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| __NOTOC__
| | #Redirect [[Hyperparathyroidism]] |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{Infobox_Disease |
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| Name = Primary hyperparathyroidism |
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| Image = Illu thyroid parathyroid.jpg |
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| Caption = Thyroid and parathyroid. |
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| DiseasesDB = 6283 |
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| ICD10 = {{ICD10|E|21|0|e|20}} |
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| ICD9 = {{ICD9|252.01}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| MeshID = D049950 |
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| }}
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| {{Primary hyperparathyroidism}}
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| {{CMG}}
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| ==Overview==
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| '''Primary hyperparathyroidism''' causes [[hypercalcemia]] (elevated blood calcium levels) through the excessive secretion of [[parathyroid hormone]] (PTH), usually by an [[adenoma]] (benign tumors) of the [[parathyroid gland]]s. Its incidence is approximately 42 per 100,000 people. It is almost exactly three times as common in women as men.
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| ==Signs and Symptoms==
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| The signs and symptoms of primary hyperparathyroidism are those of hypercalcemia. They are classically summarized by the mnemonic "stones, bones, abdominal groans and psychic moans".
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| * "Stones" refers to [[kidney stones]], [[nephrocalcinosis]], and [[diabetes insipidus]] (polyuria and polydipsia). These can ultimately lead to [[renal failure]].
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| * "Bones" refers to bone-related complications. The classic bone disease in hyperparathyroidism is [[osteitis fibrosa cystica]], which results in pain and sometimes pathological fractures. Other bone diseases associated with hyperparathyroidism are [[osteoporosis]], [[osteomalacia]], and [[arthritis]].
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| * "Abdominal groans" refers to gastrointestinal symptoms of [[constipation]], [[indigestion]], [[nausea]] and [[vomiting]]. Hypercalcemia can lead to [[peptic ulcers]] and [[acute pancreatitis]].
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| * "Psychic moans" refers to effects on the [[central nervous system]]. Symptoms include lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma.
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| * [[Left ventricular hypertrophy]].<ref>{{cite journal |author=Stefenelli T, Abela C, Frank H, ''et al'' |title=Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up |journal=J. Clin. Endocrinol. Metab. |volume=82 |issue=1 |pages=106-12 |year=1997 |pmid=8989242 |doi= |url=http://jcem.endojournals.org/cgi/content/full/82/1/106}}</ref>
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| Other signs include proximal muscle weakness, itching, and band [[keratopathy]] of the eyes.
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| ==Diagnosis==
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| The diagnosis of primary hyperparathyroidism is made by blood tests. Serum calcium levels are elevated.
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| ==Complications==
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| The classic bone disease in hyperparathyroidism is [[osteitis fibrosa cystica]], which results in pain and sometimes pathological fractures. Other bone diseases associated with hyperparathyroidism are [[osteoporosis]], [[osteomalacia]], and [[arthritis]].
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| ==Treatment==
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| Treatment is usually surgical removal of the gland(s) containing adenomas.
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| ===Medications===
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| Medications include estrogen replacement therapy in postmenopausal women and [[bisphosphonate]]s. [[Bisphosphonate]]s may improve bone turnover.<ref name="pmid15240609">{{cite journal |author=Khan AA, Bilezikian JP, Kung AW, ''et al'' |title=Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=7 |pages=3319-25 |year=2004 |pmid=15240609 |doi=10.1210/jc.2003-030908}}</ref>
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| ===Surgery===
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| ==Related Chapters==
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| *[[Secondary hyperparathyroidism]]
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| *[[Tertiary hyperparathyroidism]]
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| ==References==
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| {{Reflist|2}}
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| {{Endocrine pathology}}
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| [[sv:Primär hyperparatyreos]]
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| {{WikiDoc Sources}}
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| [[Category:Endocrinology]]
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| [[Category:Disease]]
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