A complex homeostatic system involving the interplay of thebones, the kidneys, and the intestines has evolved to maintainextracellular calcium concentrations within a relatively narrowrange.1 The primary regulator of this system is parathyroidhormone, the release of which is initiated by signals from thecalcium-sensing receptor. Overproduction of parathyroid hormonegives rise to hypercalcemia by stimulating the efflux of calciumfrom bone, increasing the reabsorption of urinary calcium, andpromoting the uptake of dietary calcium by means of the activationof vitamin D.1 Parathyroid hormonedependent hypercalcemiais commonly caused by parathyroid adenomas and hyperplasia.2Rarer causes of parathyroid . . . [Full Text of this Article]
Case Report
Methods
Results
Response of Hyperparathyroidism to Glucocorticoid Therapy
Parathyroid Hormone Levels after Subtotal Parathyroidectomy
Autoantibodies to the Calcium-Sensing Receptor
Treatment
Discussion
Source Information
From the Departments of Endocrinology (J.C.P., D.S.) and Medicine (J.C.P., Y.-B.C.), Massachusetts General Hospital; and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School (O.K., E.M.B.) all in Boston.
Address reprint requests to Dr. Pallais at the Department of Medicine, Massachusetts General Hospital, 55 Fruit St., GRB 740, Boston, MA 02114, or at jpallais@partners.org.
Makita, N., Sato, J., Manaka, K., Shoji, Y., Oishi, A., Hashimoto, M., Fujita, T., Iiri, T.
(2007). An acquired hypocalciuric hypercalcemia autoantibody induces allosteric transition among active human Ca-sensing receptor conformations. Proc. Natl. Acad. Sci. USA
104: 5443-5448
[Abstract][Full Text]
Marx, S. J., Simonds, W. F.
(2005). Hereditary Hormone Excess: Genes, Molecular Pathways, and Syndromes. Endocr. Rev.
26: 615-661
[Abstract][Full Text]
Rickels, M. R., Mandel, S. J., Shakibai, N., Pallais, J. C., Brown, E. M.
(2004). Hypocalciuric Hypercalcemia and Autoantibodies against the Calcium-Sensing Receptor. NEJM
351: 2237-2238
[Full Text]
Seeman, E., Strewler, G. J.
(2004). Clinical and Basic Research Papers - July 2004 Selections. IBMS BoneKEy
1: 1-5
[Full Text]