Primary hyperparathyroidism

Alternative names

Parathyroid-related hypercalcemia

Definition

Primary hyperparathyroidism involves excessive production of parathyroid hormone, caused by enlargement of one or more of the parathyroid glands.

Causes, incidence, and risk factors

The parathyroid glands are located at the front and base of the neck at the 4 corners of the thyroid gland. The glands produce parathyroid hormone (PTH), which regulates calcium and phosphorus balance in the body.

In primary hyperparathyroidism, increased secretion of parathyroid hormone occurs because one or more of the glands have become enlarged. The effects of increased calcium are seen in several body systems including the skeletal, gastrointestinal, renal (kidney), muscular, and central nervous system.

The disease is most common in people over 60, but can also be seen in younger adults. Women are more likely to be affected than men. Radiation to the head and neck increases risk. Hyperparathyroidism in childhood is distinctly unusual.

Rarely, the disease is caused by parathyroid carcinoma.

Symptoms

• Fatigue
  
• Fractures
  
• Decreased height
  
• Upper Abdominal pain
  
• Loss of appetite
  
• nausea
  
• Muscular weakness
  
• Muscle pain
  
• Depression
  
• Personality changes
  
• Stupor and possibly coma
  
• Kidney stones
  
• Increased urination
  

Signs and tests

• Radioimmunoassay of parathyroid hormone shows an increased level.
  
• Serum calcium is increased.
  
• Serum phosphorus may be decreased.
  
• Serum alkaline phosphatase may be increased.
  
• Bone x-ray may show bone reabsorption or fractures.
  
• Imaging of the kidneys or ureters may show calcification or obstruction.
  
• ECG may show abnormalities.