pyrophosphate and Hyperparathyroidism

Topics: Calcium Pyrophosphate; Chondrocalcinosis; Crystallization; Diphosphates; Humans; Hyperparathyroidism; Hypothyroidism; Radiography

Topics: Acidosis, Renal Tubular; Bacterial Infections; Citrates; Crystallization; Cystinuria; Diphosphates; Female; Gastrointestinal Diseases; Humans; Hypercalcemia; Hyperparathyroidism; Magnesium; Male; Metabolism, Inborn Errors; Mucoproteins; Oxalates; Quaternary Ammonium Compounds; Sarcoidosis; Solubility; Uric Acid; Urinary Calculi; Vitamin D; Xanthine Oxidase

Topics: Androgens; Bone Diseases; Diphosphates; Estrogens; Fluorides; Heparin; Humans; Hyperparathyroidism; Metabolic Diseases; Organophosphonates; Osteitis Deformans; Osteomalacia; Osteoporosis; Parathyroid Hormone; Phosphates; Plicamycin

Topics: Bone and Bones; Bone Development; Bone Diseases; Calcitonin; Calcium Metabolism Disorders; Child, Preschool; Densitometry; Diphosphates; Homeostasis; Humans; Hyperparathyroidism; Hypophosphatasia; Hypophosphatemia, Familial; Infant; Metabolism, Inborn Errors; Microradiography; Osteogenesis Imperfecta; Osteoporosis; Parathyroid Glands; Parathyroid Hormone; Phosphorus Metabolism Disorders; Pseudohypoparathyroidism; Rickets; Vitamin D

Topics: Adrenal Cortex Hormones; Aged; Aging; Bone and Bones; Bone Diseases; Bone Resorption; Calcium; Diphosphates; Female; Humans; Hyperparathyroidism; Hypoparathyroidism; Menopause; Metabolic Diseases; Osteogenesis; Osteomalacia; Osteoporosis; Space Flight

Topics: Absorption; Acidosis, Renal Tubular; Alkalies; Aluminum; Biopsy; Bone Diseases; Calcium; Diphosphates; Humans; Hydroxides; Hyperparathyroidism; Hypocalcemia; Kidney Failure, Chronic; Kidney Glomerulus; Magnesium; Ossification, Heterotopic; Osteitis Fibrosa Cystica; Osteomalacia; Osteoporosis; Osteosclerosis; Parathyroid Glands; Phosphates; Radiography; Renal Dialysis; Vitamin D

Vascular calcification is associated with increased cardiovascular risk and occurs by osteochondrogenic differentiation of vascular cells. Many of the same regulatory factors that control skeletal mineralization, including the complex metabolic pathway controlling levels of the activator, inorganic phosphate, and the potent inhibitor, pyrophosphate, also govern vascular calcification. We previously found that the cAMP/PKA signaling pathway mediates in vitro vascular cell calcification induced by inflammatory factors including tumor necrosis factor-alpha 1 and oxidized phospholipids. In this report, we tested whether this signaling pathway modulates phosphate and pyrophosphate metabolism. Treatment of primary murine aortic cells with the PKA activator, forskolin, significantly induced osteoblastic differentiation markers, including alkaline phosphatase (ALP), osteopontin, and osteocalcin as well as the pyrophosphate generator, ectonucleotide-pyrophosphatase/phosphodiesterase-1 (Enpp1) and the pyrophosphate transporter, ankylosis protein, but not the sodium/phosphate cotransporter, Pit-1. In the presence of a substrate for ALP, beta-glycerophosphate, which generates inorganic phosphate, forskolin also enhanced matrix mineralization. Inhibitors of ALP or Pit-1 abrogated forskolin-induced osteopontin expression and mineralization but not forskolin-induced osteocalcin or ALP. These results suggest that phosphate is necessary for PKA-induced calcification of vascular cells and that the extent of PKA-induced calcification is controlled by feedback induction of the inhibitor, pyrophosphate.

Topics: Alkaline Phosphatase; Animals; Aorta; Biological Transport; Calcinosis; Cell Differentiation; Cells, Cultured; Colforsin; Cyclic AMP-Dependent Protein Kinases; Diphosphates; Hyperparathyroidism; Mice; Osteoblasts; Osteocalcin; Osteopontin; Phosphates

Inorganic pyrophosphate (PPi) levels were estimated by radiometric assay in urine and in synovial fluid (SF) from asymptomatic, nonarthritic knees of patients with untreated metabolic disease and normal controls. SF PPi was significantly elevated in patients with hyperparathyroidism (mean +/- SEM 19 +/- 3 microM; n = 9), hemochromatosis (23 +/- 5 microM; n = 6), and hypomagnesemia (27 +/- 0.1 microM; n = 2) compared with normal subjects (10 +/- 0.5 microM, n = 50), and was low in patients with hypothyroidism (4.2 +/- 2.3 microM; n = 11) (P less than 0.05 all comparisons). Urinary PPi was elevated only in those with hypophosphatasia. Local elevation of ionic PPi may be relevant to the mechanism of crystal formation in metabolic diseases predisposing to calcium pyrophosphate dihydrate (CPPD) crystal deposition. The finding of low SF PPi levels in patients with hypothyroidism further questions the association between this condition and CPPD.

Topics: Adult; Aged; Aged, 80 and over; Calcium Pyrophosphate; Creatinine; Crystallization; Diphosphates; Endocrine System Diseases; Female; Hemochromatosis; Humans; Hyperparathyroidism; Hypophosphatasia; Hypothyroidism; Magnesium Deficiency; Male; Metabolic Diseases; Middle Aged; Synovial Fluid

Recent advances in technology have lead to the development of a high-definition microfocal X-ray unit allowing macroradiographic examination of different parts of the body at x 5 to x 10 magnification and with a high spatial resolution. Its applications in the study of a number of arthritides, metabolic and some other bone diseases are described in terms of early detection of diagnostic features. Emphasis is placed on the advantages of direct accurate measurement of these features, providing a precise evaluation of disease progression and response to therapy.

Topics: Arthritis, Rheumatoid; Bone and Bones; Child; Diphosphates; Humans; Hyperparathyroidism; Male; Osteoarthritis; Radiation Dosage; Radiography; Scleroderma, Systemic; X-Ray Intensifying Screens

A patient with primary hyperparathyroidism whose bone scan showed signs of extensive pulmonary and gastric calcifications is described. The patient also had renal insufficiency. A review of the literature and of data of 13 patients with primary hyperparathyroidism who were seen in the Department of Internal Medicine at the University Hospital of Maastricht, led to the conclusion that only in patients with renal insufficiency could ectopic calcifications be expected to occur. Phosphate retention, rather than the hyperphosphaturia that occurs in that particular situation, is cited as the cause.

Topics: Bone and Bones; Calcinosis; Diphosphates; Humans; Hyperparathyroidism; Lung Diseases; Male; Middle Aged; Radionuclide Imaging; Stomach Diseases; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Animals; Diphosphates; Etidronic Acid; Humans; Hyperparathyroidism; Organotechnetium Compounds; Radionuclide Imaging; Rats; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Bone and Bones; Diphosphates; Humans; Hyperparathyroidism; Radionuclide Imaging; Technetium

A prospective, controlled study of patients with primary hyperparathyroidism has been carried out to establish the relation of this endocrinopathy to calcium pyrophosphate dihydrate crystal deposition disease. Eight of 26 patients with documented hyperparathyroidism were found to have chondrocalcinosis compared to four of 104 individuals in the control group (p less than 0.01). Two of these eight patients had confirmed pseudogout attacks shortly after parathyroidectomy. Four other patients, including two without chondrocalcinosis, gave a history of typical pseudogout. Patients with hyperparathyroidism and chondrocalcinosis were significantly older than those without the articular lesion (p = 0.006). We could not delineate specific metabolic abnormalities of hyperparathyroidism which contributed to the development of chondrocalcinosis.

Topics: Adult; Aged; Calcium Pyrophosphate; Chondrocalcinosis; Diphosphates; Female; Humans; Hyperparathyroidism; Male; Middle Aged; Organ Size; Parathyroid Glands; Parathyroid Hormone; Prospective Studies; Radiography; Synovial Fluid

Most patients with primary hyperparathyroidism have normal 5-hr bone-to-soft-tissue ratios for 99MTc-pyrophosphate. In contrast, all five patients with advanced secondary hyperparathyroidism in this study showed significant (p less than 0.001) increases of bone uptake. In the early period after parathyroidectomy, there was no quantitative or qualitative change in uptake. A limited decrease of bone uptake was observed only after prolonged periods of observation. In itself, parathyroid activity seems to have little direct influence on bone uptake of 99MTc-pyrophosphate.

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Bone and Bones; Bone Resorption; Diphosphates; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Male; Middle Aged; Parathyroid Hormone; Radionuclide Imaging; Technetium

Skeletal abnormalities in 12 patients with primary hyperparathyroidism, five patients with pseudohypoparathyroidism, and three patients with hypoparathyroidism were studied to compare the diagnostic sensitivity of bone radiologic examination to that of radionuclide studies using 99mTc-Sn-pyrophosphate (99mTc-PPi) a skeletal-seeking radiopharmaceutical. The results were compared with bone mineral content as measrued by the Norland--Cameron densitometer. Kinetic data of the blood disappearance and plasma clearance of 99mTc-PPi were obtained and compared with data of control subjects without evidence of parathyroid disease. Bone imaging with 99mTc-PPi may be more sensitive than routine skeletal radiographs and bone mineral analysis for the evaluation of skeletal abnormalities in patients with parathyroid disfunction. The enhanced plasma clearance of the tracer observed in patients with primary hyperparathyroidism may reflect the direct effect of excessive parathyroid hormone on the renal handling of 99mTc-Sn-pyrophosphate.

Topics: Adolescent; Adult; Aged; Bone and Bones; Diphosphates; Female; Humans; Hyperparathyroidism; Hypoparathyroidism; Kinetics; Male; Middle Aged; Minerals; Parathyroid Diseases; Parathyroid Hormone; Pseudohypoparathyroidism; Radionuclide Imaging; Technetium

Topics: Bone Diseases; Bone Resorption; Diphosphates; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Pseudohypoparathyroidism; Radionuclide Imaging; Technetium

This communication describes a series of clinical and animal in vivo and in vitro investigations designed to elucidate the mechanism of 99mTc-Sn-phosphate complex concentration in metabolic bone disease. Rachitic and lathyritic animals were used as experimental models. Based on these studies it is concluded that 99mTc alters the pharmacology of the phosphate complexes, in particular pyrophosphate, which was the test agent most extensively employed, so that the usual affinity for mineral is for the greater part replaced by organic matrix binding. There is also evidence to suggest the immature collagen moiety of the organic matrix is the prime target of 99mTc-Sn-phosphate complex binding. Specifically, the aldehyde groups of the collagen molecule are suspected as being the major site of interaction.

Topics: Aminopropionitrile; Animals; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphates; Humans; Hydroxyproline; Hyperparathyroidism; In Vitro Techniques; Lathyrism; Organophosphorus Compounds; Osteitis Deformans; Osteomalacia; Radionuclide Imaging; Rats; Renal Dialysis; Rickets; Technetium

In a group of hospital patients with various diseases, the urinary hydroxyproline-to-creatinine ratio showed a significant correlation (r = 0.63; p less than 0.001) with the 5-hr bone-to-soft-tissue ratio for 99mTc-pyrophosphate uptake. In patients on chronic hemodialysis, a similar correlation was found between the 5-hr bone-to-soft-tissue ratio and hydroxyproline levels in plasma and serum. The findings suggest that 99mTc-pyrophosphate binding by bone is related to collagen metabolism.

Topics: Aged; Bone and Bones; Bone Diseases; Diphosphates; Female; Humans; Hydroxyproline; Hyperparathyroidism; Male; Middle Aged; Osteoporosis; Radionuclide Imaging; Renal Dialysis; Technetium

A study was undertaken to investigate the behavior of 99mTc-Sn-pyrophosphate complex in metabolic bone disease. Of clinical importance was the generalized increased periarticular bone accumulation of the radiopharmaceutical in osteomalacia and in combined osteomalacia and osteitis fibrosa as found in patients with chronic renal failure. The pattern in primary hyperparathyroidism was variable. There was no correlation between the initial rates of accumulation of the radiophosphate complex or its bone to soft-tissue uptake ratio at 5 hr when compared with the degree of osteomalacia and osteitis fibrosa. It is postulated that the 99mTc-Sn-pyrophosphate complex has greater affinity for immature collagen than the crystal surface.

Topics: Adenocarcinoma; Adult; Aged; Anorexia Nervosa; Bone Diseases; Diphosphates; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Middle Aged; Osteitis Deformans; Osteitis Fibrosa Cystica; Osteomalacia; Parathyroid Neoplasms; Radionuclide Imaging; Renal Dialysis; Technetium

Topics: Adult; Aged; Arthritis; Calcium; Chondrocalcinosis; Crystallization; Diabetes Complications; Diet Therapy; Diphosphates; Female; Gout; Humans; Hyperparathyroidism; Knee Joint; Leukocytes; Male; Middle Aged; Physical Therapy Modalities; Radiography; Synovial Fluid; Synovitis; Uric Acid

Topics: Alkaline Phosphatase; Cellulose; Cholelithiasis; Diphosphates; Electrophoresis; Hepatitis; Humans; Hyperparathyroidism; Hyperthyroidism; Intestinal Mucosa; Isoenzymes; Jejunum; Kidney Failure, Chronic; Kinetics; Liver; Liver Cirrhosis; Neoplasm Metastasis; Organ Specificity; Osteoporosis; Pyrophosphatases; Regression Analysis; Vinyl Compounds

Topics: Antibodies, Antinuclear; Arthritis, Rheumatoid; Biopsy; Connective Tissue; Dermatomyositis; Diphosphates; Gout; Humans; Hyperparathyroidism; Inflammation; Joint Diseases; Lupus Erythematosus, Systemic; Neutrophils; Polyarteritis Nodosa; Psoriasis; Rheumatoid Factor; Salicylates; Sarcoidosis; Spondylitis, Ankylosing; Synovial Fluid; Synovial Membrane; Uric Acid

Topics: Adenoma; Adult; Diagnosis, Differential; Diphosphates; Female; Humans; Hyperparathyroidism; Male; Middle Aged; Parathyroid Neoplasms; Urinary Calculi

Topics: Acidosis, Renal Tubular; Adult; Calcium; Cystinuria; Diphosphates; Female; Humans; Hyperparathyroidism; Male; Nephrocalcinosis; Oxalates; Peptides; Urinary Bladder Calculi

Topics: Animals; Bone and Bones; Bone Resorption; Calcium; Diphosphates; Humans; Hyperparathyroidism; Male; Parathyroid Hormone; Phosphates; Proline; Rats

Topics: Acromegaly; Adult; Calcinosis; Calcium Phosphates; Cartilage Diseases; Diagnosis, Differential; Diphosphates; Gout; Hemochromatosis; Humans; Hyperparathyroidism; Joints; Male; Microscopy, Polarization; Middle Aged; Radiography; Terminology as Topic

Topics: Adolescent; Adult; Aged; Bone Diseases; Child; Child, Preschool; Diphosphates; Female; Humans; Hydroxyproline; Hyperparathyroidism; Hyperthyroidism; Male; Middle Aged; Osteitis Deformans; Osteomalacia; Osteoporosis; Parathyroid Glands; Phosphorus Isotopes

Topics: Adenoma; Aged; Calcinosis; Calcium; Carpal Tunnel Syndrome; Diphosphates; Gout; Humans; Hyperparathyroidism; Male; Mediastinal Neoplasms; Parathyroid Neoplasms; Photomicrography; Synovial Fluid; Tendons; Ulna; Wrist

Topics: Bone and Bones; Calcium; Dental Caries; Diphosphates; Homeostasis; Hydroxyapatites; Hyperparathyroidism; Hyperthyroidism; Hypophosphatasia; Osteitis Deformans; Osteoporosis; Phosphates; Saliva; Solubility

Topics: Bone Neoplasms; Bone Resorption; Chromatography; Diphosphates; Fluids and Secretions; Humans; Hydroxyproline; Hyperparathyroidism; Hyperthyroidism; Osteitis Deformans; Phosphorus; Urine