Hyperparathyroidism

Definition

Hyperparathyroidism disease occur from excessive secretion of parathyroid hormone from one or more of the four parathyroid glands. In which, PTH promotes bone resorption, and hypersecretion may leads to hypercalcemia and hypophosphatemia. Overproduction of PTH by a tumor or hyperplastic tissue increases intestinal calcium absorption and it reduces renal calcium clearance, and it also increases bone calcium release. Hyperparathyroidism has two types such as primary or secondary.

Causes of Hyperparathyroidism

Primary hyperparathyroidism may be caused by such as:

• Increased secretion of PTH by one or more enlarged parathyroid glands
• Parathyroid carcinoma
• Previous exposure to radiation in the face or neck
• Certain medications, such as thiazide diuretics and lithium
• Heredity

Secondary hyperparathyroidism may be caused by such as:

• Rickets
• Chronic renal failure
• Vitamin D deficiency
• Malabsorption syndrome
• Osteomalacia due to phenytoin

Symptoms of Hyperparathyroidism

Symptoms of primary hyperparathyroidism may be occur from hypercalcemia and they may include:

• Tenal and urinary systems such as polyuria, nocturia, dehydration, renal colic pain, and renal insufficiency
• Musculoskeletal system include vague aches and pains, localized swellings, bone tenderness, osteopenia and osteoporosis, erosions of the juxta-articular surface, subchondral fractures, and muscle weakness and atrophy, particularly in the legs
• Gastrointestinal system such as pancreatitis causing constant, severe epigastric pain that radiates to the back, peptic ulcers causing abdominal pain, anorexia, nausea, and vomiting

Symptoms of secondary hyperparathyroidism may include:

• Central nervous system such as psychomotor and personality disturbances, depression, poor memory, ataxia, overt psychosis, stupor and, possibly coma
• Integumentary system such as skin necrosis and pruritus that may be caused by ectopic calcifications in the skin

Another various complications of hyperparathy roidism may be occur such as:

• Pathologic fractures
• Renal damage
• Urinary tract infections
• Hypertension
• Arrhythmias
• Insulin hypersecretion
• Pseudogout

Treatment of Hyperparathyroidism

If you have this disease, then you should be use Possible treatment and treatments depend on the type of disease. If you have primary hyperparathyroidism, then surgery is the only definitive therapy. If you have mild hyperparathyroidism, then only effective long-term medical therapy is maintaining hydration. Treatment of primary disease includes:

• In which, you can treat this disease by surgery to remove the adenoma or, depending on the extent of hyperplasia, all but one-half of one gland, to provide normal PTR levels.
• You can also use the other treatment to decreasing calcium levels using such methods as forcing fluids,limiting dietary intake of calcium, and promoting sodium and calcium excretion through forced diuresis and use of furosemide or ethacrynic acid.
• You should use oral sodium or potassium phosphate, subcutaneous calcitonin (Calcimar), IV. plicamycin for the treatment of this disease.

Treatment of secondary disease includes:

• Vitamin D to correct the underlying cause of parathyroid hyperplasia; aluminum hydroxide preparation to correct hyperphosphatemia in the patient with kidney disease.