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| style="background: #F0FFFF; text-align: center;" |Cardiac complications<ref name="pmid8989242">{{cite journal |vauthors=Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B |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=10.1210/jcem.82.1.3666 |url=}}</ref>
| style="background: #F0FFFF; text-align: center;" |Cardiac complications<ref name="pmid8989242">{{cite journal |vauthors=Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B |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=10.1210/jcem.82.1.3666 |url=}}</ref>
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*Aortic and mitral valve calcification
*Calcific deposits in the myocardium
*Left ventricular hypertrophy
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| style="background: #F0FFFF; text-align: center;" |Endocrine complications
| style="background: #F0FFFF; text-align: center;" |Endocrine complications<ref name="pmid22874807">{{cite journal |vauthors=Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ |title=The association of primary hyperparathyroidism with pancreatitis |journal=J. Clin. Gastroenterol. |volume=46 |issue=8 |pages=656–61 |year=2012 |pmid=22874807 |pmc=4428665 |doi=10.1097/MCG.0b013e31825c446c |url=}}</ref>
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*Pancreatitis
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| style="background: #F0FFFF; text-align: center;" |Gastrointestinal complications
| style="background: #F0FFFF; text-align: center;" |Gastrointestinal complications<ref name="pmid3878002">{{cite journal |vauthors=Corlew DS, Bryda SL, Bradley EL, DiGirolamo M |title=Observations on the course of untreated primary hyperparathyroidism |journal=Surgery |volume=98 |issue=6 |pages=1064–71 |year=1985 |pmid=3878002 |doi= |url=}}</ref>
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*Peptic ulcer disease
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| style="background: #F0FFFF; text-align: center;" |Hematologic complications
| style="background: #F0FFFF; text-align: center;" |Hematologic complications
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| style="background: #F0FFFF; text-align: center;" |Metabolic complications
| style="background: #F0FFFF; text-align: center;" |Metabolic complications<ref name="pmid3812520">{{cite journal |vauthors=Fitzpatrick LA, Bilezikian JP |title=Acute primary hyperparathyroidism |journal=Am. J. Med. |volume=82 |issue=2 |pages=275–82 |year=1987 |pmid=3812520 |doi= |url=}}</ref><ref name="pmid25447624">{{cite journal |vauthors=Ahmad S, Kuraganti G, Steenkamp D |title=Hypercalcemic crisis: a clinical review |journal=Am. J. Med. |volume=128 |issue=3 |pages=239–45 |year=2015 |pmid=25447624 |doi=10.1016/j.amjmed.2014.09.030 |url=}}</ref><ref name="pmid3878002">{{cite journal |vauthors=Corlew DS, Bryda SL, Bradley EL, DiGirolamo M |title=Observations on the course of untreated primary hyperparathyroidism |journal=Surgery |volume=98 |issue=6 |pages=1064–71 |year=1985 |pmid=3878002 |doi= |url=}}</ref><ref name="pmid11493580">{{cite journal| author=Lips P| title=Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. | journal=Endocr Rev | year= 2001 | volume= 22 | issue= 4 | pages= 477-501 | pmid=11493580 | doi=10.1210/edrv.22.4.0437 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11493580  }} </ref>
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*Hypercalcemic crisis
*Osteomalacia
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| style="background: #F0FFFF; text-align: center;" |Neurologic complications
| style="background: #F0FFFF; text-align: center;" |Neurologic complications
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| style="background: #F0FFFF; text-align: center;" |Neuromuscular complications
| style="background: #F0FFFF; text-align: center;" |Neuromuscular complications
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*Neuropathic muscle disease
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| style="background: #F0FFFF; text-align: center;" |Pregnancy related complications
| style="background: #F0FFFF; text-align: center;" |Pregnancy related complications<ref name="pmid17569990">{{cite journal |vauthors=Poomthavorn P, Ongphiphadhanakul B, Mahachoklertwattana P |title=Transient neonatal hypoparathyroidism in two siblings unmasking maternal normocalcemic hyperparathyroidism |journal=Eur. J. Pediatr. |volume=167 |issue=4 |pages=431–4 |year=2008 |pmid=17569990 |doi=10.1007/s00431-007-0528-6 |url=}}</ref>
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*Neonatal hypoparathyroidism
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| style="background: #F0FFFF; text-align: center;" |Psychiatric complications
| style="background: #F0FFFF; text-align: center;" |Psychiatric complications<ref name="pmid19336505">{{cite journal |vauthors=Walker MD, McMahon DJ, Inabnet WB, Lazar RM, Brown I, Vardy S, Cosman F, Silverberg SJ |title=Neuropsychological features in primary hyperparathyroidism: a prospective study |journal=J. Clin. Endocrinol. Metab. |volume=94 |issue=6 |pages=1951–8 |year=2009 |pmid=19336505 |pmc=2690425 |doi=10.1210/jc.2008-2574 |url=}}</ref><ref name="pmid21917870">{{cite journal |vauthors=Espiritu RP, Kearns AE, Vickers KS, Grant C, Ryu E, Wermers RA |title=Depression in primary hyperparathyroidism: prevalence and benefit of surgery |journal=J. Clin. Endocrinol. Metab. |volume=96 |issue=11 |pages=E1737–45 |year=2011 |pmid=21917870 |doi=10.1210/jc.2011-1486 |url=}}</ref><ref name="pmid2608590">{{cite journal |vauthors=McAllion SJ, Paterson CR |title=Psychiatric morbidity in primary hyperparathyroidism |journal=Postgrad Med J |volume=65 |issue=767 |pages=628–31 |year=1989 |pmid=2608590 |pmc=2429194 |doi= |url=}}</ref>
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*Anxiety
*Cognitive dysfunction including verbal memory and nonverbal abstraction
*Depression
*Irritability
*Lack of concentration
*Sleep disturbances
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| style="background: #F0FFFF; text-align: center;" |Renal complications
| style="background: #F0FFFF; text-align: center;" |Renal complications<ref name="pmid12412783">{{cite journal |vauthors=Peacock M |title=Primary hyperparathyroidism and the kidney: biochemical and clinical spectrum |journal=J. Bone Miner. Res. |volume=17 Suppl 2 |issue= |pages=N87–94 |year=2002 |pmid=12412783 |doi= |url=}}</ref><ref name="pmid22470864">{{cite journal |vauthors=Lila AR, Sarathi V, Jagtap V, Bandgar T, Menon PS, Shah NS |title=Renal manifestations of primary hyperparathyroidism |journal=Indian J Endocrinol Metab |volume=16 |issue=2 |pages=258–62 |year=2012 |pmid=22470864 |pmc=3313745 |doi=10.4103/2230-8210.93745 |url=}}</ref><ref name="pmid19808852">{{cite journal |vauthors=Tassone F, Gianotti L, Emmolo I, Ghio M, Borretta G |title=Glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism |journal=J. Clin. Endocrinol. Metab. |volume=94 |issue=11 |pages=4458–61 |year=2009 |pmid=19808852 |doi=10.1210/jc.2009-0587 |url=}}</ref>
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*Hypercalciuria
*Nephrolithiasis
*Nephrocalcinosis
*Renal insufficiency (impairement of GFR)
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| style="background: #F0FFFF; text-align: center;" |Rheumatologic complications
| style="background: #F0FFFF; text-align: center;" |Rheumatologic complications<ref name="pmid20305774">{{cite journal |vauthors=Michael JW, Schlüter-Brust KU, Eysel P |title=The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee |journal=Dtsch Arztebl Int |volume=107 |issue=9 |pages=152–62 |year=2010 |pmid=20305774 |pmc=2841860 |doi=10.3238/arztebl.2010.0152 |url=}}</ref><ref>{{cite book | last = Hochberg | first = Marc | title = Rheumatology|chapter=204. Primary hyperparathyroidism: rheumatologic manifestations and bone disease |page=1668| publisher = Mosby/Elsevier | location = Philadelphia, PA | year = 2015 | isbn = 9780323091381}}</ref><ref name="pmid11890884">{{cite journal |vauthors=Rubin MR, Silverberg SJ |title=Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy |journal=Curr Rheumatol Rep |volume=4 |issue=2 |pages=179–85 |year=2002 |pmid=11890884 |doi= |url=}}</ref>
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Revision as of 18:23, 22 August 2017

Hyperparathyroidism Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

Primary hyperparathyroidism

  • Primary hyperparathyroidism usually develops in the fifth decade of life, in post-menopausal women and starts as asymptomatic hypercalcemia in presence of increased parathyroid hormone.
  • If left untreated, some of patients with primary hyperparathyroidism may commonly develop marked hypercalcemia, marked hypercalciuria, cortical bone demineralization and nephrolithiasis.[1][2]

Secondary hyperparathyroidism

  • Secondary hyperparathyroidism arise in the early course of chronic renal failure. As renal failure progress, secondary hyperparathyroidism becomes more notable.[3]
  • Secondary hyperparathyroidism leads to vascular calcification due to elevated calcium and phosphorus levels. This is strongly associated with increase in morbidity and mortality.[4]
  • If left untreated, secondary hyperparathyroidism carries an increased risk of vascular calcification with increasing age and duration of dialysis in patients.

Tertiary hyperparathyroidism

  • Tertiary hyperparathyroidism usually develops in post renal transplant patients.
  • If left untreated, tertiary hyperparathyroidism in post renal transplant patients may carry the risk of amyloid deposition, calciphylaxis, destructive or erosive spondyloarthropathy, osteonecrosis, and musculoskeletal infections.[5]

Complications

Complications involving Organ system Complications of hyperparathyroidism
Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism
Cardiac complications[6]
  • Aortic and mitral valve calcification
  • Calcific deposits in the myocardium
  • Left ventricular hypertrophy
Endocrine complications[7]
  • Pancreatitis
Gastrointestinal complications[8]
  • Peptic ulcer disease
Hematologic complications ---
Metabolic complications[9][10][8][11]
  • Hypercalcemic crisis
  • Osteomalacia
Neurologic complications ---
Neuromuscular complications
  • Neuropathic muscle disease
Pregnancy related complications[12]
  • Neonatal hypoparathyroidism
Psychiatric complications[13][14][15]
  • Anxiety
  • Cognitive dysfunction including verbal memory and nonverbal abstraction
  • Depression
  • Irritability
  • Lack of concentration
  • Sleep disturbances
Renal complications[1][16][17]
  • Hypercalciuria
  • Nephrolithiasis
  • Nephrocalcinosis
  • Renal insufficiency (impairement of GFR)
Rheumatologic complications[18][19][20]
Skeletal complications
System non-specific complications

Prognosis

  • Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
  • Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
  • The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
  • [Subtype of disease/malignancy] is associated with the most favorable prognosis.
  • The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.

References

  1. ↑ 1.0 1.1 Peacock M (2002). "Primary hyperparathyroidism and the kidney: biochemical and clinical spectrum". J. Bone Miner. Res. 17 Suppl 2: N87–94. PMID 12412783.
  2. ↑ Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, Jacobs TP, Siris ES, Cafferty M, Parisien MV (1989). "Skeletal disease in primary hyperparathyroidism". J. Bone Miner. Res. 4 (3): 283–91. doi:10.1002/jbmr.5650040302. PMID 2763869.
  3. ↑ Nikodimopoulou M, Liakos S (2011). "Secondary hyperparathyroidism and target organs in chronic kidney disease". Hippokratia. 15 (Suppl 1): 33–8. PMC 3139677. PMID 21897756.
  4. ↑ Cunningham J, Locatelli F, Rodriguez M (2011). "Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options". Clin J Am Soc Nephrol. 6 (4): 913–21. doi:10.2215/CJN.06040710. PMID 21454719.
  5. ↑ Jevtic V (2003). "Imaging of renal osteodystrophy". Eur J Radiol. 46 (2): 85–95. doi:10.1016/S0720-048X(03)00072-X. PMID 12714225.
  6. ↑ Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B (1997). "Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up". J. Clin. Endocrinol. Metab. 82 (1): 106–12. doi:10.1210/jcem.82.1.3666. PMID 8989242.
  7. ↑ Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ (2012). "The association of primary hyperparathyroidism with pancreatitis". J. Clin. Gastroenterol. 46 (8): 656–61. doi:10.1097/MCG.0b013e31825c446c. PMC 4428665. PMID 22874807.
  8. ↑ 8.0 8.1 Corlew DS, Bryda SL, Bradley EL, DiGirolamo M (1985). "Observations on the course of untreated primary hyperparathyroidism". Surgery. 98 (6): 1064–71. PMID 3878002.
  9. ↑ Fitzpatrick LA, Bilezikian JP (1987). "Acute primary hyperparathyroidism". Am. J. Med. 82 (2): 275–82. PMID 3812520.
  10. ↑ Ahmad S, Kuraganti G, Steenkamp D (2015). "Hypercalcemic crisis: a clinical review". Am. J. Med. 128 (3): 239–45. doi:10.1016/j.amjmed.2014.09.030. PMID 25447624.
  11. ↑ Lips P (2001). "Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications". Endocr Rev. 22 (4): 477–501. doi:10.1210/edrv.22.4.0437. PMID 11493580.
  12. ↑ Poomthavorn P, Ongphiphadhanakul B, Mahachoklertwattana P (2008). "Transient neonatal hypoparathyroidism in two siblings unmasking maternal normocalcemic hyperparathyroidism". Eur. J. Pediatr. 167 (4): 431–4. doi:10.1007/s00431-007-0528-6. PMID 17569990.
  13. ↑ Walker MD, McMahon DJ, Inabnet WB, Lazar RM, Brown I, Vardy S, Cosman F, Silverberg SJ (2009). "Neuropsychological features in primary hyperparathyroidism: a prospective study". J. Clin. Endocrinol. Metab. 94 (6): 1951–8. doi:10.1210/jc.2008-2574. PMC 2690425. PMID 19336505.
  14. ↑ Espiritu RP, Kearns AE, Vickers KS, Grant C, Ryu E, Wermers RA (2011). "Depression in primary hyperparathyroidism: prevalence and benefit of surgery". J. Clin. Endocrinol. Metab. 96 (11): E1737–45. doi:10.1210/jc.2011-1486. PMID 21917870.
  15. ↑ McAllion SJ, Paterson CR (1989). "Psychiatric morbidity in primary hyperparathyroidism". Postgrad Med J. 65 (767): 628–31. PMC 2429194. PMID 2608590.
  16. ↑ Lila AR, Sarathi V, Jagtap V, Bandgar T, Menon PS, Shah NS (2012). "Renal manifestations of primary hyperparathyroidism". Indian J Endocrinol Metab. 16 (2): 258–62. doi:10.4103/2230-8210.93745. PMC 3313745. PMID 22470864.
  17. ↑ Tassone F, Gianotti L, Emmolo I, Ghio M, Borretta G (2009). "Glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism". J. Clin. Endocrinol. Metab. 94 (11): 4458–61. doi:10.1210/jc.2009-0587. PMID 19808852.
  18. ↑ Michael JW, Schlüter-Brust KU, Eysel P (2010). "The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee". Dtsch Arztebl Int. 107 (9): 152–62. doi:10.3238/arztebl.2010.0152. PMC 2841860. PMID 20305774.
  19. ↑ Hochberg, Marc (2015). "204. Primary hyperparathyroidism: rheumatologic manifestations and bone disease". Rheumatology. Philadelphia, PA: Mosby/Elsevier. p. 1668. ISBN 9780323091381.
  20. ↑ Rubin MR, Silverberg SJ (2002). "Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy". Curr Rheumatol Rep. 4 (2): 179–85. PMID 11890884.

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