Calcium Intake in Patients With Primary Hyperparathyroidism

Dent, C. E.; Hartland, Beth; Hicks, John; Sykes, Elizabeth

doi:10.1016/s0140-6736(61)90632-8

Cited by 35 publications

(11 citation statements)

References 2 publications

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“…The same is observed in our study and various other series [3,22]. One previous study in India by Hari Narayan (1995) [18] reported normocalcemia in 50% of cases in Vit D defi ciency.…”

Section: Discussionsupporting

confidence: 92%

“…In our series 88% of patients are below 40 years of age of which 47% are below 20 years, same as in other developing countries [4,14,17,18,19]. Compated to this, the mean age is reported from developed countries is 55 to 62 years [3,8,16, 18] While 22.4 years is the mean age in our series Norris (1947), [16] Dent (1961), [22] Sivula (1985) reported that the majority of patients in their series were above 40 years.…”

Section: Discussionsupporting

confidence: 74%

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Primary hyperparathyroidism: retrospective 10-year study of 32 cases

2008

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Background Parathyroid glands are endocrine glands that regulate calcium metabolism. Usually four in number, they lie mostly on the posterior aspect of thyroid glands. Primary hyper-parathyroidism (PHPT) refers to a condition wherein they secrete an excess of parathyroid hormone leading to signs and symptoms of hypercalcemia.Patients and Methods Thirty-two patients of primary hyper-parathyroidism were seen by us in the ten years. Majority of patients were below 40 years of age (88%). Male: female ratio was 1:4. The diagnosis was made incidentally in patients who reported for various signs and symptoms not responding to treatment. High serum calcium pointed to the diagnosis of primary parathyroid hyperplasia. It was confi rmed by high level of serum parathyroid hormone and localization of enlarged parathyroid glands by USG / MRI and / or Tc-99 Technetium scan. Of the 32 patients examined, 43 parathyroid glands were excised, fi ve cases had two glands excised; out of these 4 cases underwent parathyroid reimplantation in neck/forearm muscles. One unusual case underwent operation for giant-cell tumor of the head of humerus. This patient presented with excessive vomiting not responding standard medical management in post-operative period.Results During investigations serum calcium was found to be very high, the diagnosis was confi rmed by fi nding high parathyroid hormone and corroborated by T 99 Technetium scan. Parathyroidectomy was done in all cases, of which 59% (18 cases) developed mild to severe tetany due to hypocalcaemia.Conclusion Primary hyperplasia of thyroid gland is the most important cause of hypercalcemia. Hypercalcemia is found in all cases of PHPT in our series with high parathyroid hormone levels. Majority of our cases have one gland involvement and hypocalcaemia in our series is unusually high following excision of involved gland.

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“…The same is observed in our study and various other series [3,22]. One previous study in India by Hari Narayan (1995) [18] reported normocalcemia in 50% of cases in Vit D defi ciency.…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 74%

Primary hyperparathyroidism: retrospective 10-year study of 32 cases

2008

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“…Interestingly, almost 60% of our patients were above the age of 40 years, similar to the Western experience, [8][9][10] but contradicting the Indian report, where 68% of the patients were below the age of 40. 11 Women showed a higher ratio of 7:1 to men, and a mean age of 46 years at presentation, which is similar to the Western experience.…”

Section: Discussioncontrasting

confidence: 47%

Primary Hyperparathyroidism: King Khalid University Hospital Experience

Fouda

1999

Ann Saudi Med

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Background: This study was conducted to examine the prevalence, mode of presentation and management of primary hyperparathyroidism in one of the major hospitals in Saudi Arabia. Patients and Methods:This was a retrospective analysis of 24 cases of primary hyperparathyroidism, comprising 21 females and three males, who were seen at King Khalid University Hospital over a period of 16 years from 1982 until December 1997. Results: The prevalence of the disease was estimated to be 11.34 per 100,000 hospital population. The majority of the patients presented with musculoskeletal complaints (62%-67%) and/or renal complications (58%). Hypercalcemia was seen in 92% of the cases. Serum PTH was available for 21 patients and 20 had significantly elevated levels. Fifty percent of the patients had features of hyperparathyroid bone disease on plain x-ray, while 79% showed osteopenia of the femoral neck on dual x-ray absorptiometry, and almost all the patients had lumbar osteopenia. Fifty percent of the patients had features of metabolic bone disease on bone scan. Thallium-technetium subtraction studies proved to be the most reliable tool, with 83% sensitivity, followed by ultrasound scan of the neck, with a sensitivity of 55%. CT scan of the neck was attempted in only seven patients (29%), with a sensitivity of 86%. Twenty-one patients (87.5%) underwent surgical exploration and removal of the parathyroid adenoma. Single parathyroid adenoma was identified in 85% of the cases, 5% had multiple adenomas, and 5% had hyperplasia of the parathyroid gland. Conclusion: Our results showed that primary hyperparathyroidism is not a rare disease in Saudi Arabia. It has a tendency for late presentation with complications. We believe that routine screening for calcium and early identification of such cases are warranted to reduce the morbidity of this easily treatable disorder. Ann Saudi Med 1999;19(2):110-115.

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“…Albright & Reifenstein (1948) considered it was due to a poor dietary intake of calcium, but Dent, Hartland, Hicks & Sykes (1961) demonstrated that there was no significant difference between the dietary calcium intake of those with and those without bone disease. However, Hodgkinson (1963) showed that, in primary hyperparathyroidism, there is an increase in the proportion of dietary calcium which is absorbed and that some patients, without clinical evidence of bone disease, are virtually in calcium balance, despite hypercalciuria.…”

Section: Discussionmentioning

confidence: 99%

Changes in total Body Calcium Content in Primary Hyperparathyroidism

1972

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1. The change in total body calcium content after surgery for primary hyperparathyroidism was studied in seven patients by whole body neutron activation analysis. Three patients who remained in the uncontrolled state for up to 12 months were also studied by this technique.2. The technique and its reproducibility are described. Changes in total body calcium greater than f 4 % should be detectable using this method.3. The change in total body calcium after surgery was variable. Total body calcium content decreased in three cases after apparently successful parathyroidectomy. Not all the cases experiencing an increase in body calcium content had radiological evidence of bone disease.4. The role of relative hypoparathyroidism due to suppression of normal parathyroid tissue by a functioning adenoma is discussed.

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Calcium Intake in Patients With Primary Hyperparathyroidism

Cited by 35 publications

References 2 publications

Primary hyperparathyroidism: retrospective 10-year study of 32 cases

Primary hyperparathyroidism: retrospective 10-year study of 32 cases

Primary Hyperparathyroidism: King Khalid University Hospital Experience

Changes in total Body Calcium Content in Primary Hyperparathyroidism

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