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Hyperparathyroidism – excess production of parathyroid hormone.
Primary hyperparathyroidism - Hypercalcemia with elevated or inappropriately normal conc of PTH Most commonly due to a benign overgrowth of parathyroid tissue ( adenoma) in a single gland ( in 80 % cases ) or as a multiple gland disorder. The problem is in the gland. A common disorder which can cause significant renal and skeletal complications.
Persistent hypercalcemia and an elevated PTH. Exceptions are if the patient is on thiazide diuretics , lithium excess , 24 hr urinary calcium and creatinine excretion can be used further in evaluation particularly to r/o a rare condition familial hypocalciuric hypercalcemia.
Happens due to the result of a physiological or pathophysiologic response to hypocalcemia in an attempt to maintain calcium balance, for e.g in circumstances as vitamin D deficiency Chronic renal failure and the resulting alterations in Vit D , phosphorus and calcium
Any condition causing hypocalcemia or Vitamin D deficiency can lead to secondary hyperparathyroidismThe problem is extrinsic.
Diagnosis based on clinical presentation and metabolic derangement. Assessment consists of monitoring the values of PTH , calcium , phosphorus , VIt D & renal function.
Tertiary hyperparathyroidism - Less common A progression from long standing secondary...
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