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Hyperparathyroidism

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Geriatric Diseases

Abstract

Tertiary hyperparathyroidism occurs in patients with chronic renal failure, increases with age and is higher in postmenopausal women. The incidental finding of asymptomatic PHPT in the older patient poses problems, and there is little guidance on how to manage them. In hyperparathyroidism, the plasma calcium level is rarely >3.00 mmol/L, but the ionised calcium is almost always elevated and is a more sensitive test. In secondary hyperparathyroidism (SHPT), the abnormality in the parathyroid glands is induced by a sustained hypocalcaemic stimulus and usually associated with parathyroid hyperplasia. Tertiary hyperparathyroidism occurs in patients with chronic renal failure. The chapter reviews hyperparathyroidism and the management.

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References

  1. Bolland MJ, Grey AB, Gamble GD, Reid LR. Association between primary hyperparathyroidism and increased body weight: A meta analysis. J Clin Endocrinol Metab. 2004; 90(3):1525.

    Article  PubMed  Google Scholar 

  2. Conroy S, Moulias S, Wassif WS. Primary hyperparathyroidism I n the older person. Age Ageing. 2003; 32: 571–578.

    Article  PubMed  Google Scholar 

  3. Adami S, Marcocci C, Gatt D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res. 2002;17(suppl 2): N18–23.

    PubMed  Google Scholar 

  4. Wermier RA, Khosle S, Atkinson EG, Achenbach SJ, Oberg AL, Grant CS, et al. The rise and fall of primary hyperparathyroidism : population based study in Rochester, Minnesota. Ann Int Med, 1997;126 (6): 433–40.

    Article  Google Scholar 

  5. Need AG, O’Loughlin PD, Morris HA, Horowitz M, Nordin BE. The effects of age and other variables on serum parathyroid hormone in postmenopausal women attending an osteoporosis center. J Clin Endocrinol Metab. 2004;89(4): 1646–9.

    Article  CAS  PubMed  Google Scholar 

  6. Alaami O, Fang TD, Song HM, Nacamuli RP. Physiological features of aging persons. Arch Surg 2003;138: 1068–1976.

    Article  Google Scholar 

  7. Chan AK, Duh QY, Katz MH, Siperstein AE, Clark OH. Clinical manifestations of primary hyperparathyroidism before and after parathyroidectomy: A case control study. Ann Surg. 1995; 222(3): 402–414.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Wahl RA, Hentschl F, Vorlander L, Schabram J. Primary hyperparathyroidism –early diagnosis in patients referred for surgery. Langenbecks Arch Surg. 2000; 385(8):515–20.

    Article  CAS  PubMed  Google Scholar 

  9. Bilezikian JP, Meng X, Shi Y, Silverberg SJ. Primary hyperthyroidism in women. New York and Beijing “A tale of two cities”. Int J Fertil Womens Med. 2000; 45:158–165.

    CAS  PubMed  Google Scholar 

  10. Mishra SK, Agarwal G, Kar DK, Gupta SK, Methal A, Rastad J. Unique clinical characteristics of primary hyperthyroidism in India. Br J Surg. 2001; 88 (5):708–714.

    Article  CAS  PubMed  Google Scholar 

  11. Mozes G, Curlee KJ, Rowland CM, van Heerden J, Thompson GB, Grant CS, et al. The predictive value of laboratory findings in patients with primary hyperparathyroidism. J Am Coll Surg. 2002; 194 (2):126–30.

    Article  PubMed  Google Scholar 

  12. Delorme S, Hoffner S. Diagnosis of hyperparathyroidism. Radiologe. 2003; 43(4):275–83.

    Article  CAS  PubMed  Google Scholar 

  13. Ernst O. Hyperparathyroidism: CT and MR findings. J Radiol 2009; 90(3):409–12. (abstract).

    Article  CAS  PubMed  Google Scholar 

  14. Marcocci C, Cianferotti L, Cetani F. Bone disease in primary hyperparathyroidism. Ther Adv Musculoskelet Dis. 2012 4(5): 357–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. National Institute of Health Consensus Development Conference Panel NIH conference. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference. Ann Intern Med. 1991; 110: 593–7.

    Google Scholar 

  16. Chow CC, Chan WB, Li JK,Chan NN, Chan MH, Ko GT, et al. Oral alendronate increases bone mineral density in post-menopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 2003;88 (2): 581–7.

    Article  CAS  PubMed  Google Scholar 

  17. Parker CR, Blackwell PJ, Fairbairn HJ, Hosking DJ. Alendronate in the treatment of primary hyperparathyroidism related osteoporosis. J Clin Endocrinol Metab. 2002;8(10):4482–9.

    Article  Google Scholar 

  18. Vestergaard P, Thomsen S. Medical treatment of secondary and tertiary hyperparathyroidism. Curr Drug Saf. 2011;6(2):108–12.

    Article  PubMed  Google Scholar 

  19. Pitt SC, Sippel Rebecca RS, Chen H. Secondary and tertiary hyperparathyroidism, State of the Art Surgical Management. Surg Clin North Am. 2009; 89(5):1227–1239.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dabbagh S. Renal osteodystrophy. Curr Opin Pediatr 1998; 10 (2): 190–6.

    Article  CAS  PubMed  Google Scholar 

  21. Cunningham J, Locatelli F, Rodriguez M. Secondary hyperparathyroidism: Pathogenesis, Disease Progression, and Therapeutic Options. CJASN. 2011; 6 (4):913–921.

    Article  CAS  PubMed  Google Scholar 

  22. Pitt SC, Sippi RS, Chen H. Secondary and tertiary hyperparathyroidism: State of the Art Surgical Management. Surg Clin North Am. 2009; 89(5): 1227–1239.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Drueke TB, Ritz E. treatment of secondary hyperparathyroidism in chronic kidney disease patients with cinacalcet/or vitamin D derivatives. Clin J Am Soc Nephrol. 2009;4 (1):234–41.

    Article  CAS  PubMed  Google Scholar 

  24. Nakai K, Komaba H, Fukugawa M. Management of mineral and bone disorder in chronic kidney disease. quo vadis? Ther Apher Dial. 2009; Suppl 1 S2–6.

    Google Scholar 

  25. Triponez F, Clark O, Vanrenthergem Y, Evenepoel P. Surgical treatment of persistent hyperparathyroidism after renal transplantation. Ann Surg. 2008;248:18.

    Article  PubMed  Google Scholar 

  26. Texas Institute for reproductive Medicine and Endocrine. PA. http://wwwhormoneproblem.com/Parathyr.htm. accessed 3 8.2012.

  27. Sciume S, Geraci G, Pisello, Facella T, Li Volsi F, Licata A, et al. Complications in thyroid surgery symptomatic post-operative hypoparathyroidism, incidence, surgical technique and treatment. Ann Ital Chir. 2006;77(2):115–22.

    PubMed  Google Scholar 

  28. Page C, Strunski V. Primary risk in total thyroidectomy for bilateral benign multinodular goitre: a report of 351surgical cases. L. Laryngol Otol. 2007;121:237–41.

    CAS  Google Scholar 

  29. Bilezkian JP, Khan I, Potts JT, Brandi ML, Clarke BL, Shoback D, et al. Hyperparathyroidism in the adult: Epidemiology, diagnosis, pathophysiology. Target-organ involvement. Treatment and challenges for future research. J Bone Min Res. 2011; 26(10):2317–2337.

    Article  Google Scholar 

  30. Hypoparathyroidism. Prolonged QT initially may progress to ventricular fibrillation or heart block. Patient.co.uk. Hyperparathyroidism. http://www.Patient.co.uk/doctor/hypoparathyroidism-pro. Retrieved on 26 February 2015.

  31. Hagstrom E, Hellman P, Larsson TE, Ingelsson E, Berglund G, Sundstrom J, et al. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation. 2009; 119: 2760–2771.

    Article  Google Scholar 

  32. Hedbach GM, Odin AS. Cardiovascular disease, hypertension and renal failure in primary hyperparathyroidism. J Int Med. 2002; 251:478–483.

    Google Scholar 

  33. Nilsson IL, Yin L, Lundgren E, Rastad CJ, Ekbom A. Clinical prevalence of primary hyperparathyroidism in Europe-nationwide cohort analysis on mortality from non malignant causes. J Bone Miner Res. 2002; 17 Suppl 2:N63–74.

    Google Scholar 

  34. Walker MD, Fleischer JB, Tullio MR, Homme S, Rinidek T, Stein EM, et al. Cardiac studies and diastolic function in mild primary hyperparathyroidism. Clin Endocrinol Metab. 2010; 95:2172–2173.

    Article  CAS  Google Scholar 

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Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2018). Hyperparathyroidism. In: Geriatric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-33434-9_48

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  • DOI: https://doi.org/10.1007/978-3-319-33434-9_48

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33433-2

  • Online ISBN: 978-3-319-33434-9

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