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| ==Overview== | | == Classification == |
| | | {| class="wikitable" |
| ==Historical Perspective==
| | ! colspan="4" |Classification of hyperparathyridism |
| | | |- |
| ===Discovery===
| | |Features |
| * In 1852, Sir Richard Owen, Hunterian Professor and Conservator of the Museum in the Royal College of Surgeons of England, described parathyroids in rhinoceros.<ref name="pmid15459265">{{cite journal |vauthors=Modarai B, Sawyer A, Ellis H |title=The glands of Owen |journal=J R Soc Med |volume=97 |issue=10 |pages=494–5 |year=2004 |pmid=15459265 |pmc=1079622 |doi=10.1258/jrsm.97.10.494 |url=}}</ref>
| | |'''Primary hyperparathyroidism''' |
| * In 1880, Ivar Sandström, a Swedish anatomist, described parathyroids in human following 50 autopsies. He found tow parathyroid glands bilaterally in 43 out of 50 autopsies.<ref name="pmid25913489">{{cite journal |vauthors=Johansson H |title=The Uppsala anatomist Ivar Sandström and the parathyroid gland |journal=Ups. J. Med. Sci. |volume=120 |issue=2 |pages=72–7 |year=2015 |pmid=25913489 |pmc=4463479 |doi=10.3109/03009734.2015.1027426 |url=}}</ref>
| | |'''Secondary hyperparathyroidism''' |
| * In 1909, William George MacCallum and Carl Voegtlin, demonstrated associatioin between parathyroid gland calcium, and tetany.<ref name="pmid19867238">{{cite journal |vauthors=Maccallum WG, Voegtlin C |title=ON THE RELATION OF TETANY TO THE PARATHYROID GLANDS AND TO CALCIUM METABOLISM |journal=J. Exp. Med. |volume=11 |issue=1 |pages=118–51 |year=1909 |pmid=19867238 |pmc=2124703 |doi= |url=}}</ref>
| | |'''Tertiary hyperparathyroidism''' |
| * In 1924, James Bertram Collip, a Canadian biochemist, discovered and extracted parathormone.<ref>{{cite journal |author = Collip, J. B.|title = THE EXTRACTION OF A PARATHYROID HORMONE WHICH WILL PREVENT OR CONTROL PARATHYROID TETANY AND WHICH REGULATES THE LEVEL OF BLOOD CALCIUM|volume = 63|number = 2|pages = 395-438|year = 1925|URL = http://www.jbc.org/content/63/2/395.short|journal = Journal of Biological Chemistry}}</ref>
| | |- |
| * In 1932, L. I. Pugsley AND Hans Selye described the histological changes in the bone responsible for action of parathyroid hormone and on calcium metabolism in rat experiments. <ref>{{cite journal |last1=PUGSLEY |first1=L. I. |last2=SELYE |first2=HANS |date=July 28, 1933 |title=THE HISTOLOGICAL CHANGES IN THE BONE RESPONSIBLE FOR THE ACTION OF PARATHYROID HORMONE ON THE CALCIUM METABOLISM OF THE RAT.|url=http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.1933.sp003032/pdf |journal=The Journal of Physiology |volume=79 |issue=1 |pages=113-117 |doi= |access-date= }}</ref>
| | |Pathology |
| * In 1948, Nigel Ashworth Barnicot, an English anthropologist described the association between parathyroid hormone and bone resorption.<ref name="pmid18113751">{{cite journal |vauthors=BARNICOT NA |title=The local action of the parathyroid and other tissues on bone in intracerebral grafts |journal=J. Anat. |volume=82 |issue=Pt. 4 |pages=233–48 |year=1948 |pmid=18113751 |doi= |url=}}</ref>
| | |Hyperfunction of parathyroid cells due to hyperplasia, adenoma or carcinoma. |
| * In the same year, Iftakhar Jahan and Robert F. Pitts described effect of parathyroid hormone in decreasing calcium and magnesium excretion.<ref name="pmid18102666">{{cite journal |vauthors=JAHAN I, PITTS RF |title=Effect of parathyroid on renal tubular reabsorption of phosphate and calcium |journal=Am. J. Physiol. |volume=155 |issue=1 |pages=42–9 |year=1948 |pmid=18102666 |doi= |url=}}</ref>
| | |Physiological stimulation of parathyroid in response to hypocalcaemia. |
| * In 1959, Howard Rasmussen and Lyman C. Craig at the Rockefeller Institute for Medical Research purified parathyroid hormone.<ref name="RasmussenCraig1959">{{cite journal|last1=Rasmussen|first1=Howard|last2=Craig|first2=Lyman C.|title=PURIFICATION OF PARATHYROID HORMONE BY USE OF COUNTERCURRENT DISTRIBUTION|journal=Journal of the American Chemical Society|volume=81|issue=18|year=1959|pages=5003–5003|issn=0002-7863|doi=10.1021/ja01527a066}}</ref> They also isolated the active polypeptide (parathormone B) from bovine parathyroid gland and gave its tentative formula in 1961.<ref>{{Cite journal||last1=Rasmussen|first1=Howard|last2=Craig|first2=Lyman C.|title = Isolation of a Parathyroid Polypeptide from Acetic Acid Extracts of Bovine Parathyroid Glands|volume = 236| number = 4|pages = 1083-1086|year = 1961|URL = http://www.jbc.org/content/236/4/1083.short|journal = {Journal of Biological Chemistry}}</ref>
| | |Following long term physiological stimulation leading to hyperplasia. |
| | | |- |
| ==Landmark Events in the Development of Treatment Strategies==
| | |Cause |
| *In 1925, James Bertram Collip along with Douglous B Leitch treated tetany with the help of parathyroid hormone extract. They names the extract as Parathyrin.<ref name="pmid20315252">{{cite journal |vauthors=Collip JB, Leitch DB |title=A Case of Tetany treated with Parathyrin |journal=Can Med Assoc J |volume=15 |issue=1 |pages=59–60 |year=1925 |pmid=20315252 |pmc=1707993 |doi= |url=}}</ref>
| | | |
| *In 1925, Felix Mandl, a viennese surgeon performed first parathyroidectomy to treat a patient suffering from suffering from osteitis fibrosa cystica.<ref>{{cite book |last1=Thompson |first1=Scott M. |last2=Thompson |first2=Geoffrey B. |date=April 8, 2015|title=Felix Mandl |url=https://link.springer.com/chapter/10.1007%2F978-3-319-13662-2_25 |location= |publisher=Surgical Endocrinopathies |page=153-156 |isbn= 978-3-319-13661-5 |author-link= }}</ref>
| | | |
| ==References==
| | | |
| {{Reflist|2}}
| | |- |
| | | |Associations |
| {{WH}}
| | |May be associated with multiple endocrine neoplasia. |
| {{WS}}
| | |Usually due to chronic renal failure or other causes of Vitamin D deficiency. |
| | |Seen in chronic renal failure. |
| | |- |
| | |Serum calcium |
| | |High |
| | |Low/Normal |
| | |High |
| | |- |
| | |Serum phosphate |
| | |Low/Normal |
| | |High |
| | |High |
| | |- |
| | |Management |
| | |Usually surgery if symptomatic. Cincacalcet can be considered in those not fit for surgery. |
| | |Treatment of underlying cause. |
| | |Usually cinacalcet or surgery in those that don't respond. |
| | |} |