrine and non-endocrine diseases when compared to the normal population [42].…”

Section: Pathogenesismentioning

confidence: 64%

Multiple endocrine neoplasia type 1 (MEN 1) revisited

Padberg

Schröder

Heitz

et al. 1995

Vichows Archiv A Pathol Anat

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Multiple endocrine neoplasia type 1 (MEN 1) is an inherited disease of the neuroendocrine cell system affecting primarily the parathyroids, pancreas, duodenum and the anterior pituitary. The pancreatic and duodenal turnouts may metastasize, but generally have a low malignant potential. The diagnosis of MEN 1 is usually made in the second decade of life and based on the involvement of at least two organs and a family history. The recent discovery of the MEN 1 locus on the centromeric region of the long arm of chromosome 11 may become a further diagnostic criterion. The use of flanking DNA markers permits presymptomatic testing for MEN 1 in affected families.

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Section: Pathogenesismentioning

confidence: 64%

Multiple endocrine neoplasia type 1 (MEN 1) revisited

Padberg

Schröder

Heitz

et al. 1995

Vichows Archiv A Pathol Anat

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“…A recent epidemiologic review in Sweden [1] reported that more than 1% of all postmenopausal females could be diagnosed as having pHPT.…”

mentioning

confidence: 99%

Clinical and Biochemical Presentation of Primary Hyperparathyroidism in Kansai District of Japan.

1997

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Abstract. Although the number of patients with primary hyperparathyroidism (pHPT) has increased since biochemical screening came to be widely employed, few data are available concerning the clinical analysis of Japanese patients. We therefore tried to determine the recent clinical and biochemical state of Japanese patients with pHPT. Clinical and biochemical data were analyzed in a series of 103 pHPT patients who had been hospitalized in Kobe University Hospital during a 17 year period from 1979 to 1995. The data were obtained from the hospital records and additionally from information through questionnaires performed in 1995. Patients were 29 males and 74 females. The average ages at diagnosis were 53.4 ± 16.0 (SD) year-old and 53.9 ± 15.2 year-old, respectively. The major clinical symptoms were nephrolithiasis (35.9%), thirst/polyuria (33.0%), easy fatigability (20.4%) and back pain/lumbago (16.5%), but 19.4% of the patients were asymptomatic. Out of 87 cases who received parathyroidectomy, 10 (11.5%) were diagnosed with parathyroid carcinoma. Age-and sex-corrected bone mineral density (BMD) of the radius was significantly lower in the group with back pain/lumbago than in the group without the symptom. Similarly, radial BMD was lower in the group with a high serum alkaline phosphatase value. Patients with nephrolithiasis had a lower urinary calcium/creatinine ratio (UCa/ UCr; 0.305 ± 0.188 mg/mg) than the patients without nephrolithiasis (0.400 ± 0.160 mg/mg). This inconsistent result suggests that some important factors except urinary calcium would contribute to urinary stone formation in pHPT. Our data mostly agreed with previous reports on a Caucasian population except for a relatively high prevalence of parathyroid carcinoma, but the negative correlation between nephrolithiasis and urinary calcium was not easily explicable. This finding should be confirmed by analyzing a larger number of cases.

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“…In contrast, there was no consensus about the management of patients with asymptomatic primary hyperparathyroidism. However, an ever-increasing amount of recent data suggest that these "asymptomatic" patients have symptoms that are recognized only in retrospect once their parathyroid disease has been cured [5,6]. In addition, asymptomatic patients have subtle neuropsychiatric impairment as well as progressive cardiovascular disease, which can result in premature death [7,8].…”

Section: Opinion Statementmentioning

confidence: 98%