Centres of Excellence -> Endocrinology and Diabetes -> Hyperparathyroidism

Hyperparathyroidism (overproduction of parathyroid hormone)

Increased function of the parathyroid glands is characterized by an excess secretion of their hormone - parathyroid hormone (PTH) - which increases the concentration of calcium in the blood by mobilizing calcium from the bones. We call such a condition primary hyperparathyroidism.

Causes of primary hyperparathyroidism

The most common causes of primary hyperparathyroidism are enlargement (benign hyperplasia) of one or more parathyroid glands and benign tumors of the parathyroid glands (in 85% of cases they are adenomas). Adenomas occur as an isolated disease or as part of MEN syndrome or different family syndromes caused by mutations of certain genes.

Symptoms of primary hyperparathyroidism

Symptoms of primary hyperparathyroidism are basically symptoms and complications of hypercalcemia. Depending on the level of PTH and calcium in the blood, patients are asymptomatic, have mild symptoms or a strongly pronounced clinical picture that includes the formation of kidney stones with all their complications, muscle weakness, fatigue and muscle pain, digestive disorders (nausea, vomiting), cardiovascular (changes in the ECG, deposition of calcium in the walls of blood vessels, increase in blood pressure), nervous (lethargy, disorders of consciousness, coma), nephrological (profuse urination) and bone system (osteoporosis due to mobilization of calcium from the skeleton).

Diagnosis and treatment of primary hyperparathyroidism

The diagnostic procedure includes a specialist, ultrasound and scintigraphic examination of the parathyroid glands, laboratory and hormonal tests and other methods (densitometry). During treatment, the method of choice is surgical removal of the pathological process with the possibility of postoperative (iatrogenic) hypoparathyroidism . An elevated level of calcium in the blood is treated with plenty of fluids, sometimes corticosteroids and other medications.

Symptoms of secondary and tertiary hyperparathyroidism

Secondary hyperparathyroidism is characterized by increased secretion of the hormone PTH from the parathyroid glands in response to any condition that causes a decrease in blood calcium levels. Most often, it is a lack of vitamin D and all conditions associated with chronic renal failure. Other etiological factors include chronic malnutrition, difficulties with calcium absorption in the intestines and chronic diseases of the liver and pancreas.

Tertiary hyperparathyroidism is characterized by autonomous secretion of PTH, independent of the level of calcium in the blood. One of the causes is cancer of the parathyroid glands and other malignant tumors that secrete PTH.

Diagnosis and treatment of secondary and tertiary hyperparathyroidism

Treatment depends on the etiology of the disorder. The diagnostic procedure includes specialist, ultrasound and scintigraphic examination of the parathyroid glands, laboratory and hormonal tests and other methods (densitometry).

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