[Primary hyperparathyroidism and skeletal x-ray--a study on elevated serum calcium discovered by chance].
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Bone Resorption↗
Biomedical subjects
T Christensson
Publications and source records attributed to T Christensson.
Extreme hyponatremia in patients with myelomatosis: an effect of cationic paraproteins.
Three patients with IgG myelomatosis and extreme hyponatremia are described. By isoelectric focusing of the M-component it is demonstrated that the subnormal sodium value is most likely explained by a cationic effect of the myeloma globulin.
Aged↗
Hyperparathyroidism and radiation therapy.
Hypercalcaemic hyperparathyroidism has been diagnosed more commonly in recent years. This reflects an increasing awareness of and a growing interest in the disease. In the search for possible aetiologic mechanisms behind the development of parathyroid adenomata, certain environmental factors have been suggested. This study indicates that a significantly (p less than 0.01) greater number of patients who had parathyroid adenomata had previously undergone radiation therapy involving the neck region compared with normocalcaemic control subjects. The observed and controlled cases originate from a medical screening programme done as part of a health check-up including almost 16 000 persons in the Stockholm area. It is recommended that special attention to a past history of possible neck irradiation be paid in subjects suspected of suffering from hyperparathyroidism.
Adenoma↗
Hypocalcaemia with zonular cataract due to idiopathic hypoparathyroidism. With a note on the prevalence of severe hypocalcaemia in a health screening.
A 59-year-old woman with idiopathic hypoparathyroidism who had tetany and zonular cataract is described. Twelve years ago she had had a period with cramps and convulsions, followed by an absence of symptoms for several years. Judging from the distance between the opacity of cataract and the surface of the lens, the onset of the cataract was estimated to have occurred 11 years ago and the apparent cessation of cataract development 10 years ago. It is suggested that the absence of hypocalcaemic symptoms during the last 10 years was associated with an increase in serum calcium levels, possibly connected with the onset of menopause. The occurrence of hypocalcaemia was analyzed in a health-screened population of 15 903 persons. Nine of the subjects were found to have a serum calcium level of less than 2.10 mmol/l, giving a prevalence of 0.6%0. None had primary hypoparathyroidism, which illustrates the rarity of this condition.
Cataract↗
Serum urate in subjects with hypercalcaemic hyperparathyroidism.
A positive correlation was found between serum urate and elevated serum calcium in patients with hypercalcaemic primary hyperparathyroidism. No such correlation was detected in normocalcaemic controls, matched with respect to age and sex. Neither was such a correlation confirmed either in subjects with normalized serum calcium levels after extirpation of parathyroid adenomata, or in subjects with hypercalcaemia due to other conditions than primary hyperparathyroidism, such as various malignancies, sarcoidosis and hyperthyroidism. The positive correlation between elevated serum calcium and serum urate (within normal limits) in subjects with hypercalcaemic hyperparathyroidism is suggested in subjects with hypercalcaemic hyperparathyroidism is suggested to be a clue to the explanation of an association between hyperparathyroidism and urate retention.
Female↗
Serum lipids before and after parathyroidectomy in patients with primary hyperparathyroidism.
Eight males and 36 females with hypercalcaemia were operated upon for primary hyperparathyroidism and parathyroid adenomata were revealed in every case. The serum levels of cholesterol and triglycerides were determined before the operations and 6,12 and 18 months after them. Furthermore, the serum lipids of the patients were compared with those of a normacalcaemic sex- and age-matched control group. The serum cholesterol concentration in primary hyperparathyroidism was about 8-10% lower in both females and males compared with the correspondeing control cases and the levels of serum trigycerides were about 22% and 60% lower. After operation the serum cholesterol concentration returned to a normal level and the triglycerides nomalized. The results are discussed in the light of present knowledge about dietary calcium intake, primary hyperparathyroidism and lipid metabolism.
Adenoma↗
Hypercalcemia and primary hyperparathyroidism. Prevalence in patients receiving thiazides as detected in a health screen.
Twenty patients being treated with thiazides were found among 95 subjects (21%) with hyercalcemia verified in repeated determinations in a health screening of 15,903 persons. There were 1,034 patients treated with thiazides in this total health screening. The prevalence of hypercalcemia in the patients treated with thiazides in this total health screening. The prevalence of hypercalcemia in the patients treated with thiazide (1.9%) was considerably higher than the prevalence of hypercalcemia found in the entire health-screened population (0.6%). The thiazide treatment was withdrawn in the 20 hypercalcemic subjects after an examination, and the patients were observed at intervals during a follow-up period of one year. The necks of 14 were explored during or after the follow-up period because of an initial serum calcium level greater than 3.0 mmole/liter or persistent hypercalcemia. Parathyroid adenomas were seen in all patients receiving surgery. Single adenomas predominated in surgical findings. The finding of the present high number of patients with primary hyperparathyroidism may be associated with elevated blood pressure resulting in thiazide treatment after detection.
Adenoma↗
Blood pressure in subjects with hypercalcaemia and primary hyperparathyroidism detected in a health screening programme.
Primary hyperparathyroidism was the most likely diagnosis in sixty-eight non-thiazide treated patients with hypercalcaemia detected in a health screening. The group included fifty-five females and thirteen males with a mean +/- SEM age of 55.0 +/- 0.7 years. On a pair basis, these patients were compared with a series of sixty-eight age- and sex-matched normocalcaemic subjects selected from the health screening register. Five subjects in each group were receiving medication for hypertension. Systolic and diastolic blood pressures were significantly higher in the hypercalcaemic subjects in the remaining fifty-eight pairs (P less than 0.001). This difference was unrelated to impaired renal filtration and many other factors associated with hypertension. It is concluded that hypercalcaemia and/or other effects of deranged parathyroid function per se may result in a blood pressure elevation on which need not necessarily attain the level of hypertension.
Adult↗
Cholelithiasis in subjects with hypercalcaemia and primary hyperparathyroidism detected in a health screening.
The frequency of gallstone disease was studied in a group of 82 subjects (69 females and 13 males; mean ages 55-0 and 52-3 years, respectively) with verified hypercalcaemia (VHC) detected in a health screening in the Stockholm area. All non-cholecystectomised subjects were examined with a peroral cholecystography. Causes of hypercalcaemia other than primary hyperparathyroidism (PHPT) had been excluded as far as possible. Sixty-two patients had been operated upon and all but two males were found to have parathyroid adenomas. The patients were compared with a series of 82 normocalcaemic age- and sex-matched subjects, selected from the health screening register. The patients with VHC and/or PHPT had about the same frequency of gallstone disease as the controls. The results are at variance with those of other investigators who have reported that PHPT is associated with an abnormally high frequency of gallstone disease. Possible explanations of the discrepancy in results is discussed.
Cholelithiasis↗
Prevalence of hypercalcaemia in a health screening in Stockholm.
A free health check, offered to 21417 20-63-year-old employees of the Stockholm City and County Council in 1971-73, was accepted by 15903 persons. The examination included a multichannel chemical analysis of a single blood sample. Serum calcium levels greater than or equal to 11.0 mg/100 ml (2.75 mmol/l) and greater than or equal to 11.1 mg/100 ml (2.78 mmol/l) were encountered in 3.9% and 1.1% of the population, respectively. Among subjects below 50 years of age, the calcium concentration was significantly higher in males than in females. This difference disappeared in older subjects, essentially because the calcium level decreased with advancing age in the men. To a further investigation were invited 178 subjects with a single serum calcium registration greater than or equal to 11.1 mg/100 ml (2.78 mmol/l). Of this group, 95 persons (53.4%) exhibited hypercalcaemia (HC) on repeated testing. Twelve had been operated on prior to the actural follow-up and found to have parathyroid adenomata. Twenty subjects were on continuous treatment with diuretics of the thiazide type and seven had diseases that might induce HC (two had hyperthyroidism, two hypothyroidism, one sarcoidosis, one hypernephroma and one mammary carcinoma). In 56 patients the laboratory and physical examinations did not reveal any obvious cause for the HC except possible hyperparathyoidism (HPT). Eighty (84.2%) of the 95 HC subjects were women, mostly over 50 years. The 95 persons constituted 6% of the total number of health-screened persons. The highest prevalence, 13%, was recorded for women aged 60-63. The prevalence of HPT in the total material was 3.6%, which is higher than that found in several other studies. This is based on surgical findings to date.
Adult↗
Clinical and laboratory findings in subjects with hypercalcaemia. A study including cases with primary hyperparathyroidism detected in a health screening.
Primary hyperparathyroidism (PHPT) was the most likely diagnosis in 68 non-thiazide-treated patients with hypercalcaemia detected in a health screening. The group comprised 55 females and 13 males, with a mean age of 55.0 +/- 0.7 (S.E.M.) years. On a pair basis these patients (the observation group) were compared with a series of 68 age- and sex-matched normocalcaemic subjects (the control group) selected from the health screening register. Renal calcui and reduced creatinine clearance were encountered less frequently in the observation group than in many reports of hospitalized patients with PHPT. Compared with the control group, the observation group comprised a greater number of subjects with renal calculi (usually multiple and bilateral), constipation, mental depression and reduced creatinine clearance. The ECG Q-T interval was shorter in the observation group than in the control group. No differences were found with respect to the occurrence of gastritis and/or peptic ulcer, poly-dipsia, polyuria and general muscle weakness. On the basis of this and a previous study it was concluded that at least 3% of the 15903 subjects participating in the health screening suffered from "asymptomatic" hypercalcaemia and most probably from "asymptomatic" PHPT.
Adult↗
Menopausal age of females with hypercalcaemia. A study including cases with primary hyperparathyroidism, detected in a health screening.
The mean age at natural menopause of 7 328 women participating in a health screening conducted by the Stockholm City and County Council was 50.2 years. The corresponding age encountered for a subgroup of 49 women with hypercalcaemia (very probably due to primary hyperparathyroidism) confirmed in repeated determinations was 45.7 +/- 0.4 (mean +/- S.E.M.) and significantly lower than that (50.1 +/- 0.4 years) of a normocalcaemic age-martched control group (p less than 0.001). The health screening was performed about eight years after the women's menopause. The observation and control groups showed a significant difference with regard to the serum calcium level but no difference was found with respect to marital, parital or socio-economic status or disorders that may result in early or late menopause.
Age Factors↗
[Treatment of acute renal failure with peritoneal dialysis].
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Acute Kidney Injury↗