Studies in Calcium, Parathyroid Hormone and Calcitonin Metabolism and Associated Skeletal Disorders

Abstract

The association of hyperparathyroidism with Paget’s disease, the changes in bone mineral density after parathyroidectomy, the surgical experience with a large number of patients with hyperparathyroidism, the findings of stable bone mineral density and renal function in hyperparathyroid patients during long term follow up, and, most importantly, in a large study continued over several decades, the reduced life expectancy of patients with primary hyrperparathyroidism are described. The effective use of salmon calcitonin in a large number of patients with Paget’s disease, the use of pentagastrin to stimulate calcitonin release in persons with suspected occult medullary thyroid carcinoma, the evaluation of the impact of quantified exercise on circulating calcitonin, the evaluation of the interaction of circulating calcitonin with osteoblastic and osteoclastic function in bone in patients with chronic renal failure are described. The usefulness of the measurement of bone mineral density in the diagnosis and follow up of patients with osteoporosis, the value of the use of intravenous pamidronate in the treatment of osteoporosis, the finding that bone mineral density is a predictor of mortality in patients with chronic renal failure, the finding that long term treatment of postmenopausal women with formononetin reduces serum LDL cholesterol but does not preserve bone mineral density, the finding of low bone mineral density in persons with chronic fatigue syndrome, the failure of supplemental vitamin D to preserve bone mineral density in post-menopausal women, the effect of inhaled steroids on the bone mineral density of children, the finding that the heterozygous C282Y HFE mutation in postmenopausal women is associated with low bone mineral density and that venesection in a premenopausal woman with haemochromatosis improved bone mineral density are described. The findings of a high serum vasopressin in persons with hypercalcaemia and a high serum 1,25-OH vitamin D in a person with T-cell lymphoma are described. An extensive study of the role of FGF-23 in the clinical manifestations of oncogenic osteomalacia, and a unique study of cell function in a patient with fibrogenesis imperfecta ossium are described. The first description of diabetes insipidus in a patient with hypoparathyroidism is presented.