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Effect of protein and phosphate restricted and calcium and alphacalcidol supplemented diet on renal and parathyroid functions and protein status in chronic renal failure patients.

OBJECTIVE: To assess the effect of low protein (0.6 g/kg/day), low phosphate (5-10 mg/kg/day) diet with calcium (600 mg/day) and alpha-D3 (0 … ) improved from a basal value of 29.35 +/- 18.2 ml/min to 39.25 +/- 27 ml/min after 6 months. Serum parathyroid hormone (PTH) level of 197.65 +/- 133.7 pg/ml and post treatment level of 254.55 +/- 217.19 after 6 months were not different (p > 0.05). Serum calcium remained stationary with a slight increase in serum phosphorus. Phosphorus had a negative correlation wit …

Clinical profile and outcome of primary hyperparathyroidism accompanied by chronic renal failure.

We encountered 5 cases of primary hyperparathyroidism (PHPT) accompanied by chronic renal failure over the past 4 years. Neither hypocalcemia nor hyperphosphatemia was found in the past records. The parathyroid hormone (PTH) levels in these cases were extraordinarily higher than those in usual patients suffering from renal failure. The manifestation of PHPT-developed insidiously together with the decline of renal function. Serum 1,25(OH)2D3 levels were lower than normal range in all cases, and which in turn might accelerate the progression of PHPT in a similar way as the development of seconda…

Induction of hyperparathyroidism by radioactive iodine.

External irradiation to the head and neck has been associated with the emergence of hyperparathyroidism, due both to adenoma and hyperplasia since a single case report was published in 1975. A recent report indicates that there may be some association between hyperparathyroidism and radioiodine administered for thyroid disease. Eight patients are presented herein, all female and in middle age, who presented with hyperparathyroidism due to adenoma (six patients) or hyperplasia (one patient who had undergone radioiodine treatment). In three patients, the dose of radioiodine exceeded 30 mCi. The

Parathyroid function in different stages of vitamin D deficiency rickets.

Direct measurements of parathyroid activity are available in only small numbers of children with vitamin D deficiency rickets (VDR). Therefore serum immunoreactive parathyroid hormone (iPTH) and the urinary cyclic adenosine-3',5'-monophosphate excretion (UcAMP) were measured together with other important indices of calcium metabolism in 24 patients (aged 2-42 months) with VDR before vitamin D treatment. iPTH and UcAMP were significantly elevated in comparison to age-matched controls. In patients there was a highly significant positive correlation between iPTH and UcAMP and a negative relations…

[Diagnostic steps and management of a rare cause of hypercalcemia].

Background: Distinguishing familial hypocalciuric hypercalcemia (FHH) a rare cause of usually mild, parathyroid hormone-dependent hypercalcemia from other causes is central for management due to its benign and usually mild course. Case: Diagnostic approach to a mild hypercalcemia in a 36-years-old female with FHH. Conclusion: This case highlights the importance of a precise and stepwise diagnostic approach to identify rare causes of hypercalcemia like FHH, an autosomal-dominant inherited, pathogenic variant of the calcium sensing receptor.

Brown Tumors Mimicking Skeletal Metastases: A Diagnostic Pitfall in Primary Hyperparathyroidism.

Brown tumors are rare but important manifestations of primary hyperparathyroidism (PHPT). These benign, fibrotic, and erosive bony lesions result from localized rapid osteoclastic activity driven by excessive parathyroid hormone levels. Although brown tumors are considered one of the most pathognomonic signs of PHPT, they are infrequently encountered in clinical practice. They closely mimic malignant osteolytic processes, posing a diagnostic challenge, especially in cases of undiagnosed hyperparathyroidism. Radiographic findings often resemble those of metastatic bone disease or primary bone m…

Vitamin D and the Kidney: Two Players, One Console.

Vitamin D belongs to the group of liposoluble steroids mainly involved in bone metabolism by modulating calcium and phosphorus absorption or reabsorption at various levels, as well as parathyroid hormone production. Recent evidence has shown the extra-bone effects of vitamin D, including glucose homeostasis, cardiovascular protection, and anti-inflammatory and antiproliferative effects. This narrative review provides an overall view of vitamin D's role in different settings, with a special focus on chronic kidney disease and kidney transplant.

Report of two novel mutations in PTHLH associated with brachydactyly type E and literature review.

Autosomal-dominant brachydactyly type E is a congenital limb malformation characterized by small hands and feet as a result of shortened metacarpals and metatarsals. Alterations that predict haploinsufficiency of PTHLH, the gene coding for parathyroid hormone related protein (PTHrP), have been identified as a cause of this disorder in seven families. Here, we report three patients affected with brachydactyly type E, caused by PTHLH mutations expected to result in haploinsufficiency, and discuss our data compared to published reports.

Hypocalcemia in a paediatric case: from the clinical features to diagnosis.

Pseudohypoparathyroidism refers to end-organ resistance that primarily impairs the renal actions of parathyroid hormone (PTH), a key regulator of calcium homeostasis. Its diagnosis is complex because of the multiple variants of this entity, and more so because intravenous PTH is not available for the Ellsworth-Howard test. We report a symptomatic paediatric case of hypocalcaemia, the clinical features of which, and the course after treatment, suggest that it is most probably a case of pseudohypoparathyroidism type Ib.

Primary hypomagnesemia caused by isolated magnesium malabsorption: atypical case in adult.

Isolated magnesium malabsorption is a rare disorder, which bas been described in no more than 30 patients worldwide. Patients with this disorder typically present with convulsion and diarrhea in early infancy. Hypomagnesemia and hypocalcemia were found in a 35-year-old man with muscle cramps, who bad been diagnosed as primary hypoparathyroidism. Oral magnesium therapy corrected the low serum calcium, magnesium and parathyroid hormone levels. We report an atypical case of isolated magnesium malabsorption in an adult.

Pseudohypoparathyroidism, parkinsonism syndrome, with no basal ganglia calcification.

A 20 year old woman with pseudohypoparathyroidism, Parkinsonism and no basal ganglia calcifications shown by computed tomography is reported. She has typical features of pseudohypoparathyroidism and biochemical evidence of end-organ resistance to parathyroid hormone. She is mentally retarded and has tremor, rigidity, bradykinesia, and stooped posture. The cause of Parkinsonism in pseudohypoparathyroidism is thought to be basal ganglia calcification. This patient must have another pathophysiology, perhaps directly related to a G protein defect, causing impaired neurotransmission.

Bone density and cortical thickness in nutritional vitamin D deficiency: effect of secondary hyperparathyroidism.

Measurements of bone mineral index, mean metacarpal cortical thickness, plasma calcium, alkaline phosphatase and serum 25-hydroxyvitamin D and parathyroid hormone concentrations were carried out in 39 Asian vegetarian patients with hypovitaminosis D. It was concluded that PTH is probably the major determinant of osteopenia in patients with osteomalacia and secondary hyperparathyroidism; and that the presence of secondary hyperparathyroidism in association with hypovitaminosis D should be an absolute indication for vitamin D supplementation even in asymptomatic patients.

The effect of hyperparathyroidism on the course of rheumatoid arthritis.

Rheumatoid arthritis and primary hyperparathyroidism have been diagnosed in three patients. This is likely to represent the coincidence of two common diseases but the clinical features are discussed with particular reference to the presence and withdrawal of raised levels of circulating parathyroid hormone (PTH). It is argued that raised levels of PTH potentiate the effects of the rheumatoid disease on bone and joints. Other musculoskeletal features of hyperparathyroidism and the actions of PTH on bone are reviewed.

Prediction of radiographic severity of renal osteodystrophy by serum values.

Renal osteodystrophy, a frequent complication of chronic renal failure, is usually assessed by periodic X-rays of bone which are both poorly reproducible and expensive. Seeking a better screening test for osteodystrophy, we evaluated the usefulness of serum alkaline phosphatase as a predictor of bone disease and of hyperparathyroidism. Alkaline phosphatase, despite nonspecificity, correlates with the severity of osteodystrophy and with the increase in serum parathyroid hormone concentration. Serial measurements of alkaline phosphatase can predict changes in these parameters.

Central Precocious Puberty in a Boy with Pseudohypoparathyroidism Type 1A due to a Novel GNAS Variant, with Congenital Hypothyroidism as the First Manifestation.

Pseudohypoparathyroidism (PHP) type 1A (PHP1A) is a disorder of multiple hormone resistance, mainly parathyroid hormone. It is associated with Albright hereditary osteodystrophy phenotypes. Patients with PHP1A may initially present with hypothyroidism during infancy and later develop typical PHP1A characteristics during their childhood. Central precocious puberty (CPP) is extremely rare among PHP1A patients in whom gonadotropin resistance is more usual. This is a case report of a 9.5-year-old boy with congenital hypothyroidism who developed hypocalcemia secondary to PHP. He had relatively shor…

Gene structure, transcripts and calciotropic effects of the PTH family of peptides in Xenopus and chicken.

BACKGROUND: Parathyroid hormone (PTH) and PTH-related peptide (PTHrP) belong to a family of endocrine factors that share a highly conserved N-terminal region (amino acids 1-34) and play key roles in calcium homeostasis, bone formation and skeletal development. Recently, PTH-like peptide (PTH-L) was identified in teleost fish raising questions about the evolution of these proteins. Although PTH and PTHrP have been intensively studied in mammals their function in other vertebrates is poorly documented. Amphibians and birds occupy unique phylogenetic positions, the former at the transition of aqu…

Эффективность вибрации всего тела на гормональной реакции у людей с гормональными расстройствами: систематический обзор и метаанализ.

Цель. Цель этого систематического обзора заключается в изучении нынешней литературы о воздействии вибрации всего тела на гормональный уровень у людей с гормональными расстройствами. Методы. Систематический поиск проводился в шести электронных базах данных с целью получения результатов исследований воздействия вибрации всего тела на гормональный уровень у лиц с гормональными расстройствами. Полученные исследования оценивались на основе заранее установленных критериев отбора в два этапа: название и абстрактная фильтрация и полнотекстовая фильтрация. Качество проведенных исследований оценивалось

Совпадение в аннотации оригинала
Objective. This systematic review aims to examine the current literature on the effects of whole-body vibration on hormonal levels in indivi … d no effect for whole-body vibration on insulin, gonadal hormones, ghrelin and leptin, adiponectin, parathyroid hormone, and insulin-like growth factor 1 in women with fibromyalgia. Conclusion. The whole-body vibration training may have an action in endocrine system as observed by the alteration of plasma concentration of thyroid hormones, prolactin, cortisol and iri …

Endocrine regulation of calcium and phosphate in rat eye lens and its significance in cataract formation.

Parathyroid hormone (PTH), calcitonin (CT)and calciferol (Vit. D3) operate synchronously to maintain a balance between calcium and phosphate levels in serum. An aberration of specific steps in the homeostatic process results in hypo/hyper phosphatemia. These aberrations may eventually lead to several diseased states. PTH and Vit. D3 induced hypercalcemia can, however, be significantly inhibited by calcitonin (CT). These findings have been correlated with the levels of calcium and phosphate obtained from human senile cataractous lenses of cortical and nuclear types. The comparison of the result…

[Clinical aspects of metabolic nephropathies, interstitial nephritis and urolithiasis in calciphylaxis].

The problem of abacterial nephropathies associated with impaired calcium metabolism is discussed from the standpoint of membranous pathology. The data are presented on the similarity of the calciphylaxis pathogenesis described for the first time by H. Selye to calcium nephrolithiasis. The disease is viewed as the result of pronounced modification of the phospholipid layer of cell membranes under the influence of peroxidation, phospholipase activity and other processes induced by calcium-regulating hormones (parathyroid hormone, D3 and calcitonin). It is assumed that the clinical manifestations…

[Osteosis deformans of thyroid origin. Radiological, histomorphometric and pathophysiological study (author's transl)].

A 73-year-old woman with severe, old standing thyrotoxicosis developed osteosis with deformities of the lower limbs and spine resembling osteomalacia. All the well-known radiological, and histomorphometric features of thyroid osteosis were caricaturally present in this patient who, in addition, exhibited curvatures of the lower limbs that are exceptionally described in hyperthyroidism. A study of standard phosphorus/calcium values, 25 OH D values, circulating parathyroid hormone levels and fractional absorption of 47Ca before and after thyroidectomy enables the authors to discuss the current p…