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[Kidney involvement in sarcoidosis].

Sarcoidosis is a chronic multisystemic inflammatory disorder of unknown etiology, characterized by the presence of non-necrotizing epithelioid and giant cell granulomas. Various renal manifestations have been reported in patients with sarcoidosis. Disorders of bone and mineral metabolism related to the overexpression of 25-hydroxyvitamin-D1α-hydroxylase by alveolar and granuloma macrophages are frequently associated with sarcoidosis. Hypercalcemia and hypercalciuria are a major cause of renal injury predisposing to pre renal azotemia, acute tubular necrosis, nephrolithiasis and nephrocalcinosi…

Metabolic effects of synthetic calcitriol (Rocaltrol) in the treatment of postmenopausal osteoporosis.

The long-term safety and efficacy of synthetic 1,25-(OH)2D3 (calcitriol; Rocaltrol) in the treatment of women with type 1 osteoporosis is being assessed in a randomized trial. Patients were allocated in double-blind fashion to 1,25-(OH)2D3 or matching placebo. Initially, the calcium intake was adjusted to 1,000 mg/d. The study protocol called for increasing the dose of 1,25-(OH)2D3 until patients developed either hypercalcemia or hypercalciuria. However, in order to maintain a higher dose of calcitriol on a long-term basis, the calcium intake had to be reduced to 600 mg/d in those receiving ca…

An evaluation of the size of the parathyroid glands.

The size of the parathyroid gland was evaluated at different functional levels of the gland (control: 216 glands in 54 autopsy cases, chronic renal failure: 74 glands in 21 autopsy cases, hypercalcemia: 16 glands in 15 patients with primary hyperparathyroidism). This study is based on the fact that chronic renal failure causes a hypersecretory state of parathyroid hormone (PTH), and that hypercalcemia suppresses PTH secretion. The size of the parathyroid gland was represented by the largest area cut through the hilum of the gland. Interstitial and fatty tissues were excluded from the measuring…

Atypical manifestations of infantile-onset nephropathic cystinosis: a diagnostic challenge.

A 7-month-old male infant was referred to us for evaluation of hypercalcemia and failure to thrive. He was the second-born child to third-degree consanguineous parents with a birth weight of 3.5 kg. The index child was severely underweight. Initial laboratory investigations showed hypercalcemia (13.6 mg/dL), hypophosphatemia, hyponatremia, hypokalemia and hypochloremia. The initial serum bicarbonate level was 20.9 mEq/L. The urine calcium: creatinine ratio (0.05) was normal. He was noted to have polyuria (6 mL/kg/hr) and required intravenous fluids to maintain intravascular volume and manage h…

Hyperparathyroidism.

Hyperparathyroidism is a disease characterized by hypercalcemia with hypophosphoremia resulting from increased secretion of parathyroid hormone (PTH). The disease may be divided into 3 forms: a) primary, b) secondary, c) tertiary (secondary refractory form). Primary hyperparathyroidism is rare in children; hyperplasia is more frequent during the early years of life (neonates and infants) and is difficult to distinguish from adenoma in children. The disease may be asymptomatic; elevated calcemia levels (>12 <13.5 mg/dl) are accompanied by anorexia, asthenia and persistent stipsis; severely elev…

Воздействие даратумумаба на костное заболевание у пациентов с недавно диагностированным множественным миелом: многоцентральное ретроспективное исследование.

ДАРАtumumab (Dara), гуманизированный моноклонный антитело IgG/, направленный на CD38, продемонстрировал значительную эффективность в лечении множественной миеломы (MM). Однако его воздействие на болезнь костей миэломы (МБД) и события, связанные со скелетом (СРС), по-прежнему недостаточно изучено. Разъяснение влияния Dara на частотность ПДБ имеет большое клиническое значение для управления ММ. МЕТОДЫ: Мы провели многоцентральный ретроспективный анализ 164 вновь диагностированные пациенты MM (NDMM), которые прошли курс лечения первой линии с использованием или без применения режима, основанного

Совпадение в аннотации оригинала
BACKGROUND: Daratumumab (Dara), a humanized IgGκ monoclonal antibody targeting CD38, has shown significant efficacy in the treatment of mult … first SRE within 6 months. Subgroup analyses were performed based on risk stratification, baseline hypercalcemia, extramedullary disease, circulating plasma cells, and use of anti-bone resorption drugs. Statistical analyses included Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards models with adjustment for covariates. RESULTS: The o …

Evaluation for primary hyperparathyroidism after radioactive iodine treatment in patients with Graves' disease.

BACKGROUND: Retrospective studies are conflicting regarding the risk of primary hyperparathyroidism after radioactive iodine treatment. We hypothesized that primary hyperparathyroidism rates are greater after radioactive iodine than after thyroidectomy and that patients with hypercalcemia after treatment for Graves' disease are not adequately evaluated for primary hyperparathyroidism, contributing to underdiagnosis of radioactive iodine-associated primary hyperparathyroidism. METHODS: This retrospective review considers patients undergoing radioactive iodine or thyroidectomy for Graves' disea…

Paraneoplastic Manifestation of Primary Squamous Cell Cancer of the Thyroid Gland.

Paraneoplastic manifestation (PNM) of cancers is a non-metastatic, non-invasive systemic effect of malignancies due to chemokines and hormones produced by the primary neoplasm. Squamous cell cancers (SCCs) are known to present with PNM. Primary SCC of thyroid accounts for <1% of all thyroid malignancies and carries a very poor prognosis. We present a rare case of SCC arising from the thyroid gland who presented with fever, leukemoid reaction and hypercalcemia as part of PNM. A 67-year-old male patient presented with two months history of intermittent high-grade fever, weakness, loss of weight …

Abnormal Calcium Levels are Associated With Worse Maternal and Fetal Outcomes; Results From an Exploratory Study.

CONTEXT: Precise estimates of the incidence of hyper- and hypocalcemia in pregnancy are unknown. Abnormal calcium levels have been associated with unfavorable pregnancy-related outcomes. OBJECTIVE: Determine frequency of hypercalcemia and hypocalcemia in pregnancy when tested and their associations with maternal and fetal outcomes. DESIGN: Exploratory retrospective cohort study. SETTING: Single tertiary care maternity unit. PATIENTS: Pregnant women with expected delivery date between 2017 and 2019 and a second additional cohort of pregnant women with hypercalcemia between 2014 and 2016 and…

Paraneoplastic syndrome frequency and prognostic effect in hepatocellular carcinoma patients.

OBJECTIVE: Symptomatic hepatocellular carcinoma (HCC) patients may generally display constitutional symptoms such as abdominal pain, weight loss, anorexia and localized mass, or atypical clinical features of paraneoplastic syndrome (PNS) such as hypercholesterolemia, hypercalcemia, hypoglycemia, erythrocytosis and thrombocytosis. The most common PNS in HCC is hypercholesterolemia, hypercalcemia, hypoglycemia and erythrocytosis. The aim of this study isto evaluate the relationship of PNS in HCC patients. MATERIAL AND METHOD: In this study, the data of 534 patients who were followed up with the…

Incidence, survival time, and surgical treatment of parathyroid carcinomas in dogs: 100 cases (2010-2019).

OBJECTIVE: To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of posto … me were recorded. RESULTS: 100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules …

Correlates of parathyroid hormone concentration in hemodialysis patients.

BACKGROUND: The implications of chemical hyperparathyroidism on bone and mineral metabolism measures in maintenance hemodialysis (MHD) are not well known. We hypothesized that a higher serum intact parathyroid hormone (iPTH) level is associated with the higher likelihood of hyperphosphatemia, hyperphosphatasemia [high serum alkaline phosphatase (ALP) levels] and hypercalcemia. METHODS: Over an 8-year period (July 2001-June 2009), we identified 106 760 MHD patients with iPTH and calcium (Ca), phosphorous (P) and ALP data from a large dialysis clinic. Logistic regression models were examined to…

Glucocorticoids possess calcitonin-like antihypercalcemic properties in rats.

The interaction among parathyroid hormone (PTH), calcitonin (CT), and glucocorticoids on blood calcium (Ca) was examined. Prior studies had … doses of rat or bovine PTH 1-34 or calcitriol. Also, administered cortisol restricted the increased hypercalcemia induced by PTH in ADX-TPTX rats. Expanding on the results in TPTX rats with induced hypercalcemia, we found that neither the ADX effect nor the glucocorticoid effect occurred in thyroid-intact rats with or without functional PTT. These as well as pr …

Parathyroid hormone-related protein (PTHrP) and malignancy.

PTHrP (parathyroid hormone related protein) is an important mediator of malignancy-related tumor progression and hypercalcemia that shares considerable homology and functionality with parathyroid hormone. In this chapter, we review what has been elucidated to date regarding PTHrP's role in malignancies. Starting with a review of calcium metabolism and regulation, we then summarize the discovery and structure of PTHrP and development of sensitive immunoassays for specific measurement. Subsequently, we explore its role in tumor progression, with emphasis on the primary tumor as well as skeletal …

A novel case of neonatal severe hyperparathyroidism successfully treated with a type II calcimimetic drug.

We report a boy with hypercalcemia due to neonatal severe hyperparathyroidism (NSHPT) caused by a compound heterozygous mutation in the calcium sensing receptor (CaSR) managed successfully on a type II calcimimetic drug. The hypercalcemia was temporarily treated by hyperhydration, bisphosphonate and calcium depleted milk. At 29 days of age cinacalcet was introduced. The starting dose was 0.5 mg/kg/day and was subsequently titrated to the point of efficacy (5.2 mg/kg/day) when a persuasive reduction in parathyroid hormone and calcium concentrations was observed. We propose a trial of type II ca…

Secondary hyperparathyroidism as a palpable intrathyroid parathyroid gland in a patient with hypophosphatemic osteomalacia.

Secondary hyperparathyroidism is sometimes seen in patients with hypophosphatemic osteomalacia after long-term oral phosphate therapy. Parathyroidectomy is sometimes needed for the correction of hypercalcemia in these patients, and is rarely performed in patients without hypercalcemia. A 46-year-old female patient had hypophosphatemic osteomalacia with unknown cause and secondary hyperparathyroidism. A palpable neck mass developed after long-term oral phosphate therapy. An intrathyroid parathyroid gland was confirmed through partial thyroidectomy and parathyroidectomy. Renal phosphate wasting …

[Clinical and biochemical diagnosis of pHPT and sHPT, surgical indications from the internal medicine viewpoint].

Hypercalcemia and a relative nonsuppressibility of parathyroid hormone by calcium are the biochemical hallmarks of primary hyperparathyroidism. An elevated PTH level should be defined in a highly sensitive and specific test system. Primary HPT is the single major cause of hypercalcemia in outpatients. A definitive medical option to manage PHP does not exist. Surgical neck exploration by an experienced surgeon has a very high success rate for cure in both symptomatic and asymptomatic disease forms. Secondary HPT is mostly due to renal failure. Nonsuppressibility of PTH by use of vitamin D stero…