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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]
This is called hyperparathyroidism; it leads to hypercalcemia, kidney stones, osteoporosis, and various other symptoms. Hyperparathyroidism was first described in 1925 and the symptoms have collectively become known as "moans, groans, stones, and bones." By far, the most common symptom is fatigue, but depression, memory loss, and bone aches are ...
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.
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.
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]
Micrograph of a parathyroid adenoma (left) and normal parathyroid gland (right). H&E stain.. Hyperparathyroidism is confirmed by blood tests such as calcium and PTH levels. A specific test for parathyroid adenoma is sestamibi parathyroid scintigraphy, often referred to as sestamibi scan or, more colloquially, MIBI scan.
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.
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