HYPERPARATHYROIDISM

Highlights :

HYPERPARATHYROIDISM

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Friday, 11 December 2009 08:57

HYPERPARATHYROIDISM

"The disease of bones, stones and abdominal groans"

Types:
Ä 1ry: "Commonest due to ® parathyroid adenoma 85%
or ® hyperplasia of parathyroids
Ä 2 ry: hormone as a feedback to low Ca. bl. level.
ÄTertiary: autonomous hyperplastic tissue due to long period of hypocalcaemia e.g. in renal failure
Clinical Picture:
Ä Mobilization of Ca. from bones ®
(1) Bone cysts "lower jaw"
(2) Path. fr. & wedging of vertebrae.
Ä Ca excretion ® recurrent multiple stones which may lead to renal damage.
ÄGastric & pancreatic secretion ® peptic ulcer and pancreatitis.
Diagnosis:
Ä Blood ® bl. calcium with ¯ bl. phosphorous.
ÄUrine ® urine Ca & phosphorous.
Ä X-ray on bones ® bone cysts.
Ä Radio immunoassay ® parathormone hormone.
Differential Diagnosis:
1. From other causes of hypercalcemia: bone secondaries, Paget’s disease of bone, sarcoidosis.
2. Renal tubular acidosis.
3. Hypervitaminosis D.
Treatment:
1- Parathyroid adenoma ® Excise the adenoma.
2- Parathyroid hyperplasia ® Excise 3 glands and most of the 4th. The remaining part may be transplanted to the Biceps muscle to facilitate re-exploration if needed.
SOURCE: Prof. AYMAN SALEM'S BOOK
Copyright: (Vascular Society of Egypt ) & (Medical Educational web)
Not to be reproduced without permission of Vascular Society of Egypt

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