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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
Causes of primary hyperparathyroidism include parathyroid adenoma (80% of patients), multiglandular disease usually seen as hyperplasia of the 4 parathyroid glands (15-20% of patients), parathyroid carcinoma (less than 1% of patients). [15] Primary hyperparathyroidism occurs sporadically and most patients do not have a family history. [15]
Metastatic calcification is deposition of calcium salts in otherwise normal tissue, because of elevated serum levels of calcium, [1] which can occur because of deranged metabolism as well as increased absorption or decreased excretion of calcium and related minerals, as seen in hyperparathyroidism.
Hyperparathyroidism is a condition caused by overproduction of PTH, and can be divided into three types. [citation needed] Primary hyperparathyroidism happens when the normal mechanism of regulation by negative feedback of calcium is interrupted, or in other words the amount of blood calcium would ordinarily signal less production of PTH.
There are a number of causes of hypercalciuria including genetic (idiopathic), primary hyperparathyroidism, immobilization, pagets disease, Multiple Myeloma, Calcium excess, Vitamin D excess/increased sensitivity, drug-induced hypercalciuria, sarcoidosis, hyperthyroidism, Cushing's disease, and renal tubular acidosis.
These causes are rare and constitute about 1% of all causes of hypercalcemia of malignancy. [22] Hypercalcemia of malignancy usually portends a poor prognosis, and the medial survival is 25–52 days of its development. [22] It has an incidence of 30% in those with cancer, and the prevalence is estimated to be about 2-3% in the United States. [22]
This may cause bone pain and tenderness, due to increased bone resorption. With increased circulating calcium, there may be other symptoms associated with hypercalcemia, most commonly dehydration. Hyperparathyroidism is most commonly caused by a benign proliferation of chief cells in one parathyroid gland, and rarely in MEN syndrome.
The first signs of a parathyroid adenoma and the resulting primary hyperparathyroidism can include bone fractures and urinary calculi such as kidney stones. [1]Often, a parathyroid adenoma is diagnosed by an incidental finding on blood tests that reveal high calcium levels. [3]