Hyperparathyroidism
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Clinic
- It is an increase in parathyroid hormone (PTH) levels in the blood.
- Tow types: Primary and Secondary hyperparathyroidism
- Symptoms of hyperparathyroidism are caused by inappropriately normal or elevated blood calcium leaving the bones and flowing into the blood stream in response to increased production of parathyroid hormone. In healthy people, when blood calcium levels are high, parathyroid hormone levels should be low.
- In long-standing hyperparathyroidism, the most common symptom is kidney stones.
- Other symptoms may include bone pain, weakness, depression, confusion, and increased urination.
- Both primary and secondary may result in osteoporosis
Primary hyperparathyroidism = Hyper calcemia
- Primary hyperparathyroidism is due to a single benign tumor known as a parathyroid adenoma (80% of cases)
- Very rarely it may be due to parathyroid cancer.
- 75% of primary hyperparathyroidisms are asymptomatic
- Asymptomatic patients may have other symptoms such as depression, anxiety, gastrointestinal distress, and neuromuscular problems
- The diagnosis of primary hyperparathyroidism is made by finding elevated calcium and PTH in the blood.
- Common manifestations of hypercalcemia include
- Weakness and fatigue
- Depression
- Bone pain
- Myalgias
- Decreased appetite
- Nausea and vomiting
- Constipation
- Pancreatitis
- Polyuria
- Polydipsia
- Cognitive impairment
- Kidney stones
- Vertigo
- Osteopenia or osteoporosis
- History of acquired racquet nails (brachyonychia) may be indicative of bone resorption.
Secondary
- In secondary hyperparathyroidism due to lack of Vitamin D absorption, the parathyroid gland is behaving normally
- Clinical problems are due to bone resorption and manifest as bone syndromes such as rickets, osteomalacia, and renal osteodystrophy.
Causes
- Low serum Calcium level
- Low serum Vit-D level