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Introduction About 80–90% of primary hyperparathyroidism (pHPT) cases are caused by parathyroid adenoma. Long-term increased parathyroid hormone (PTH) secretion leads to a generalized disorder of calcium, phosphate and bone metabolism. The
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Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland
Endocrinology, Department of Public Health, Group Administration, Helsinki University Hospital, University of Eastern Finland, Abdominal Center, University of Helsinki and Helsinki University Hospital, Post Box 340, FI-00290 Helsinki, Finland
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Health-related quality of life (HRQoL) is frequently impaired in primary hyperparathyroidism (PHPT) but it is unclear if surgery is beneficial. The objective was to prospectively assess HRQoL in PHPT (n=124) with the 15D instrument before and after surgery, to compare it with that of a comparable sample of the general population (n=4295), and search for predictors of HRQoL and its change. HRQoL, and clinical and laboratory parameters were measured before and at 6 and 12 months after surgery. Regression techniques were used to search for predictors of HRQoL and gains from treatment. Before surgery, PHPT patients had significantly lower mean 15D score compared to controls (0.813 vs 0.904, P<0.001). Excretion, mental function, discomfort and symptoms, distress, depression, vitality, and sexual activity were most impaired (all P<0.001). Number of medications (P=0.001) and subjective symptoms (P<0.05) but not calcium or parathyroid hormone (PTH) predicted impaired HRQoL. Serum 25-hydroxyvitamin D (25OHD) was of borderline significance (P=0.051). Compared to baseline, mean 15D score improved significantly 6 months after surgery (0.813 vs 0.865, P<0.001) and the effect sustained at 1 year (0.878, P<0.001). The improvement was clinically important in 77.4% of patients (P<0.001). Educational level independently predicted improvement (P<0.005). HRQoL is severely impaired in PHPT but improves significantly after surgery. The 15D is a sensitive tool for assessing HRQoL and recognizing patients likely to benefit from surgery.
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about 3 months after the onset of hypercalcemia ( 7 ). Median survival in patients with squamous cell carcinoma and hypercalcemia was 17–64 days ( 8 , 9 ). In a series of patients with parathyroid hormone-related peptide (PTH-RP) mediated hypercalcemia
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Introduction Hypoparathyroidism (HPT) is the partial or complete reduction of parathyroid hormone (PTH) secretion from the parathyroid glands. PTH stimulates 1-alpha-hydroxylase enzyme to produce 1,25(OH) 2 -vitamin D, which facilitates active
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-CT >13 mm 0 7–13 mm 1 <7 mm or no lesions 2 WIN >1600 0 801–1600 1 <800 2 MGD, multiglandular disease; PTH, parathyroid hormone. The most commonly used are the CaPTHUS score
Department of Pharmacology, University of Michigan, Ann Arbor, Michigan, USA
Veterans Affairs Medical Center, Ann Arbor, Michigan, USA
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obtained with thyroxine therapy for severe hypothyroidism, estrogen for ovarian failure, growth hormone for pituitary dwarfism, and most recently, recombinant parathyroid hormone for hypoparathyroidism ( 2 ). These sweeping responses to properly
The University of Warwick, Coventry, UK
Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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), is expressed primarily in the renal proximal tubule ( 1 , 2 ), and is positively and negatively regulated by parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), respectively ( 3 ). While the kidney has a central role in 1,25(OH) 2 D
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Department of Clinical Chemistry, Amsterdam Gastroenterology & Metabolism, Amsterdam UMC, University of Amsterdam, Endocrine Laboratory, Amsterdam, Netherlands
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Introduction Parathyroid hormone (PTH) plays a critical role in maintaining adequate serum calcium homeostasis. It increases serum calcium by stimulating bone resorption, promoting phosphate excretion, converting vitamin D to its active form
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magnesaemia) Cytotoxic drug-induced hypocalcaemia Pancreatitis, rhabdomyolysis and large volume blood transfusions Investigations Serum calcium (adjusted for albumin) Phosphate Parathyroid hormone (PTH) Urea and electrolytes Vitamin D Magnesium
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Center for Regenerative Medicine and Skeletal Development, Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
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Division of Endocrinology and Metabolism, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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). Approximately 85% of all PHPT cases are caused by sporadic single-gland parathyroid adenomas (PTAs), benign tumors which typically release inappropriately high levels of parathyroid hormone (PTH) and cause hypercalcemia, in turn often leading to osteoporosis
