is overactivity of the
Parathyroid Gland s resulting in excess production of
Parathyroid Hormone (PTH). Increased PTH consequently leads to increased serum calcium (
Hypercalcemia ) due to 1) increased bone resorption, allowing flow of calcium from bone to blood, 2) reduces renal clearance of calcium, and 3) increases intestinal calcium absorption.
The majority of patients with hyperparathyroidism are asymptomatic. Manifestations of hyperparathyroidism usually involves the kidney (stones) and the skeletal system (bone pain due to fibrous tissue replacement, termed
Osteitis Fibrosa Cystica )
If symptomatic, hyperparathyroidism can be classically remembered by the rhyme "moans" (myalgia), "groans" (abdominal pain), "stones" (kidney), "bones" (bone pain), and "psychiatric overtones" (confusion, altered mental state, lethargy, fatigue).
Other symptoms include:
Headache s,
Sleep Disorder s, memory problems,
Gastroesophageal Reflux , decreased sex drive, thinning hair,
Hypertension , and heart palpitations.
The gold standard of diagnosis is the
PTH Immunoassay . Once an elevated PTH has been confirmed, goal of diagnosis is to determine whether the hyperparathyroidism is primary or secondary in origin by obtaining a serum
Calcium level. If the calcium level is high, then the diagnosis is very likely
Primary Hyperparathyroidism ; if low or normal, then it is most likely
Secondary Hyperparathyroidism .
Treatment is first and foremost directed at hypercalcemia, if symptomatic. (see
Hypercalcemia )
If asymptomatic, treatment can then be directed towards the underlying cause
