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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 ...
Parathyroidectomy is the surgical removal of one or more of the (usually) four parathyroid glands.This procedure is used to remove an adenoma or hyperplasia of these glands when they are producing excessive parathyroid hormone (PTH): hyperparathyroidism.
Primary hyperparathyroidism is the most common type. [1] Certain exposures increase the risk of developing primary hyperparathyroidism such as sex and age. It occurs three times more often in women than men and is often diagnosed between the ages of 50 and 60 but is not uncommon before then. [2] The disease was first described in the 1700s. [32]
Approximately 60 percent of parathyroid adenomas may be imaged by sestamibi scanning. The natural distribution of causation for primary hyperparathyroidism is roughly 85% solitary adenomas, 10-15% diffuse hyperplasia, and 1% cancer. Imaging is not as reliable in patients with multiglandular parathyroid disease.
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]
During parathyroid surgery if there is an adenoma the transplantation is not recommended; instead it is cryopreserved for research an if there is a recurrent hypoparathyroidism. [2] [5] The surgery is indicated for all patients that are diagnosed with hyperparathyroidism with or without symptoms, especially in younger patients.
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