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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 ...
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]
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]
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 also very common. Primary hyperparathyroidism is relatively more common in postmenopausal women.
After recognition, primary hyperparathyroidism should be proved or excluded. [10] In extreme cases of primary hyperparathyroidism, removal of the parathyroid gland after surgical neck exploration is the only way to avoid death. [10] The diagnostic program should be performed within hours, in parallel with measures to lower serum calcium. [10]
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 ...
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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]