Hyperparathyroidism

Excerpt

Parathyroid hormone is among the major regulators of calcium homeostasis and bone turnover; alterations of parathyroid hormone secretion are involved in the pathogenesis of several metabolic bone diseases. Remarkably, two physicians from Vienna (Jakob Erdheim and Felix Mandl) made significant contributions to the pathophysiology and treatment of hyperparathyroidism. The American endocrinologist Fuller Albright, who—among numerous other discoveries in calcium metabolism—recognized the role of the menopause in the pathophysiology of osteoporosis, in a presidential address distinguished an “Austro-German pathological approach” and an “American physiological approach” to the elucidation of hyperparathyroidism [1]. The existence of “glandulae parathyreoideae” in humans was first described in 1880 by Ivar Sandström from Sweden. In 1891 von Recklinghausen reported on an autopsy case with osteitis fibrosa cystica. In 1906 the Viennese pathologist Jakob Erdheim induced tetany in rats by the removal of the parathyroid glands and consequently discovered the role of these glands in the metabolism of calcium. One year later in an autopsy series of patients that died with osteomalacia, Erdheim for the first time recognized compensatory parathyroid hypertrophy/hyperplasia. In the late 1920s Fuller Albright spent 1 year in Vienna with Jakob Erdheim; Albright was very much impressed by Erdheim and stated “that he knew more about disease processes than any living man” [1]. …