| Incidence, structure, and function of enlarged parathyroid glands discovered accidentally during thyroid surgery. | |
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MedLine Citation:
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PMID: 8506524 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Operation on rare patients with mainly a severe renal stone disease and considerably elevated urinary calcium excretion has substantiated the association of parathyroid gland abnormalities with normocalcemia. This study examines incidence, structure, and functional characteristics of enlarged parathyroid glands of patients with normocalcemia scheduled for thyroid surgery. METHODS: Eleven enlarged parathyroid glands weighing 110 to 1000 mg were discovered in 9 (1.5%) of 594 patients with normocalcemia undergoing thyroid operation. The preoperative total serum calcium concentration was 2.30 to 2.52 mmol/L and less than 2.38 mmol/L in four of the nine patients. Intact serum parathyroid hormone and alkaline phosphatase levels were elevated in only one individual, and all patients showed normal serum creatinine values. RESULTS: All but three of the 11 enlarged parathyroid glands exhibited microscopic abnormality on routine histopathologic examination, including staining for cytoplasmic fat with oil red 0. Immunohistochemical staining with a monoclonal antibody recognizing the functionally important calcium receptor of the parathyroid cell surface and analysis of the calcium-regulated cytoplasmic Ca2+ concentration of dispersed parathyroid cells substantiated that only a single gland of 130 mg had no discernible functional abnormality. CONCLUSIONS: The findings underline the diagnostic difficulties of parathyroid histopathology and support the presence of disturbed parathyroid hormone secretion even in normocalcemic patients with enlarged parathyroid glands. The functional derangement of these glands substantiates the indication for their surgical excision even in patients exhibiting midnormal serum calcium concentrations, although their possible contribution to the development of a clinically overt hyperparathyroidism can only be speculated. |
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Authors:
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P Hellman; U Ohrvall; C Rudberg; G Bjerneroth; C Juhlin; L Grimelius; P Ridefelt; G Akerstr?m; J Rastad |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Surgery Volume: 113 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1993 Jun |
Date Detail:
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Created Date: 1993-07-08 Completed Date: 1993-07-08 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 655-61 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University Hospital, Uppsala, Sweden. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Calcium / blood, metabolism Cytoplasm / metabolism Female Humans Hyperparathyroidism / etiology Hypertrophy Male Middle Aged Parathyroid Glands / pathology* Parathyroid Hormone / secretion Thyroid Gland / surgery |
| Chemical | |
Reg. No./Substance:
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0/Parathyroid Hormone; 7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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