hyperparathyroidism

parathyroid glands

•The parathyroid glands are four pea-sized glands located on the thyroid gland in the neck. Person is born with one or more of the parathyroid glands embedded in the thyroid, in the thymus, or located elsewhere around this area .

FUNCTION OF PARATHYROID GLAND

•The parathyroid glands secrete PTH, a substance that helps maintain the correct balance of calcium and phosphorus in the body. PTH regulates the level of calcium in the blood, release of calcium from bone, absorption of calcium in the intestine, and excretion of calcium in the urine.

hyperparathyroidism

DEFINATION:

Hyperparathyroidism is the overproduction by the parathyroid glands of a hormone called parathyroid hormone (parathormone) .

hyperparathyroidism

Classification1-Primary

hyperparathyroidism:results from a hyperfunction of the parathyroid glands themselves.

•2-Secondary hyperparathyroidism::

•Secondary hyperparathyroidism is the reaction of the parathyroid glands to a hypocalcemia caused by something other than a parathyroid pathology, e.g. chronic renal failure

•3-Tertiary hyperparathyroidism:

•Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone (PTH) after a long period of secondary hyperparathyroidism and resulting in hypercalcemia.

Symptoms and signs:

1-increased level of calcium .2-The most common symptom is

fatigue and tiredness.3-Other very common symptoms are

lack of energy.4 -memory problems.

5 -depression. 6-problems with concentration.7- problems sleeping. Other manifestations of hyperparathyroidism usually involve the kidney (stones) and the skeletal system (bone pain due to the development of osteoporosis).

Laboratory tests:

1-Serum calcium.

2-Serum phosphorus.

3-Alkaline phosphatase.

Etiology:

1-Primary hyperparathyroidism:*The most common cause is a

benign parathyroid adenoma that loses its sensitivity to circulating calcium levels. Usually, only one of the four parathyroid glands is affected .

*A less common cause is from multiple endocrine neoplasia (MEN

2-Secondary hyperparathyroidism :Secondary hyperparathyroidism is due to resistance to the actions of PTH, usually due to chronic renal failure. The bone disease in secondary parathyroidism along with renal failure is termed renal osteodystrophy

3-Tertiary hyperparathyroidism:

Tertiary hyperparathyroidism, quartary and quintary hyperparathyroidism are rare forms that are caused by long lasting disorders of the calcium feedback control system. When the hyperparathyroidism can not be corrected by medication one calls it tertiary hyperparathyroidism

Diagnosis:

PTH serum calcium Likely type high High primary high low or normal secondary

TREATMENT:

1-Surgery to remove the enlarged gland or glands) is the main treatment for the disorder.

2-Calcimimetics are a new class of drug that turns off secretion of PTH. They have been approved by the Food and Drug Administration for the treatment of hyperparathyroidism secondary to

kidney failure and dialysis.

PREPARED BY:PH.BATOOL ALI.

SUPERVISED BY:

DR.KHADRIA.