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Hyperparathyroidism (HPT)

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Parathyroid Gland Disorders

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Abstract

Hyperparathyroidism (HPT) was initially thought to be rare and always presenting with advanced renal and skeletal pathology. Nowadays, it is considered a common endocrine disorder with a rising incidence, four times more common in women than men. It is the third commonest endocrine condition after thyroid disease and diabetes mellitus, and is frequently diagnosed in asymptomatic patients. Hyperparathyroidism could be sporadic or familial. Familial HPT (FHPT) accounts for 1–2% of cases of HPT in adults, but 25–45% in children. HPT is classified into primary (PHPT), secondary (SHPT), and tertiary (THPT) reflecting the different mechanisms by which excess of PTH develops from overproduction of PTH by the parathyroid gland. PHPT results from parathyroid hyperplasia or parathyroid tumors of which nearly 90% are benign (adenoma) and 10% are malignant (adenocarcinoma). Parathyroid surgeons must adopt a pragmatic approach when choosing diagnostic tests (not to over-investigate), selecting right operations (simpler, better), aiming at providing excellent outcomes (to meet high patient expectations), and to achieve all of these in the most cost-effective way (government priority). This chapter explores the epidemiology, etiology, surgical pathology, clinical picture, diagnosis (diagnostic and localizing studies), and treatment of PHPT, SHPT, and THPT. It also discusses special situations of PHPT disorder, namely, PHPT in children, in the elderly, and in pregnancy, in addition to PHPT with intra-thoracic parathyroids and cancer in PHPT. Finally, this chapter addresses the disorder of familial HPT in multiple endocrine neoplasia syndromes.

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  1. Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Mahmoud F. Sakr

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Sakr, M.F. (2022). Hyperparathyroidism (HPT). In: Parathyroid Gland Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-07418-9_7

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