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Growth hormone secretion in primary and secondary hyperparathyroidism.
[familial hypocalciuric hypercalcemia]
Primary
hyperparathyroidism
(
PHP
)
is
associated
with
impaired
GH
secretion
.
Whether
this
effect
is
due
to
hypercalcemia
or
to
increased
serum
PTH
concentration
is
unclear
.
However
,
patients
with
familial
hypocalciuric
hypercalcemia
(
FHH
)
,
who
have
normal
PTH
and
increased
serum
calcium
concentrations
,
also
have
an
impaired
GH
secretion
,
suggesting
that
calcium
rather
than
PTH
is
responsable
for
this
effect
on
GH
secretion
.
To
further
investigate
this
issue
,
10
consecutive
patients
with
secondary
hyperparathyroidism
(
SHP
)
due
to
vitamin
D
deficiency
were
evaluated
by
the
GH
response
to
GHRH
+
arginine
(
Arg
)
test
.
A
group
of
60
consecutive
untreated
PHP
patients
served
as
controls
.
Mean
GH
response
to
GHRH
+
Arg
test
was
15
.
8
+
/
-
14
microg
/
l
and
37
.
5
+
/
-
16
microg
/
l
(
p
<
0
.
001
)
in
PHP
and
in
SHP
patients
,
respectively
.
Forty
-
two
out
of
60
(
70
%
)
PHP
patients
had
a
suppressed
or
blunted
GH
response
,
whereas
all
SHP
patients
had
normal
GH
response
.
The
results
of
the
present
study
confirm
and
extend
our
previous
observations
that
PHP
is
associated
with
an
impaired
GH
secretion
in
the
majority
of
cases
,
and
indicate
that
SHP
patients
have
no
abnormality
of
GH
secretion
.
Thus
,
hypercalcemia
rather
than
increased
serum
PTH
is
responsible
for
the
abnormality
of
GH
secretion
.
Diseases
Validation
Diseases presenting
"primary hyperparathyroidism"
symptom
cystinuria
familial hypocalciuric hypercalcemia
primary hyperoxaluria type 1
This symptom has already been validated