[Bone metabolism in rheumatoid arthritis].
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Biomedical subjects
Publications and source records attributed to M Fuss.
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On the basis of 100 cases of hypercalcemia, the authors attempt to elucidate the criteria of the etiologic diagnosis. Kidney lithiasis or nephrocalcinosis suggested a primary hyperparathyroidism (HPT I) or an intoxication due to vitamin D. X rays of the skeleton and quantitative histological exams of the bone were not useful in the diagnosis of HPT I. The level of parathormone in the plasma is the best parameter to be used in distinguishing HPT I from other diseases. In the absence of renal insufficiency or severe intestinal disorders, a phospharemia below 2.6 mg/100 ml, a chloremia above 103 m EG/l and bicarbonates below 25 m Eg/l indicate an HPT I or a paraneoplasic. A phosphoremia above 3.2 mg/100 ml runs counter to this diagnosis. The chloremia/phosphoremia ratio is not more helpful than the phosphoremia alone.
Presentation of a case of Sipple's syndrome with bilateral malignant pheochromocytoma, bilateral thyroid medullary carcinoma and two parathyroid adenomas. The principal characters of the syndrome, the diagnostic tests, the necessity of a prospective survey of family relatives are discussed.
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