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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
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]
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.
Parathyroidectomy may also be required in secondary hyperparathyroidism. This situation arises mainly in people with severe chronic kidney disease in which the parathyroid glands are overactive to compensate for the low calcium and vitamin D levels often present in CKD. In many cases, the parathyroid hormone production improves when these ...
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]
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 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.
Cinacalcet, sold under the brand name Sensipar among others, is a medication used to treat primary hyperparathyroidism, tertiary hyperparathyroidism and parathyroid carcinoma. [ 4 ] [ 6 ] [ 5 ] Cinacalcet acts as a calcimimetic (i.e., it mimics the action of calcium on tissues ) by allosteric activation of the calcium-sensing receptor that is ...