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Secondary hyperparathyroidism is due to physiological (i.e. appropriate) secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels). The most common causes are vitamin D deficiency [ 47 ] (caused by lack of sunlight, diet or malabsorption) and chronic kidney failure .
This condition causes many diseases related with calcium reabsorption, because the principal function of the parathyroid hormone is to regulate it. Parathyroid surgery could be performed in two different ways: first is a complete parathyroidectomy, and second is the auto transplantation of the removed parathyroid glands.
Primary hyperparathyroidism is most commonly due to solitary parathyroid adenoma. Less commonly it may be due to double parathyroid adenomas or parathyroid hyperplasia. Tc99 sestamibi scan of head, neck and upper thorax is the most commonly used test for localizing parathyroid adenomas having a sensitivity and specificity of 70–80%.
Post-surgical hypoparathyroidism is the most common form, and can be temporary (due to suppression of tissue after removal of a malfunctioning gland) or permanent, if all parathyroid tissue has been removed. [1] Inherited hypoparathyroidism is rare and is due to a mutation in the calcium sensing receptor.
The most common causes of CKD are high blood pressure and diabetes, "which damage the small blood vessels and filtering units in the kidneys over time," says Nagata. Other potential causes he ...
If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In people with chronic kidney failure, treatment consists of dietary restriction of phosphorus; supplements containing an active form of vitamin D, such as calcitriol, doxercalciferol, paricalcitol; and phosphate binders, which are either calcium-based and non-calcium based.
Levothyroxine, a drug used to treat hypothyroidism, can lead to reduced bone mass and density in older adults with normal thyroid levels, a small cohort study has shown.
Tertiary hyperparathyroidism is a condition involving the overproduction of the hormone, parathyroid hormone, produced by the parathyroid glands. [1] The parathyroid glands are involved in monitoring and regulating blood calcium levels and respond by either producing or ceasing to produce parathyroid hormone.
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