Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body's four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck.The parathyroid glands produce parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning.Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism.Secondary hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur.
Symptoms may be so mild and nonspecific that they don't seem at all related to parathyroid function, or they may be severe. The range of signs and symptoms include:Fragile bones that easily fracture (osteoporosis),Kidney stones,Excessive urination,Abdominal pain,Tiring easily or weakness,Depression or forgetfulness,Bone and joint pain,Frequent complaints of illness with no apparent cause,Nausea, vomiting or loss of appetite
The only 2 choices available for patients with primary hyperparathyroidism are to simply do nothing or to have the diseased parathyroid gland (or infrequently, more than one diseased parathyroid gland) surgically removed. Some physicians will elect to not refer their patients for an operation if they have a mild form of primary hyperparathyroidism.Much of this management style stems from the fact that standard parathyroid surgery in the past required the use of general anesthesia and was a major operation. But it's important to understand that parathyroid disease will get worse. It won't go away on its own. Remember, it is caused by a tumor that has developed from one of the parathyroid glands. Waiting will just allow the parathyroid tumor to grow bigger.Your age should also not be a reason to forego surgery. The new minimally invasive parathyroidectomy techniques have been performed on patients of many ages. The procedure uses local anesthesia that sends patients home in a matter of hours. To learn more, read our article about minimally invasive parathyroid surgery.
Primary hyperparathyroidism (PHPT) is a disease caused by overactive parathyroid glands with consequent hypercalcemia. The main cause in 85%-90% of cases, is the presence of a solitary parathyroid adenoma. In the other affected patients, hyperplasia or multiple adenomas occur, the latter common in familial forms. PHPT occurs most commonly in individuals over 50 years of age and in postmenopausal women, showing a prevalence of about 0.78% in patients evaluated in reference services. Although the clinical presentation is variable the asymptomatic hypercalcemia form, detected by routine screening, is the most common (50% to 80%). However, the presentation is variable, with patients demonstrating a range from normocalcemia to severe hypercalcemic PHPT.Results are expressed in absolute values and percentages, or means and standard deviation, as appropriate. 226 (34%) DU answered the questionnaire, providing data about 32,264 HD patients. The prevalence rate of severe SHP (PTH > 1,000 pg/mL) was 10.7 % (n = 3,463). 68 hospitals countrywide perform PTX. Around 40% of them are university centers. 49 (21.7%) DU reported not to have a specialized medical center to refer their patients with severe SHP. 74 (33%) DU reported that the time interval between surgery indication and its performance was over 6 months.