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Primary hyperparathyroidism (or PHPT) is a medical condition where the parathyroid gland (or a benign tumor within it) produce excess amounts of parathyroid hormone (PTH). ). The symptoms of the condition relate to the resulting elevated serum calcium (hypercalcemia), which can cause digestive symptoms, kidney stones, psychiatric abnormalities, and bone dis
the treatment of secondary hyperparathyroidism (HPT) in children aged three years and older with end stage renal disease (ESRD) on maintenance dialysis therapy in whom secondary HPT is not adequately controlled with standard of care therapy. [5] part of a therapeutic regimen including phosphate binders and/or vitamin D sterols, as appropriate. [5]
Tertiary hyperparathyroidism is defined by autonomous release of parathyroid hormone while in a hypercalcaemic state. Unlike primary hyperparathyroidism, hypercalcemia in the tertiary form is thought to be the result of resolution of secondary hyperparathyroidism rather than adenoma formation alone. [4] [11] [10]
[59] [60] Treatment of secondary hyperparathyroidism with a calcimimetic in those on dialysis for CKD does not alter the risk of early death; however, it does decrease the likelihood of needing a parathyroidectomy. [61] Treatment carries the risk of low blood calcium levels and vomiting. [61]
Parathyroid cancer occurs in midlife at the same rate in men and women. [12] Conditions that appear to result in an increased risk of parathyroid cancer include multiple endocrine neoplasia type 1, [13] autosomal dominant familial isolated hyperparathyroidism [13] and hyperparathyroidism-jaw tumor syndrome [1] (which also is hereditary). [1]
Common cancer types that are associated with hypercalcemia of malignancy include: Solid tumor with metastasis via local osteolytic hypercalcemia: which can be due to any tumor that metastasizes to the bone. But common causes include breast cancer, lung cancer, kidney cancer, and myeloma or lymphoma of the bone [22]
Hyperparathyroidism occurs most commonly in postmenopausal women. Hyperparathyroidism can be caused by a tumor, or adenoma, in the parathyroid gland or by increased levels of parathyroid hormone due to hypocalcemia. [2] Approximately 10% of individuals with cancer experience hypercalcemia due to malignancy. [2]
Hyperparathyroidism is present in ≥ 90% of patients. Asymptomatic hypercalcemia is the most common manifestation: about 25% of patients have evidence of nephrolithiasis or nephrocalcinosis. In contrast to sporadic cases of hyperparathyroidism, diffuse hyperplasia or multiple adenomas are more common than solitary adenomas.