Hyperparathyroidism

Abstract

Hyperparathyroidism is due to increased activity of the parathyroid glands, either from an intrinsic abnormal change altering excretion of parathyroid hormone (primary or tertiary hyperparathyroidism) or from an extrinsic abnormal change affecting calcium homoeostasis stimulating production of parathyroid hormone (secondary hyperparathyroidism). Primary hyperparathyroidism is the third most common endocrine disorder, with the highest incidence in postmenopausal women. Asymptomatic disease is common, and severe disease with renal stones and metabolic bone disease arises less frequently now than it did 20-30 years ago. Primary hyperparathyroidism can be cured by surgical removal of an adenoma, increasingly by minimally invasive parathyroidectomy. Medical management of mild disease is possible with bisphosphonates, hormone replacement therapy, and calcimimetics. Vitamin D deficiency is a common cause of secondary hyperparathyroidism, particularly in elderly people. However, the biochemical definition of vitamin D deficiency and its treatment are subject to much debate. Secondary hyperparathyroidism as the result of chronic kidney disease is important in the genesis of renal bone disease, and several new treatments could help achieve the guidelines set out by the kidney disease outcomes quality initiative.

Association between atypical parathyroid adenoma and neurofibromatosis

“…Prevalence depends on the population studied and the detection methods used (4), and women between 55 and 75 are the most common individuals affected by the disease. In relation to clinical presentation, most individuals are asymptomatic and hypercalcemia is evidenced in routine exams.…”

Aldosterone and Parathyroid Hormone: A Complex and Clinically Relevant Relationship

“…These results are of particular importance when considering the crucial role of PTH for the diagnosis and treatment of bone and mineral disorders [2] and the accumulating data on PTH and cardiovascular risk [3][4][5]. With our letter we seek to guide the attention towards previous data suggesting that the renin-angiotensinaldosterone system (RAAS) may also have a significant impact on PTH levels [5][6][7][8][9].…”

“…We therefore believe that the awareness of an interplay between PTH and aldosterone could, for selected cases, be clinically relevant for diagnostic considerations of patients with elevated levels of any of these two hormones. Apart from this, concomitant elevations of both hormones in states of either hyperparathyroidism or aldosteronism could hypothetically underlie the increased risk of mortality or cardiovascular disease associated with high PTH or aldosterone levels [2][3][4][5]16]. Whether beneficial effects of treatments of PTH or aldosterone excess are significantly mediated by an impact on both hormones warrants further studies.…”

Hiperparatireoidismo Primário - Diferentes Modalidades De Tratamentos

“…O hiperparatireoidismo primário (HPTP) é uma doença caracterizada pelo aumento excessivo da produção do paratormônio (PTH), geralmente acima de 60 pg/ml, por uma ou várias glândulas paratireóides, resultando em hipercalcemia (elevação sérica acima de 10,4mg/dl) e hipofosfatemia (abaixo de 2,5mg/dl) 1 . O HPTP ocorre em aproximadamente 1% da população, sendo mais comumente encontrado em indivíduos acima de 55 anos e em mulheres na pós-menopausa 2 .…”

“…O HPTP ocorre em aproximadamente 1% da população, sendo mais comumente encontrado em indivíduos acima de 55 anos e em mulheres na pós-menopausa 2 . A etiologia mais comum da doença é o adenoma de uma glândula solitária (75-85%), seguido de hiperplasia multiglandular em 10-15% dos casos e de adenomas duplos em 4-5%, sendo raramente ocasionada por um carcinoma de paratireoide 1,3 .…”