Primary Hyperparathyroidism of Postmenopausal Women

Lundgren, Ewa

doi:10.3109/03009739909178956

Cited by 7 publications

(2 citation statements)

References 276 publications

(187 reference statements)

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“…Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a prevalence of three per thousand in the general population, a male:female ratio of 1:3.3 (6) and a prevalence of 2.5-3% in women aged over 65 years (7). The increased parathyroid hormone (PTH) levels may be the result of parathyroid adenoma (80-85% of cases), hyperplasia (15%) or carcinoma (1-3%).…”

Section: Introductionmentioning

confidence: 99%

Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study

Massironi

Cavalcoli

Rossi

et al. 2013

European Journal of Endocrinology

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Design: The coexistence of chronic autoimmune atrophic gastritis (CAAG) and primary hyperparathyroidism (PHPT) has been described previously, even if its extent and underlying mechanisms remain poorly understood. We therefore prospectively evaluated this association in two series of patients, one with CAAG and the other with sporadic PHPT. Methods: From January 2005 to March 2012, 107 histologically confirmed CAAG patients and 149 PHPT patients were consecutively enrolled. Routine laboratory assays included serum calcium, parathyroid hormone (PTH), plasma gastrin and chromogranin A (CgA). In CAAG patients with high PTH levels, ionized calcium and 25(OH)-vitamin D were evaluated. All CAAG and hypergastrinemic PHPT patients received an upper gastrointestinal endoscopy. Exclusion criteria were familial PHPT, MEN1 syndrome, treatment with proton pump inhibitor drugs, Helicobacter pylori infection and renal failure. Results: Of the 107 CAAG patients, nine (8.4%) had PHPT and 13 (12.1%) had secondary hyperparathyroidism stemming from vitamin D deficiency. Among the 149 PHPT patients, 11 (7.4%) had CAAG. Gastrin and CgA levels were similar in the CAAG patients with vs those without hyperparathyroidism (either primary or secondary), and calcium and PTH levels were similar in the PHPT patients with vs those without CAAG. Conclusions: This study confirms a non-casual association between PHPT and CAAG. The prevalence of PHPT in CAAG patients is threefold that of the general population (8.4 vs 1-3%), and the prevalence of CAAG in PHPT patients is fourfold that of the general population (7.4 vs 2%). The mechanisms underlying this association remain unknown, but a potential role for autoimmunity is suggested.

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Section: Introductionmentioning

confidence: 99%

Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study

Massironi

Cavalcoli

Rossi

et al. 2013

European Journal of Endocrinology

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“…All of the hyperparathyroid patients were postmenopausal women, a particularly vulnerable group. Three percent of postmenopausal women in the general population are diagnosed with the disorder (9) (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Long‐term therapy with lithium in a private practice clinic: a naturalistic study

Luby¹,

Singareddy²

2003

Bipolar Disorders

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Controlled studies in psychopharmacology are obviously preferred to open-label or naturalistic case studies. However, controlled studies are rarely conducted over long periods, and practice-related naturalistic research can be of value, albeit anecdotal and without the use of structured rating scales. In this paper, we are reporting on 14 patients seen consistently by one psychiatrist. These patients were functional and productive at work and in family life. The patients suffered brief hypomanic or depressive episodes. Although several patients experienced serious side-effects, lithium was continued with stable mood, while the side-effects were managed in collaboration with other specialists.

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Primary Hyperparathyroidism Revisited in Menopausal Women with Serum Calcium in the Upper Normal Range at Population‐based Screening 8 Years Ago

et al. 2002

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Population-based screening showed 2.1% prevalence of primary hyperparathyroidism (pHPT) in postmenopausal women. Individuals with total serum (s)-calcium levels of 2.55 mmol/L or more at screening were diagnosed with pHPT when subsequent analysis supported inappropriately elevated intact parathormone (PTH) levels in relation to even normal s-calcium levels. The arbitrary diagnostic criteria were validated by parathyroidectomy. Herein we reinvestigated biochemical signs of pHPT in women not diagnosed with pHPT due to s-calcium 2.50 to 2.54 mmol/L (group A, n = 160) at screening or due to appropriate PTH levels on two occasions after screening (group B, n = 70). Altogether, 99 women in group A and 47 in group B underwent reinvestigation 8.8 years after screening when they were 65 to 84 years old. The s-calcium levels averaged 2.56 mmol/L and had increased in group A (mean 0.04 mmol/L) and decreased in group B (mean 0.05 mmol/L). A total of 48 and 18 females (48%, 38%), respectively, met the previously validated criteria of pHPT. Altogether 21% of them were hypercalcemic (range 2.60-3.12 mmol/L). Subgroup analysis showed that PTH had not increased with time (n = 47) and that atherogenic blood lipids, but not glucose levels, were similar in pHPT patients and matched controls (n = 37). Assuming the existence of pHPT already at screening, the prevalence of pHPT could be adjusted to 3.4%. Even the most liberal diagnostic criteria utilized at pHPT screening seemed to underdiagnose the disease by inefficient cutoff limits for s-calcium and PTH. Because one-fifth of the women with pHPT progressed to hypercalcemia, long-term follow-up is advocated for those with s-calcium in the upper normal range.

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Primary Hyperparathyroidism of Postmenopausal Women

Cited by 7 publications

References 276 publications

Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study

Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study

Long‐term therapy with lithium in a private practice clinic: a naturalistic study

Primary Hyperparathyroidism Revisited in Menopausal Women with Serum Calcium in the Upper Normal Range at Population‐based Screening 8 Years Ago

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