Sandbox : anmol
Hyperparathyroidism Microchapters |
Diagnosis |
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Treatment |
Case Studies |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Classification
Classification of hyperparathyridism | |||
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Features | Primary hyperparathyroidism | Secondary hyperparathyroidism | Tertiary hyperparathyroidism |
Pathology | Hyperfunction of parathyroid cells due to hyperplasia, adenoma or carcinoma. | Physiological stimulation of parathyroid in response to hypocalcaemia. | Following long term physiological stimulation leading to hyperplasia. |
Cause | |||
Associations | May be associated with multiple endocrine neoplasia. | 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. |
Causes
Overview
Hyperparathyroidism is caused by an increase in concentration of parathyroid hormone in serum. There are three type of hyperparathyroidism including primary, secondary and tertiary hyperparathyroidism. The causes of all hyperparathyroidism is different.
Causes of Primary hyperparathyroidism
Causes of primary hyperparathyroidism are as follows:
Common cause
- Parathyroid adenoma
Less common cause
- Parathyroid hyperplasia
- Parathyroid carcinoma
- Radiation exposure leading to parathyroid adenoma or parathyroid hyperplasia[1]
Causes of secondary hyperparathyroidism
Causes of secondary hyperparathyroidism are as follows:
Common cause
- Chronic renal failure
- Vitamin D deficiency
Less common cause
- Severe calcium deficiency
Causes of tertiary hyperparathyroidism
Causes of tertiary hyperparathyroidism are as follows:
Common cause
- Chronic renal failure
- ↑ McMullen T, Bodie G, Gill A, Ihre-Lundgren C, Shun A, Bergin M; et al. (2009). "Hyperparathyroidism after irradiation for childhood malignancy". Int J Radiat Oncol Biol Phys. 73 (4): 1164–8. doi:10.1016/j.ijrobp.2008.06.1487. PMID 18774659.