Non-autonomy of parathyroid hormone secretion in acute primary hyperparathyroidism.

Journal Article (Journal Article)

A patient with acute primary hyperparathyroidism treated with mithramycin preoperatively, underwent neck exploration and two enlarged parathyroid glands were excised: one huge adenoma (6g) and another smaller gland. Mithramycin was administered preoperatively to lower life-threatening hypercalcaemia, and parathyroid slices from the huge adenoma removed at surgery were submitted in vitro to various calcium concentrations in the media to determine the influence of calcium on parathyroid adenoma secretory pattern in acute primary hyperparathyroidism. Mithramycin induced a significant decline in calcium levels and significant elevations of calciotrophic hormones (intact PTH, mid-region specific PTH, calcitonin and calcitriol). Significant suppression in PTH output in vitro was achieved by increasing calcium levels in the media. These results exclude autonomous PTH secretion (non-calcium dependent) as a possible aetiology of acute primary hyperparathyroidism. We suggest that a sudden increase in the set-point of the diseased parathyroid cells in the presence of a huge cell mass accounts, in large part, for both the marked hypercalcaemia and elevated PTH levels in this patient.

Full Text

Duke Authors

Cited Authors

  • Schachter, PP; Christy, MD; Avigad, IS; Shabtay, M; Leight, GS

Published Date

  • December 1992

Published In

Volume / Issue

  • 37 / 6

Start / End Page

  • 565 - 569

PubMed ID

  • 1286527

International Standard Serial Number (ISSN)

  • 0300-0664

Digital Object Identifier (DOI)

  • 10.1111/j.1365-2265.1992.tb01489.x


  • eng

Conference Location

  • England