Parathyroid disease

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Parathyroid disease
Parathyroid adenoma low magnification
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Hypercalcemia, hypocalcemia, osteoporosis, kidney stones, fatigue, depression
Complications Osteitis fibrosa cystica, nephrocalcinosis, cardiac arrhythmia
Onset Varies depending on the specific condition
Duration Chronic
Types Primary hyperparathyroidism, secondary hyperparathyroidism, tertiary hyperparathyroidism, hypoparathyroidism
Causes Parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma, autoimmune disease, surgical removal
Risks Radiation exposure, genetic predisposition, multiple endocrine neoplasia
Diagnosis Blood test for calcium and parathyroid hormone levels, imaging studies
Differential diagnosis Hypercalcemia of malignancy, vitamin D deficiency, renal osteodystrophy
Prevention Depends on the underlying cause
Treatment Surgery, medication, calcium supplementation, vitamin D supplementation
Medication Calcimimetics, bisphosphonates, hormone replacement therapy
Prognosis Generally good with treatment, but varies
Frequency Common
Deaths Rare with appropriate treatment


Parathyroid disease refers to a group of disorders affecting the parathyroid glands, which are small endocrine glands located in the neck behind the thyroid gland. These glands are responsible for regulating the body's calcium levels through the secretion of parathyroid hormone (PTH).

Types of Parathyroid Disease

Parathyroid disease can be classified into several types, including:

Hyperparathyroidism

Hyperparathyroidism is a condition characterized by the overproduction of PTH. It can be further divided into:

  • Primary Hyperparathyroidism: This occurs when one or more of the parathyroid glands become overactive, often due to a benign tumor called a parathyroid adenoma.
  • Secondary Hyperparathyroidism: This is a compensatory response to chronic low calcium levels, often seen in patients with chronic kidney disease.
  • Tertiary Hyperparathyroidism: This occurs when secondary hyperparathyroidism becomes autonomous and continues even after the initial cause is resolved.

Hypoparathyroidism

Hypoparathyroidism is a condition where there is insufficient production of PTH, leading to low calcium levels in the blood. Causes can include:

  • Surgical removal or damage to the parathyroid glands during thyroidectomy or other neck surgeries.
  • Autoimmune destruction of the parathyroid glands.
  • Genetic disorders affecting parathyroid gland development.

Symptoms

The symptoms of parathyroid disease vary depending on whether the condition is hyperparathyroidism or hypoparathyroidism.

Symptoms of Hyperparathyroidism

Symptoms of Hypoparathyroidism

Diagnosis

Diagnosis of parathyroid disease typically involves:

  • Blood tests to measure levels of calcium, PTH, and phosphorus.
  • Imaging studies such as ultrasound, sestamibi scan, or CT scan to identify abnormal parathyroid glands.
  • Bone density tests to assess the impact on bone health.

Treatment

Treatment options depend on the type and severity of the parathyroid disease.

Treatment of Hyperparathyroidism

  • Surgical removal of the overactive parathyroid gland(s) (parathyroidectomy).
  • Medications to manage calcium levels, such as bisphosphonates or calcimimetics.

Treatment of Hypoparathyroidism

  • Calcium and vitamin D supplements to maintain normal calcium levels.
  • Recombinant human PTH in some cases.

See Also

References



External Links

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Contributors: Prab R. Tumpati, MD