Primary Hyperparathyroidism Presumably Caused by Chronic Parathyroiditis Manifesting from Hypocalcemia to Severe Hypercalcemia

Furuto-Kato, Sumiko; Matsukura, Shigeru; Ogata, Makoto; Azuma, Nobuyuki; Manabe, Toshiaki; Shigeno, Chohei; Asato, Ryo; Tanaka, Kiyoshi; Komatsu, Yasato; Nakao, Kazuwa

doi:10.2169/internalmedicine.44.60

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…In this study we could not identify specific clinical features which correlate with the phenomenon of remission. Interestingly, two of the three previously reported cases 11,14 and case 1 of this study had normal serum PTH values. While normal serum iPTH values in the presence of hypocalcaemia reflect partial hypoparathyroidism, it can also be regarded as evidence of a sufficient number of viable PTH secreting parathyroid cells .…”

Section: Discussionsupporting

confidence: 51%

“…Spontaneous remission of disease in hypoparathyroidism has been reported only in three cases to date 11,13,14 . Posillico et al.…”

Section: Discussionmentioning

confidence: 99%

“…Furuto‐Kato et al. 14 described a 67‐year‐old female with numbness of the fingers and low serum total calcium (1·62 mmol/l), inappropriately normal serum intact PTH of 1·4 pmol/l and normal serum magnesium levels. Her serum calcium normalized following treatment with 1,25(OH) 2 D 3 (1·5–2·0 μg/day).…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, there are three case reports of spontaneous remission in SIH 11,13,14 . We have a large cohort of patients with SIH on follow up 9,15–18 .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism

Goswami¹,

Goel²,

Tomar³

et al. 2010

Clinical Endocrinology

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Summary Background Remission of disease activity is a characteristic feature of autoimmune endocrine disorders such as Graves’ disease, Addison’s disease and occasionally in patients with premature ovarian failure. Autoimmunity is also implicated in sporadic idiopathic hypoparathyroidism (SIH) with clinical remission of disease reported in three cases. Objective To assess the rate of remission in patients with sporadic idiopathic hypoparathyroidism and review the cases reported so far. Subjects and methods Subjects included 53 patients (M:F, 24:29) with SIH who had been symptomatic for at least 1 year (range 1–31 years). They were treated with calcium and 1‐α‐(OH)D3/cholecalciferol therapy and had a mean duration of follow up of 5·0 ± 3·2 years. Treatment was withdrawn in two stages in the patients who maintained normal levels of serum total calcium during the preceding year of treatment. In stage‐1, the dose of therapy was reduced to half and subsequently all treatment was stopped (stage 2) in those patients who maintained normal serum total calcium levels on the reduced dose. Remission of SIH was defined as maintenance of normal serum total (≥2·12 mmol/l) and ionized calcium, inorganic phosphorus and serum intact parathyroid hormone (iPTH) for at least 3 months after withdrawal of calcium and 1‐α‐(OH)D3/cholecalciferol therapy. Calcium sensing receptor autoantibodies (CaSRAb) were determined by Western blot. Results Two of the 53 patients (3·8%) with SIH stayed in remission for 1 year after complete withdrawal of therapy. CaSRAb was absent in both the cases. The clinical features, age at onset and duration of hypocalcaemic symptoms in cases with remission were comparable to those who did no show remission. Conclusion Sporadic idiopathic hypoparathyroidism is not irreversible as is widely believed and spontaneous remission of disease may occur in 3·8% of patients.

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Section: Discussionsupporting

confidence: 51%

“…Spontaneous remission of disease in hypoparathyroidism has been reported only in three cases to date 11,13,14 . Posillico et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Interestingly, there are three case reports of spontaneous remission in SIH 11,13,14 . We have a large cohort of patients with SIH on follow up 9,15–18 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism

Goswami¹,

Goel²,

Tomar³

et al. 2010

Clinical Endocrinology

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show abstract

“…Substantial chronic inflammatory reaction in otherwise normal parathyroid glands is, however, rare. In surgical material, chronic parathyroiditis associated with hyperparathyroidism or hypoparathyroidism was described in only a few cases [3][4][5]. To our knowledge, chronic parathyroiditis in parathyroid adenomas was reported only in three papers.…”

Section: Introductionmentioning

confidence: 93%

Parathyroid Chief Cell Adenoma Associated with Massive Chronic Parathyroiditis in a Woman with Hyperparathyroidism

et al. 2007

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We report here the case of a 43-year-old woman with hyperparathyroidism, parathyroid chief cell adenoma, and massive chronic parathyroiditis. The patient was diagnosed with breast cancer and received chemotherapy 3 years before parathyroidectomy. The question can be raised whether chemotherapeutic agents may damage parathyroid cells leading to loss of self-tolerance and autoimmune chronic parathyroiditis.

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Nonneoplastic Parathyroid Diseases

Erickson

2010

Molecular Pathology Library

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Primary Hyperparathyroidism Presumably Caused by Chronic Parathyroiditis Manifesting from Hypocalcemia to Severe Hypercalcemia

Cited by 15 publications

References 25 publications

Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism

Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism

Parathyroid Chief Cell Adenoma Associated with Massive Chronic Parathyroiditis in a Woman with Hyperparathyroidism

Nonneoplastic Parathyroid Diseases

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