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, mainly pituitary and pancreatic tumors occur (pituitary and pancreatic tumors); in MEN 2, thyroid carcinoma and pheochromocytoma (mostly benign tumor that originates mainly in the adrenal gland and can lead to crisis-like increases in blood pressure)

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Ectopic (“not located in the physiological site”) parathyroid hormone production (neoplasm/new formation of body tissues).
  • Familial benign hypocalciuric hypercalcemia (calcium excess) – rare, autosomal-dominantly inherited disorder of calcium balance caused by an inactivating mutation of the calcium-sensitive receptor in the parathyroid gland and kidneys
  • Milk-alkali syndrome (Burnett syndrome) – disorder caused by an excess of alkalis such as milk and calcium carbonate; clinical presentation: Nausea (nausea)/vomiting, vertigo (dizziness), and ataxia (gait disturbance); laboratory diagnosis: Alkalosis with hypercalcemia (excess potassium) without increased calcium excretion in the urine and without a drop in phosphate content in the blood; hypercalcemia leads to calcinosis (calcium salt deposits) of the conjunctiva, the cornea of the eyes (“band keratitis” of the palpebral fissure) and in the renal tubules with the risk of renal insufficiency (slowly progressive reduction in renal function).
  • Addison’s disease – primary adrenocortical insufficiency leading to failure of cortisol and aldosterone production.
  • Pseudo-hyperparathyroidism – production of parathyroid substances by tumors.
  • Secondary hyperparathyroidism
  • Tertiary hyperparathyroidism
  • Thyrotoxicosis – metabolic derailment on the basis of hyperthyroidism (hyperthyroidism); life-threatening!

Musculoskeletal system and connective tissue (M00-M99).

  • Bone metastases – metastasis of tumor cells to bone.
  • Paget’s disease (synonyms: osteodystrophia deformans, Paget’s disease, Paget’s disease) – disease of the skeletal system in which there is gradual thickening of several bones, usually the spine, pelvis, extremities or skull.

Neoplasms – tumor diseases (C00-D48).

  • Parathyroid carcinoma
  • Plasmocytoma (multiple myeloma) – malignant tumor disease from the group of non-Hodgkin’s lymphomas. Its origin is in the lymphoid tissue, as in all lymphomas.

Medication

  • Lithium – drug used in bipolar disorder (manic-depressive illness) for phase prophylaxis.
  • Thiazides (diuretics (diuretic drugs)).

Secondary hyperparathyroidism

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Primary hyperparathyroidism
  • Pseudo-hypoparathyroidism
  • Tertiary hyperparathyroidism

Musculoskeletal system and connective tissue (M00-M99)

  • Bone metastases
  • Osteomalacia (softening of the bones)
  • Rickets – disorder of bone metabolism in children, leading to marked demineralization of bone and skeletal changes due to retardation of bone growth.

Tertiary hyperparathyroidism.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Primary hyperparathyroidism
  • Pseudo-hypoparathyroidism – production of parathyroid substances by tumors.
  • Secondary hyperparathyroidism

Musculoskeletal system and connective tissue (M00-M99)

  • Bone metastases
  • Osteomalacia (softening of the bones)
  • Rickets – disorder of bone metabolism in children leading to marked demineralization of bone and skeletal changes due to retardation of bone growth.