Parathyroid Gland Hyperfunction or Hyperparathyroidism

Parathyroid Hyperfunction (Hyperparathyroidism): Causes

Primary hyperparathyroidism Pathogenesis (disease development) Primary hyperparathyroidism is the term used when there is a primary disease of the parathyroid glands (lat. : glandulae parathyroideae) with increased production of parathyroid hormone and resulting hypercalcemia (calcium excess). When the extracellular calcium level is increased, the parathyroid gland reacts by reducing the production and secretion (secretion) of … Parathyroid Hyperfunction (Hyperparathyroidism): Causes

Parathyroid Hyperfunction (Hyperparathyroidism): Therapy

The therapy of secondary as well as tertiary hyperparathyroidism depends mainly on the underlying disease. General measures Review of permanent medication due topossible effect on existing disease. In secondary hyperparathyroidism: adequate outdoor exposure (UV exposure for vitamin D synthesis). Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according … Parathyroid Hyperfunction (Hyperparathyroidism): Therapy

Parathyroid Hyperfunction (Hyperparathyroidism): Medical History

Medical history (history of illness) is an important component in the diagnosis of hyperparathyroidism. Family history Are there any diseases in your family that are common? What is the general health of your family members? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). What symptoms/discomforts (e.g., flank pain/pain in the kidney area) … Parathyroid Hyperfunction (Hyperparathyroidism): Medical History

Parathyroid Hyperfunction (Hyperparathyroidism): Surgical Therapy

Primary hyperparathyroidism (pHPT) Indications for surgery in confirmed primary hyperparathyroidism: Serum calcium > 3 mmol/l Organ manifestations (see under “Symptoms – Complaints”). Dysfunction (see under “Symptoms – Complaints”). Experienced hypercalcemic crisis (combination of cardiac arrhythmias/arrhythmias, vomiting/vomiting, nausea/nausea, fever, desiccosis/dehydration, polyuria/increased urination, impaired consciousness). Mineral salt content of bone more than 2 SD (standard deviation; standard … Parathyroid Hyperfunction (Hyperparathyroidism): Surgical Therapy

Parathyroid Hyperfunction (Hyperparathyroidism): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate primary hyperparathyroidism: Kidney-related (40-50%) Functional disturbances (reversible/reversible). Electrolyte loss Hypokalemia (potassium deficiency) Hyposthenuria (reduced concentration performance of the kidneys). Polydipsia (abnormally increased thirst). Polyuria (abnormally increased urine output) Decompensation in parathyrotoxic crisis. In advanced stages: oliguria (< 500 ml urine/24 hrs) → anuria (< 100 ml urine/24 hrs) … Parathyroid Hyperfunction (Hyperparathyroidism): Symptoms, Complaints, Signs

Parathyroid Hyperfunction (Hyperparathyroidism): Or something else? Differential Diagnosis

Primary hyperparathyroidism Blood, hematopoietic organs-immune system (D50-D90). Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic disease of connective tissue with granuloma formation (skin, lungs, and lymph nodes). Multiple endocrine neoplasia (MEN) – genetic disease leading to various benign and malignant tumors; is divided into MEN 1 and MEN 2 (a and b); in MEN 1, … Parathyroid Hyperfunction (Hyperparathyroidism): Or something else? Differential Diagnosis

Parathyroid Hyperfunction (Hyperparathyroidism): Complications

The following are the most important diseases or complications that may be contributed to by primary hyperparathyroidism: Endocrine, nutritional, and metabolic diseases (E00-E90). Hypercalcemic crisis (serum calcium > 3.5 mmol/l) – polyuria (increased urination), exsiccosis (dehydration), hyperpyrexia (extreme fever: higher than 41 °C), cardiac arrhythmias, weakness and lethargy, and somnolence (drowsiness) to coma Hypercalcemia syndrome: … Parathyroid Hyperfunction (Hyperparathyroidism): Complications

Parathyroid Hyperfunction (Hyperparathyroidism): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of skin, mucous membranes. Acroosteolysis (“bone loss”) of hands and feet? Auscultation (listening) of the heart. Palpation (palpation) of the kidney bearing Palpation of the abdomen (abdomen), etc. [due … Parathyroid Hyperfunction (Hyperparathyroidism): Examination

Parathyroid Hyperfunction (Hyperparathyroidism): Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Confirming the diagnosis of primary hyperparathyroidism. Intact (1-84) parathyroid hormone (PTH) [↑] Electrolytes Calcium – in serum and urine (24-hour urine) [↑; hypercalcemia (calcium excess)] Inorganic phosphate [in serum ↓; in urine ↑] Total protein in serum To investigate renal damage: Creatinine in serum Urea Serum potassium … Parathyroid Hyperfunction (Hyperparathyroidism): Test and Diagnosis

Parathyroid Hyperfunction (Hyperparathyroidism): Drug Therapy

Therapeutic target Normalization of serum calcium levels. Therapy recommendations – primary hyperparathyroidism (pPHT) For patients with symptomatic primary hyperparathyroidism who cannot be operated on or cannot be operated on immediately: Cinacalcet (calcimimetic). Agent of first choice Leads to a decrease in serum calcium and parathyroid hormone. Other possible medications – v. a. to protect against … Parathyroid Hyperfunction (Hyperparathyroidism): Drug Therapy

Parathyroid Hyperfunction (Hyperparathyroidism): Diagnostic Tests

Mandatory medical device diagnostics. The following procedures are suitable for determining the location of a possible adenoma: Magnetic resonance imaging (MRI) – computer-assisted cross-sectional imaging procedure (using magnetic fields, i.e. without X-rays). Sonography (ultrasound examination) Spiral computed tomography (CT) 99mTc-MIBI (methoxyisobutyl-isonitrile) scintigraphy Nuclear medicine procedure that can depict functional changes in the skeletal system in … Parathyroid Hyperfunction (Hyperparathyroidism): Diagnostic Tests