Edward W. Moore

Hyperparathyroidism due to clear cell hyperplasia: Serial determinations of serum ionized calcium, parathyroid hormone and calcitonin

Abstract Serial determinations of serum ionized calcium (Ca ++ ), serum total calcium (Ca), parathyroid hormone (PTH) and calcitonin levels were made in a patient with hyperparathyroidism due to clear cell hyperplasia. Although serum Ca declined to normal levels prior to parathyroidectomy, serum Ca ++ and PTH levels remained elevated until after operation. This suggests that the calcium ion electrode may prove valuable in the diagnosis and management of patients with hyperparathyroidism, especially when they are normocalcemic. The excised parathyroid glands yielded very low PTH concentrations upon extraction, implying that in this form of hyperparathyroidism PTH secretion is excessive whereas storage is markedly reduced. CT levels were normal in both serum and excised glands. This finding is of interest in relation to the patients associated generalized neurofibromatosis and serves further to distinguish the present syndrome from that characterized by mucosal neuromas, hyperparathyroidism and medullary carcinoma of the thyroid.

ON THE RENAL SITE AND MODE OF ACTION OF GLUCOCORTICOID IN CIRRHOSIS.

in cirrhotics, patients with cirrhosis on a low-salt diet were studied. The data indicate that these agents given acutely cause increased reabsorption of sodium in the ascending loop of Henle, a segment of the tubule that is relatively impermeable to water, and thus increase the capacity of the kidney of these patients to conserve free water.