COMBINED PRIMARY AND SECONDARY HYPERPARATHYROIDISM: TWO CASE REPORTS AND A REVIEW
Authors: Emanuel Goldberg, Richard M. Torack
Journal: Annals of Internal Medicine (1960)

Article1 January 1960COMBINED PRIMARY AND SECONDARY HYPERPARATHYROIDISM: TWO CASE REPORTS AND A REVIEWEMANUEL GOLDBERG, M.D., RICHARD M. TORACK, M.D.EMANUEL GOLDBERG, M.D.Search for more papers by this author, RICHARD M. TORACK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-52-1-87 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough the literature on hyperparathyroidism is extensive, there are few case reports of functioning parathyroid adenoma occurring simultaneously with secondary hyperplasia of the parathyroid gland.2, 3, 4, 5, 6Albright and Reifenstein discussed only one such case when they wrote their classic monograph1on metabolic bone disease. Most of the reported cases have not been carefully studied ante mortem, and this is true of the two reported below. Secondary hyperplasia following the removal of a functioning adenoma where there has been irreversible damage to the kidneys has often been reported27, 50, 57, 77, 78, 79and is not hard to...Bibliography1. AlbrightReifenstein FEC: The parathyroid gland and metabolic bone disease, 1948, The Williams and Wilkins Co., Baltimore. Google Scholar2. Kalbfleisch HH: Adenome inkretorischer Drüsen bei Hypoglycämie, Frankfurt. Ztschr. f. Path. 50: 462, 1937, cited in Underdahl, L. O., Woolner, L. B., and Black, B. M.: Multiple endocrine adenomas: report of 8 cases in which the parathyroids, pituitary and pancreatic islets were involved, J. Clin. Endocrinol. 13: 20, 1953. Google Scholar3. DownsScott RSV: Hyperparathyroidism with adenoma causing renal failure and secondary hyperparathyroidism: report of a case, Arch. Int. Med. 67: 658, 1941. CrossrefGoogle Scholar4. SofferCohen LJC: Primary and secondary hyperparathyroidism, Arch. Int. Med. 71: 630, 1943. CrossrefGoogle Scholar5. LeeMcElhinneyGall CMWTEA: Unusual manifestations of parathyroid adenoma, Arch. Surg. 71: 475, 1955. CrossrefGoogle Scholar6. BogdonoffWoodsWhiteEngle MDAHJEFL: Hyperparathyroidism, Am. J. Med. 21: 583, 1956. CrossrefMedlineGoogle Scholar7. Howard JE: Personal communication, December 14, 1956. Google Scholar8. CastlemanMallory BTB: Pathology of parathyroid gland in hyperparathyroidism, Am. J. Path. 11: 1, 1935. MedlineGoogle Scholar9. CastlemanMallory BTB: Parathyroid hyperplasia in chronic renal insufficiency, Am. J. Path. 13: 553, 1937. MedlineGoogle Scholar10. HunterTurnbull DHM: Hyperparathyroidism: generalized osteitis fibrosa with observations upon the bones, the parathyroid tumors and normal parathyroid glands, Brit. J. Surg. 19: 203, 1931. CrossrefGoogle Scholar11. PappenheimerWilens AMSC: Enlargement of parathyroid glands in renal disease, Am. J. Path. 11: 73, 1935. MedlineGoogle Scholar12. ConnorsPappenheimerStoerk WHAMHC: Volume of parathyroid glands in relation to dietary calcium and phosphorus, Proc. Soc. Exper. Biol. and Med. 51: 314, 1942. CrossrefGoogle Scholar13. Anderson WA: Hyperparathyroidism and renal disease, Arch. Path. 27: 753, 1939. Google Scholar14. TalbotSobelMcArthurCrawford NBEHJWJD: Functional endocrinology from birth through adolescence, 1952, Harvard University Press, Cambridge. Google Scholar15. HandleyCohen PDV: Effect of parathyroid extract on renal function, Am. J. Physiol. 169: 188, 1952. CrossrefMedlineGoogle Scholar16. DaviesGordon BMAH: Hormonal nature of extracts of parathyroid gland stimulating phosphate excretion, Nature, London 171: 1122, 1953. CrossrefMedlineGoogle Scholar17. CrawfordLaZerte RLGD: Chronic renal disease with secondary hyperparathyroidism, Arch. Int. Med. 96: 818, 1955. CrossrefGoogle Scholar18. CrawfordOsborneTalbotTerryMorrill JDMMNBMCMF: The parathyroid glands and phosphorus homeostasis, J. Clin. Investigation 29: 1448, 1950. CrossrefMedlineGoogle Scholar19. DrakeAlbrightCastleman TGFB: Parathyroid hyperplasia in rabbits produced by parenteral phosphate administration, J. Clin. Investigation 16: 203, 1937. CrossrefMedlineGoogle Scholar20. HighmanHamilton WJB: Hyperparathyroidism in kidney disease, J. Clin. Investigation 16: 103, 1937. CrossrefMedlineGoogle Scholar21. HamiltonHighman BWJ: A test for abnormally large amounts of parathyroid hormone in the blood, J. Clin. Investigation 15: 99, 1936. CrossrefMedlineGoogle Scholar22. HighmanHamilton WTB: Hyperparathyroidism secondary to experimental renal insufficiency, Arch. Path. 26: 1029, 1938. Google Scholar23. Howard JE: Present knowledge of parathyroid function, with especial emphasis upon its limitations, in Ciba Foundation Symposium, Bone structure and metabolism, 1956, Little, Brown and Co., Boston, pp. 200-221. CrossrefGoogle Scholar24. HowardHopkinsConnor JETRTB: On certain physiologic responses to intravenous injection of calcium salts into normal, hyperparathyroid and hypoparathyroid persons, J. Clin. Endocrinol. 13: 1, 1953. CrossrefMedlineGoogle Scholar25. PattLuckhardt HMAB: Relationship of a low blood calcium to parathyroid secretion, Endocrinology 31: 384, 1942. CrossrefGoogle Scholar26. Snapper I: Parathyroid hormone and mineral metabolism, in Hormones in health and disease, edited by R. L. Craig, 1954, The Macmillan Company, New York, pp. 252-265. Google Scholar27. Johnson JW: Primary hyperparathyroidism with extensive renal calcification and secondary hyperplasia of the parathyroids: report of a case, Am. J. Path. 15: 111, 1939. MedlineGoogle Scholar28. Gall EA: Personal communication, January 24, 1957. Google Scholar29. MoldoverGechmanFriedmanSnapper AEDI: Hyperparathyroidism caused by four parathyroid adenomas in two patients with congenital renal disease, Metabolism 7: 681, 1958. MedlineGoogle Scholar30. McLeanHastings FAB: Clinical estimation and significance of the calcium ion concentration in the blood, Am. J. M. Sc. 189: 601, 1935. CrossrefGoogle Scholar31. McLeanHastings FAB: The state of calcium in the fluids of the body. The conditions affecting the ionization of calcium, J. Biol. Chem. 108: 285, 1935. CrossrefGoogle Scholar32. Black BM: Hyperparathyroidism, 1953, Charles C Thomas, Springfield, Illinois. Google Scholar33. Albright F: Common sense in endocrinology, in Hormones in health and disease, edited by R. L. Craig, 1954, The Macmillan Co., New York. Google Scholar34. RossWood WFTR: The partial purification and some observations on the nature of the parathyroid hormone, J. Biol. Chem. 146: 49, 1942. CrossrefGoogle Scholar35. L'HeureuxTeppermanWilhelm MVHMHE: A new preparation of the parathyroid hormone, J. Biol. Chem. 168: 167, 1954. CrossrefGoogle Scholar36. RobinsonThompson MHJH: An anti-growth principle derived from the parathyroid gland, J. Physiol. 76: 303, 1932. CrossrefMedlineGoogle Scholar37. BakerSison RF: Demonstration of altered tissue mucopolysaccharide in renal calculus disease by selective staining techniques, J. Urol. 72: 1032, 1954. CrossrefMedlineGoogle Scholar38. HauseLittnerDrakeRobertsonTisdall HWNTGECFF: Physiological hypertrophy of the parathyroids, its cause and its relation to rickets, Am. J. Path. 16: 277, 1940. MedlineGoogle Scholar39. FreemanChang STS: Effect of thyroparathyroidectomy and vitamin D upon serum calcium and citric acid in normal and nephrectomized dogs, Am. J. Physiol. 160: 341, 1950. CrossrefMedlineGoogle Scholar40. FreemanElliott SJR: The effect of fluoroacetate upon the plasma citrate response to parathyroidectomy and nephrectomy, Endocrinology 59: 190, 1956. CrossrefMedlineGoogle Scholar41. StewartBrown GSHF: The urinary phosphate excretion factor of parathyroid gland extracts: a hormone or an artifact?, Endocrinology 51: 80, 1952. CrossrefMedlineGoogle Scholar42. Klemperer P: Parathyroid hyperplasia and bone destruction in generalized carcinomatosis, Surg., Gynec. and Obst. 36: 11, 1923. Google Scholar43. ElliotSmith JRF: Parathyroid function and the plasma citric acid and calcium response, Endocrinology 59: 181, 1956. CrossrefMedlineGoogle Scholar44. ElliotSmith JBF: Relative effect of vitamin D and parathyroid extract on plasma calcium and citric acid of normal and thyroparathyroidectomized dogs, Endocrinology 59: 196, 1956. CrossrefMedlineGoogle Scholar45. Engle MB: Mobilization of mucoprotein by parathyroid extract, Arch. Path. 53: 339, 1952. Google Scholar46. ShetlarHowardJoelCourtrightReifenstein MARPWCLEC: The effects of parathyroid hormone on serum glycoprotein and seromucoid levels on the kidney of the rat, Endocrinology 59: 532, 1956. CrossrefMedlineGoogle Scholar47. Munson PC: Studies on the role of the parathyroids in calcium and phosphorus metabolism, Ann. New York Acad. Sc. 60: 776, 1955. CrossrefMedlineGoogle Scholar48. MerrittBauer HHW: The equilibrium between cerebrospinal fluid and blood plasma. IV. The calcium content of serum, cerebrospinal fluid and aqueous humor at different levels of parathyroid activity, J. Biol. Chem. 90: 233, 1931. CrossrefGoogle Scholar49. GregoryAndeesch RLN: The filterable calcium of the blood serum and total calcium of cerebrospinal fluid in normal, hyperparathyroid and hypoparathyroid states, Am. J. M. Sc. 191: 263, 1936. CrossrefGoogle Scholar50. Heller EP: Hyperparathyroidism. Summary of important findings in a ten year study of a case, J. Missouri M. A. 45: 26, 1948. Google Scholar51. NordinFraser BER: The effect of intravenous calcium on phosphate excretion, Clin. Sc. 13: 477, 1954. MedlineGoogle Scholar52. NordinFraser BER: The indirect assessment of parathyroid function, in Bone structure and metabolism, edited by G. E. W. Wolstenholme and C. M. O'Connor, 1956, Little, Brown and Company, Boston, pp. 222-238. CrossrefGoogle Scholar53. ElsomWoodRavdin KAFCIS: Hyperparathyroidism with renal insufficiency, Am. J. M. Sc. 191: 49, 1936. CrossrefGoogle Scholar54. Bergstrand H: Parathyroideastudien, Acta med. scandinav. 54: 539, 1921. CrossrefGoogle Scholar55. MacCallum WG: Tumor of the parathyroid gland, Bull. Johns Hopkins Hosp. 16: 87, 1905. Google Scholar56. FritzBrines GEOA: The cell type of secondary parathyroid hyperplasia, Am. J. Path. 27: 265, 1951. MedlineGoogle Scholar57. SimpsonWilson SCRR: Hyperparathyroidism with renal calcinosis, Brit. M. J. 2: 1283, 1955. CrossrefMedlineGoogle Scholar58. Eisler AB: Functional hyperplasia of the parathyroids, Brit. J. Exper. Path. 19: 342, 1938. Google Scholar59. RobertsMurphyMillerRosenthal BJJLO: The effects of parathyroid hormone upon serum levels and urinary excretion of magnesium, Surg. Forum, Vol. V, 1954 (1955), W. B. Saunders Company, Philadelphia, p. 509. Google Scholar60. RogersKeating HMFR: Primary hypertrophy and hyperplasia of the parathyroid glands as a cause of hyperparathyroidism, Am. J. Med. 3: 384, 1947. CrossrefMedlineGoogle Scholar61. Nordin BE: Primary and secondary hyperparathyroidism, in Advances in internal medicine, edited by W. Dock and I. Snapper, Vol. IX, 1958, Year Book Publishers, Inc., Chicago, pp. 81-101. Google Scholar62. PierceGuilgMerrill JMWRJP: Citrate metabolism in uremia, J. Appl. Physiol. 11: 231, 1957. CrossrefMedlineGoogle Scholar63. Stanbury SW: Azotemic renal osteodystrophy, Brit. M. Bull. 13: 57, 1957. CrossrefMedlineGoogle Scholar64. HamLittnerDrakeRobertsonTisdall AWNTGECFF: Physiological hypertrophy of the parathyroids, its cause and its relation to rickets, Am. J. Path. 16: 277, 1940. MedlineGoogle Scholar65. CarnesPappenheimerStoerck WHAMHC: Volume of parathyroid glands in relation to dietary calcium and phosphorus, Proc. Soc. Exper. Biol. and Med. 51: 314, 1942. CrossrefGoogle Scholar66. GoldmanBassett RSH: Phosphorus excretion in renal failure, J. Clin. Investigation 33: 1623, 1954. CrossrefMedlineGoogle Scholar67. YendtConnorHoward ERTBJE: In vitro calcification of rachitic rat cartilage in normal and pathological human sera with some observations on pathogenesis of renal rickets, Bull. Johns Hopkins Hosp. 96: 1, 1955. MedlineGoogle Scholar68. HellstromBirkeEdvall JGCA: Hypertension in hyperparathyroidism, Brit. J. Urol. 30: 13, 1958. CrossrefMedlineGoogle Scholar69. Whitby CG: Intermittent hyperparathyroidism, Lancet 1: 883, 1958. CrossrefMedlineGoogle Scholar70. FreemanChang STS: Role of the kidney and of citric acid in the production of a transient hypercalcemia following nephrectomy, Am. J. Physiol. 160: 335, 1950. CrossrefGoogle Scholar71. HerndonFreeman RFS: Renal citrate utilization in the dog, Am. J. Physiol. 192: 369, 1958. CrossrefMedlineGoogle Scholar72. Newman WF: The mechanism of parathyroid function, Journal Lancet 78: 190, 1958. Google Scholar73. FanconiRose AGA: The ionized, complexed, and protein bound fractions of calcium in plasma, Quart. J. Med. 27: 463, 1958. MedlineGoogle Scholar74. Rose GA: Determination of the ionized and ultrafilterable calcium of normal human plasma, Clin. Chim. Acta 2: 227, 1957. CrossrefMedlineGoogle Scholar75. ManuntaSaroffTurner GJCW: Paper electrophoretic study of Ca45 binding in sera of normal and parathyroidectomized rats, Proc. Soc. Exper. Biol. and Med. 94: 790-791 (Apr.) 1957. CrossrefMedlineGoogle Scholar76. Snapper I: Bone diseases in medical practice, 1957, Grune and Stratton, New York, pp. 90-93. Google Scholar77. LoberHertzogRice PHJCO: Parathyroid adenoma with uremia due to calcification of the kidneys, Arch. Path. 41: 661, 1946. Google Scholar78. HagvedtMathisen JW: Hyperparathyroidism, an operated case subsequently autopsied, Acta med. scandinav. 128: 103, 1947. MedlineGoogle Scholar79. GjerløwMarvik JA: Primaer og Sekundaer Hyperparathyroidisme, Nord. med. 56: 1565, 1956. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication April 17, 1959.From the Departments of Pathology and Medicine, Montefiore Hospital, Bronx, N. Y.Requests for reprints should be addressed to Emanuel Goldberg, M.D., Department of Medicine, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn 3, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPathologic study of parathyroid glands in tertiary hyperparathyroidismCase 13-1974Secondary hypercalcemic hyperparathyroidismTertiary hyperparathyroidism occurring during a renal transplantation programme: Report and discussion of three casesRenal bedingte Störungen des Calcium- und Phosphatstoffwechsels. Renale Osteopathien23. Chirurgie der EpithelkörperchenAutonomous Secondary (Renal) Parathyroid HyperplasiaCase 29-1963Biochemical Aspects of Parathyroid Function and of Hyperparathyroidism 1 January 1960Volume 52, Issue 1Page: 87-101KeywordsAdenomasCalciumComaHospital medicineHyperparathyroidismKidneysMetabolic disordersParathyroidParathyroid tumorsPyelonephritis ePublished: 1 December 2008 Issue Published: 1 January 1960 PDF downloadLoading ...