Hyperparathyroidism: Generalized osteitis fibrosa. With observations upon the bones, the parathyroid tumours, and normal parathyroid glands

Abstract

THE purpose of this paper is to set forth the evidence upon which is based the view that generalized osteitis fibrosa (von Recklinghausen) is a disease of endocrine origin. According to this view the changes in the bones are due to hyperparathyroidism, a condition associated with hyperfunction of a parathyroid tumour. Four such cases are described, and in three the effects of removal of a parathyroid tumour are recorded. Four cases of focal osteitis fibrosa are described in order to place on record the absence of any evidence of hyperparathyroidism in this disease. Finally, a case of osteomalacia is recorded. Here the blood chemistry, metabolism, and histology suffice to show that osteomalacia and generalized osteitis fibrosa are unrelated diseases. EFFECTS OF TEE PARATHYROID HORMONE.The parathyroid glands exert a specific effect upon calcium metabolism. Thc pioneer work of MacCallum and Voegtlin (1909) demonstrating a reduction of serum calcium in dogs after parathproidectomy has been abundantly confirmed. It is well established that this condition is relieved by the administration of calcium salts. The idea that it is due to guanidine intoxication remains unsupported by adequate evidence.Since the isolation by Hanson (1924) and Collip (1925) of the active principle of the parathyroid gland (parathormone) it has been repeatedly demonstrated that the injection of the extract causes an elevation of the serum calcium. Brehme and Gyorgy (1927) found that parathormone lowers the blood phosphorus and shifts the pH of the blood towards the acid side without affecting the CO, combining power of the blood. Reiss (1928) and Aub (1928) found independently that parathormone lowers the level of the blood phosphorus. This appears to be the first action, the elevation of serum calcium following only after a long latent period. Whether the effect on phosphorus is the primary effect of parathormone remains for further work

Giant cell tumours in mandible and spine: a rare complication of Paget's disease of bone.

“…Giant cell tumour complicating Paget's disease was first described in 1931, 6 and since then about 55 cases have been reported.2 7-13 It usually occurs in patients with severe Paget's disease and typically presents as a non-tender mass in the skull or facial bones, less commonly in the remaining axial skeleton, and rarely in arms and legs.8 13 9 11 Although local recurrence after treatment is common, metastasis is very uncommon. 8 The treatment of giant cell tumour in Paget's disease is often difficult.…”

The Effects of Parathormone and Ammonium Chloride on the Bones of Rabbits

“…Hunter and Turnbull reported Byrom's attempts to produce bone lesions as a result of experimental hyperparathyroidism in young rabbits (12). A litter of seven 2 month old rabbits was used.…”

Parathyroid surgery in pregnancy: review of the literature and localization by aspiration for parathyroid hormone levels

“…Since the first reported case in 1931, 4 approximately 150 patients have been reported in the English medical literature. Although calcium levels as high as 25.8 mg 100 ml À1 have been reported during pregnancy, 5 most patients have more modest degrees of hypercalcemia.…”