Hyperparathyroidism

Overview

Hyperparathyroidism is a condition where there is an overactivity in one or more body of the parathyroid gland which is located posterior to the thyroid glands. Usually parathyroid hormones present in the serum is at normal levels and this helps maintain a balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning. Types of hyperparathyroidism : Primary, Secondary, Tertiary, Malignant

Signs and Symptoms

Fragile bones that easily fracture (osteoporosis), Kidney stones, Abdominal pain, Fatigue, Depression, Bone and joint pain, Nausea, Vomiting or loss of appetite, Pruritus

Common Causes

Increase in production of parathyroid hormone, Primary causes: benign growth on the gland, malignancy of the gland, hyperplasia of the gland, Secondary causes: severe calcium deficiency due to malabsorption, severe Vitamin D deficiency, chronic kidney failure

Risk Factors

Menopause, Prolonged and severe calcium or vitamin D deficiency, Inherited disorder: multiple endocrine neoplasia type 1, Exposure of the radiation to the neck, Lithium intake

Investigation Techniques

Full blood count, Serum calcium level, Renal function test, Bone mineral density, Ultrasound of the neck, X-ray abdomen

Treatment and Prevention

Monitor calcium levels, kidney function and bone density, Mild hyperparathyroidism: low calcium diet, calcium reducing agent such as bisphosphonates and calcium receptor agonist cinacalcet, Severe hyperparathyroidism: IV saline and bisphosphonate therapy, Secondary hyperparathyroidism: diet restriction of phosphates, calcium and vitamin D supplementation, Surgical resection: only indicated when medical treatment fails and severe uncontrolled hypercalcemia.