hyperparathyroidism

• hyperparathyroidism is characterized by abnormally high levels of parathyroid hormones in the blood and this is due to overactivity of the parathyroid glands
• we have primary,secondary and tertiary hyperparathyroidism
• tertiary hyperthyroidism is a result of prolonged persistent secondary hyperthyroidism
• the aim of parathyroid hormones is to increase levels of calcium and reduce levels of phosphate in the blood
• PTH affects bones,kidneys and gut(intestine)
• primary hyperparathyroidism is common cause of hypercalcemia
• causes of primary hyperparathyroidism include: adenoma,hyperplasia and carcinoma/MEN syndrome type1 and type2
• sign of primary hyperparathyroidism include: high PTH, hypercalcemia,hypercalciuria,phosphouria-lead to hypophosphatemia
• primary hyperparathyroidism treatment include: 1)Parathyroidectomy. 2)if surgery fails, give calcimimetics
• secondary hyperparathyroidism is associated with CKD and low vitamin D levels.
• signs of secondary hyperparathyroidisn include: 1)Hyperparathyroidemia. 2)normo/hypocalcemia-because of low vitamin D. 3)hyperphosphotemia-because damaged kidneys cannot excrete phosphate
• secondary hyperparathyroidism treatment include: 1)treating chronic kidney disease. 2)low phosphate diet. 3)give phosphate binders. 4)Ergocalciferol
• because of prolonged persistent secondary hyperparathyroidism, hyperplasia will develop and this is tertiary type of hyperparathyroidism
• there will be an incraese in both calcium and phosphate levels in tertiary hyperparathyroidism
• signs of tertiary hyperparathyroidism include: extreme high parathyroid hormones, hypercalcemia, hyperphosphotemia
• tertiary hyperparathyroidism treatment include: Parathyroidectomy and calcemimetics