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Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels), with resultant hyperplasia of these glands. This disorder is primarily seen in patients with chronic kidney failure.
[30] [31] Tertiary hyperparathyroidism is differentiated from primary hyperparathyroidism by a history of chronic kidney failure and secondary hyperparathyroidism. [citation needed] Hyperparathyroidism can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. [32]
Tertiary hyperparathyroidism develops when the hyperplastic gland of secondary hyperparathyroidism constantly releases PTH, independent of the regulation systems. [2] Another condition is hypercalcemia, which refers to a calcium level above 10.5 mg/dL.
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]
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.
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]
The most common cause of primary hyperparathyroidism is a sporadic, single parathyroid adenoma [5] resulting from a clonal mutation (~97%). Less common are parathyroid hyperplasia [6] (~2.5%), parathyroid carcinoma (malignant tumor), and adenomas in more than one gland (together ~0.5%).Primary hyperparathyroidism is also a feature of several familial endocrine disorders: Multiple endocrine ...
Secondary hyperparathyroidism; ... [10] [11] [12] See also. List of MeSH codes (C19) List of ICD-9 codes 240-279: Endocrine, nutritional and metabolic diseases, and ...