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Assessment of Hyperparathyroidism

  • Judit Konya
  • Mo Aye
  • R. James England
  • Stephen L. Atkin
Chapter

Abstract

Parathyroid hormone (PTH) in concert with 1,25-dihydroxyvitamin D regulates the level of calcium and phosphate from skeletal, renal, and intestinal actions. Hyperparathyroidism (HPT) is a common endocrinological disease characterized by an elevated parathyroid hormone (PTH). Hyperparathyroidism can be primary (autonomous hyperfunction of one or more parathyroid glands), secondary (physiological response to hypocalcemia due to an underlying disease), or tertiary (post renal transplantation).

Primary HPT may be minimally symptomatic and coincidentally found. However, the signs and symptoms of hypercalcemia include renal, neurocognitive, musculoskeletal, gastrointestinal, and cardiovascular manifestations. Differential diagnoses that should be considered include vitamin D deficiency, malignancy, familial hypocalciuric hypercalcemia, and lithium or thiazide therapy.

The definitive treatment of primary HPT is parathyroidectomy; however, the clinical and biochemical features may suggest that observation alone is optimal for the patient.

Keywords

Serum Calcium Parathyroid Gland Parathyroid Carcinoma Decrease Bone Mineral Density Osteitis Fibrosa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

BMD

Bone mineral density

CaE

Fractional excretion of calcium

CaHPO4

Calcium phosphate

CaSR

Calcium-sensing receptor

dRTA

Distal renal tubular acidosis

FHH

Familial hypocalciuric hypercalcemia

MEN

Multiple endocrine neoplasia

PHPT

Primary hyperparathyroidism

PTA

Proximal renal tubular acidosis

PTH

Parathyroid hormone

PTHrP

Parathormone-related peptide

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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Judit Konya
    • 1
  • Mo Aye
    • 2
  • R. James England
    • 3
  • Stephen L. Atkin
    • 1
  1. 1.Department of Diabetes, Endocrinology and MetabolismUniversity of Hull, Brocklehurst Building, Hull Royal InfirmaryHullUK
  2. 2.Department of Diabetes, Endocrinology and MetabolismCentre for Metabolic Bone Disease Hull and East Yorkshire Hospitals NHS Trust, Hull Royal InfirmaryHullUK
  3. 3.Department of ENT/Head and Neck SurgeryHull and East Yorkshire Hospitals NHS Trust, Castle Hill HospitalEast Riding of YorkshireUK

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