Journal of Clinical Endocrinology & Metabolism, Vol 76, 139-144, Copyright © 1993 by Endocrine Society

ARTICLES

Progression of uremic hyperparathyroidism involves allelic loss on chromosome 11

A Falchetti, AE Bale, A Amorosi, C Bordi, P Cicchi, S Bandini, SJ Marx and ML Brandi
Department of Clinical Physiopathology, University of Florence, Italy.

In occasional cases of secondary hyperparathyroidism, long term stimulation of the parathyroid glands leads from compensatory to autonomous hyperfunction, and thus, hypercalcemia develops. This clinical entity, named tertiary hyperparathyroidism, is possibly due to the formation of an adenoma in one of the hyperplastic glands. Previous studies have shown that parathyroid adenomas may arise with allelic loss on chromosome 11. We tested for allelic loss at several loci on chromosome 11 in 12 enlarged parathyroid glands from 6 uremic patients and found loss of heterozygosity in 2 of the glands from 2 different patients with higher serum calcium levels (11.3 +/- 0.29 vs. 9.8 +/- 0.28 mg/dL; P < 0.004) and, therefore, ascribable to the so-called tertiary hyperparathyroidism. The 2 glands with allelic loss were significantly greater in mass than those without loss (3.42 +/- 0.37 vs. 1.60 +/- 0.54 g; P < 0.001). These data offer new evidence that autonomous parathyroid proliferation in uremic patients can develop through overgrowth by a monoclonal tumor, presumably with inactivation of a tumor suppressor gene(s) on chromosome 11.

This article has been cited by other articles:

				Y. Hibi, F. Kambe, Y. Tominaga, Y. Mizuno, H. Kobayashi, K. Iwase, T. Imai, and H. Seo Up-Regulation of the Gene Encoding Protein Kinase A Type I{alpha} Regulatory Subunit in Nodular Hyperplasia of Parathyroid Glands in Patients with Chronic Renal Failure J. Clin. Endocrinol. Metab., February 1, 2006; 91(2): 563 - 568. [Abstract] [Full Text] [PDF]

				M. Fukagawa, J. J. Kazama, and T. Shigematsu Management of patients with advanced secondary hyperparathyroidism: the Japanese approach Nephrol. Dial. Transplant., September 1, 2002; 17(9): 1553 - 1557. [Full Text] [PDF]

				Y. Imanishi, H. Tahara, N. Palanisamy, S. Spitalny, I. B. Salusky, W. Goodman, M. L. Brandi, T. B. Drueke, E. Sarfati, P. Urena, et al. Clonal Chromosomal Defects in the Molecular Pathogenesis of Refractory Hyperparathyroidism of Uremia J. Am. Soc. Nephrol., June 1, 2002; 13(6): 1490 - 1498. [Abstract] [Full Text] [PDF]

				K. Sato, T. Obara, K. Yamazaki, M. Kanbe, K. Nakajima, A. Yamada, T. Yanagisawa, Y. Kato, T. Nishikawa, and K. Takano Somatic Mutations of the MEN1 Gene and Microsatellite Instability in a Case of Tertiary Hyperparathyroidism Occurring during High Phosphate Therapy for Acquired, Hypophosphatemic Osteomalacia J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5564 - 5571. [Abstract] [Full Text] [PDF]

				H. Tahara, Y. Imanishi, T. Yamada, Y. Tsujimoto, T. Tabata, T. Inoue, M. Inaba, H. Morii, and Y. Nishizawa Rare Somatic Inactivation of the Multiple Endocrine Neoplasia Type 1 Gene in Secondary Hyperparathyroidism of Uremia J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 4113 - 4117. [Abstract] [Full Text]

				R. Mihai and J. R. Farndon Parathyroid disease and calcium metabolism Br. J. Anaesth., July 1, 2000; 85(1): 29 - 43. [Full Text] [PDF]

				T. B. DRÜEKE Cell Biology of Parathyroid Gland Hyperplasia in Chronic Renal Failure J. Am. Soc. Nephrol., June 1, 2000; 11(6): 1141 - 1152. [Full Text]

				S. B. Brown, T. T. Brierley, N. Palanisamy, I. B. Salusky, W. Goodman, M. L. Brandi, T. B. Drüeke, E. Sarfati, P. Ureña, R. S. K. Chaganti, et al. Vitamin D Receptor as a Candidate Tumor-Suppressor Gene in Severe Hyperparathyroidism of Uremia J. Clin. Endocrinol. Metab., February 1, 2000; 85(2): 868 - 872. [Abstract] [Full Text]

				F. Malberti, M. Farina, and E. Imbasciati The PTH-calcium curve and the set point of calcium in primary and secondary hyperparathyroidism Nephrol. Dial. Transplant., October 1, 1999; 14(10): 2398 - 2406. [Abstract] [Full Text] [PDF]

				O. J. Hines and H. E. Gordon Secondary Hyperparathyroidism in a Patient with Eight Parathyroid Glands J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2384 - 2386. [Abstract] [Full Text]

				A. Falchetti, A. Morelli, A. Amorosi, F. Tonelli, S. Fabiani, V. Martineti, R. Castello, L. Furlani, and M. L. Brandi Allelic Loss in Parathyroid Tumors from Individuals Homozygous for Multiple Endocrine Neoplasia Type 1 J. Clin. Endocrinol. Metab., July 1, 1997; 82(7): 2278 - 2282. [Abstract] [Full Text] [PDF]

				K. A. Hruska and S. L. Teitelbaum Renal Osteodystrophy N. Engl. J. Med., July 20, 1995; 333(3): 166 - 175. [Full Text] [PDF]