What is hyperparathyroidism?

Hyperparathyroidism is defined as the increased secretion of parathyroid hormone, which leads to a rise in calcium in the blood and urine. Depending on the cause, hyperparathyroidism is divided into primary, secondary or tertiary.

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What is the incidence of primary hyperparathyroidism, at what age does it occur and in which sex is it most common?

The incidence of primary hyperparathyroidism is about 50 per 100,000 people per year. It can occur at any age, with a peak age above 55 to 65 years. It is 2 times more common in women.

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What are the causes?

The cause of hyperparathyroidism is usually:

  • a solitary parathyroid adenoma,

Less commonly, hyperparathyroidism may be a:

  • the first manifestation of rare forms of genetic syndromes called Multiple Endocrine Neoplasia Syndromes 1 (MEN1) and 2A (MEN2A).

A very rare cause of hyperparathyroidism may be:

Sometimes hyperparathyroidism can be caused by a:

  • a familial syndrome called Familial Hypocalciuric Hypercalcemia (FHH), which leads to mild hypercalcemia for life in 50% of offspring.
  • Ectopic secretion of parathyroid hormone

Other causes not primarily related to the parathyroid glands, but secondarily lead to their increased secretion, are:

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How is hyperparathyroidism diagnosed?

Hyperparathyroidism is diagnosed through blood tests, physical examination and history. However, finding the cause of hyperparathyroidism and differentiating it from other causes leading to a rise in blood calcium requires a combination of haematological and specialised imaging studies.

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What are the Symptoms and Signs of Primary Hyperparathyroidism?

The symptoms and signs of primary hyperparathyroidism can range from none to very severe and can be life-threatening.

  • Asymptomatic
  • Osteitis fibrosa cystica
  • Nephrolithiasis (kidney stones)
  • Kidney Failure
  • Nephrocalcinosis
  • Osteopenia and Osteoporosis
  • Fractures
  • Fatigue, Muscle Weakness
  • Polydipsia, Polyuria
  • Constipation, Abdominal pain
  • Depression, Personality Disorder
  • Poor Concentration
  • Hypertension, Arrhythmias, Calcifications
  • Pancreatitis
  • Peptic Ulcer
  • Anorexia, nausea, vomiting
  • Gout
  • Parathyroid crisis
  • Coma
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What are the complications of Hyperparathyroidism?

The complications of hyperparathyroidism are due to the consequences of low calcium in the bones and high calcium in the blood:

  • Osteoporosis
  • Fractures
  • Nephrolithiasis (kidney stones)
  • Nephrocalcinosis
  • Kidney Failure
  • Cardiovascular disease
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Treatment of Hyperparathyroidism

/ / / Surgical Treatment

Patients presenting with symptoms due to hyperparathyroidism, such as nephrolithiasis, fractures or symptomatic hypercalcaemia should receive surgical treatment. Parathyroidectomy is the only definitive treatment. On the other hand, asymptomatic patients, who have advanced disease or are under 50 years of age are also candidates for surgical treatment. The aim of parathyroidectomy is to remove the parathyroid adenoma and resolve the hyperparathyroidism.

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/ / / Medical Treatment

In patients who, while meeting the above criteria, cannot be operated on, we administer medical therapy. Medical treatment is individualized and aims to reduce the increased calcium levels causing symptoms and/or improve bone density.

In our clinic, we provide individualized diagnosis and treatment based on our many years of experience in sporadic and hereditary forms of hyperparathyroidism.

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