Hyperparathyroidism history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient | The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient is expected to develop signs and symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic [[hypercalcemia]]. The classic signs and symptoms of primary hyperparathyroidism are present in a few individuals and are summarized by the mnemonic '''"moans, groans, stones, bones, psychiartic overtones".''' | ||
The majority of patients with secondary hyperparathyroidism have a history of either [[chronic renal failure]] or long term [[vitamin D deficiency]]. | |||
The majority of patients with tertiary hyperparathyroidism have a history of [[Kidney transplantation|renal transplantation]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
Although majority of patients with hyperparathyroidism have non-specific history | Although majority of patients with hyperparathyroidism have non-specific history but a detailed and thorough history from the patient is necessary. The patient may have a positive history of: | ||
*Kidney stones | *[[Kidney stones]] | ||
*Bone pain and tenderness | *[[Bone pain]] and [[tenderness]] | ||
*Fragile bones of the limbs and spine that can break easily | *Fragile bones of the limbs and spine that can break easily | ||
*Frequent and excessive urination | *Frequent and [[Polyuria|excessive urination]] | ||
*Gastrointestinal symptoms like epigastric | *[[Gastrointestinal]] symptoms like [[epigastric pain]], [[constipation]], [[indigestion]], [[nausea]], and [[vomiting]] | ||
*Feeling tired, ill, and weak | *Feeling [[Fatigue|tired]], ill, and weak | ||
*Depression and memory disturbances | *[[Depression]] and [[Dementia|memory disturbances]] | ||
*Vitamin D deficiency | *[[Vitamin D deficiency]] | ||
* | *[[Chronic renal failure]] in case secondary hyperparathyroidism is suspected | ||
*Renal transplant in case tertiary hyperparathyroidism is suspected | *[[Kidney transplantation|Renal transplant]] in case tertiary hyperparathyroidism is suspected | ||
===Symptoms=== | ===Symptoms=== | ||
====Asymptomatic Hyperparathyroidism==== | ====Asymptomatic Hyperparathyroidism==== | ||
The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient was expected to dvelop signs ans symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic hypercalcemia. | The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient was expected to dvelop signs ans symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic [[hypercalcemia]]. | ||
====Symptomatic Hyperparathyroidism==== | ====Symptomatic Hyperparathyroidism==== | ||
A few of patients that do present with symptoms, they are commonly associated with the effects of an increased level of calcium. Calcium is involved in trans-synaptic communication within | A few of patients that do present with symptoms, they are commonly associated with the effects of an increased level of [[calcium]]. [[Calcium]] is involved in trans-synaptic communication within nervous system and [[Hypercalcemia|high blood calcium]] levels have a direct effect on the [[nervous system]]. So, most of the symptoms of parathyroid disease are [[Neurology|neurological]]. The most common symptom is [[fatigue]]. Other symptoms include [[lethargy]], [[Dementia|memory disturbances]], [[Clinical depression|depression]], lack of concentration, and [[sleep disturbances]]. Other manifestations of hyperparathyroidism may include [[kidney stone]]s and the [[musculoskeletal]] symptoms ([[bone pain]] due to the development of [[osteoporosis]]). | ||
=====Common symptoms===== | =====Common symptoms===== | ||
The symptoms of hyperparathyroidism can be remembered by the rhyme "'''moans, groans, stones, bones, and psychiatric overtones'''": | The symptoms of hyperparathyroidism can be remembered by the rhyme "'''moans, groans, stones, bones, and psychiatric overtones'''": | ||
*"moans" (complaints of not feeling well) | *"moans" (complaints of not feeling well) | ||
*"groans" (abdominal pain, [[gastroesophageal reflux disease|gastroesophageal reflux]]) | *"groans" ([[abdominal pain]], [[gastroesophageal reflux disease|gastroesophageal reflux]]) | ||
*"stones" (kidney) | *"stones" ([[Kidney stones|kidney]]) | ||
*"bones" (bone pain) | *"bones" ([[bone pain]]) | ||
*"psychiatric overtones" (lethargy, fatigue, depression, memory | *"psychiatric overtones" ([[lethargy]], [[fatigue]], [[depression]], [[Dementia|memory disturbances]]) | ||
=====Less common symptoms===== | =====Less common symptoms===== | ||
*Confusion | *[[Confusion]] | ||
*Constipation | *[[Constipation]] | ||
*Decreased libido | *[[Decreased libido]] | ||
*[[arterial hypertension|Hypertension]] | *[[arterial hypertension|Hypertension]] | ||
*[[Headache]]s | *[[Headache]]s | ||
*Heart palpitations which are often due to bouts of atrial fibrillation | *Heart [[palpitations]] which are often due to bouts of [[atrial fibrillation]] | ||
*[[gastroesophageal reflux disease|Gastroesophageal reflux]] | *[[gastroesophageal reflux disease|Gastroesophageal reflux]] | ||
*Loss of appetite | *Lack of [[concentration]] | ||
*Left ventricular hypertrophy | *[[Loss of appetite]] | ||
*Nausea and vomiting | *[[Left ventricular hypertrophy]] | ||
*Peptic ulcers | *[[Nausea and vomiting]] | ||
*Polydipsia | *[[Peptic ulcer|Peptic ulcers]] | ||
*Polyuria | *[[Polydipsia]] | ||
*[[Polyuria]] | |||
*Thinning of hair | *Thinning of hair | ||
Revision as of 16:08, 23 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient is expected to develop signs and symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic hypercalcemia. The classic signs and symptoms of primary hyperparathyroidism are present in a few individuals and are summarized by the mnemonic "moans, groans, stones, bones, psychiartic overtones". The majority of patients with secondary hyperparathyroidism have a history of either chronic renal failure or long term vitamin D deficiency. The majority of patients with tertiary hyperparathyroidism have a history of renal transplantation.
History and Symptoms
History
Although majority of patients with hyperparathyroidism have non-specific history but a detailed and thorough history from the patient is necessary. The patient may have a positive history of:
- Kidney stones
- Bone pain and tenderness
- Fragile bones of the limbs and spine that can break easily
- Frequent and excessive urination
- Gastrointestinal symptoms like epigastric pain, constipation, indigestion, nausea, and vomiting
- Feeling tired, ill, and weak
- Depression and memory disturbances
- Vitamin D deficiency
- Chronic renal failure in case secondary hyperparathyroidism is suspected
- Renal transplant in case tertiary hyperparathyroidism is suspected
Symptoms
Asymptomatic Hyperparathyroidism
The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient was expected to dvelop signs ans symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic hypercalcemia.
Symptomatic Hyperparathyroidism
A few of patients that do present with symptoms, they are commonly associated with the effects of an increased level of calcium. Calcium is involved in trans-synaptic communication within nervous system and high blood calcium levels have a direct effect on the nervous system. So, most of the symptoms of parathyroid disease are neurological. The most common symptom is fatigue. Other symptoms include lethargy, memory disturbances, depression, lack of concentration, and sleep disturbances. Other manifestations of hyperparathyroidism may include kidney stones and the musculoskeletal symptoms (bone pain due to the development of osteoporosis).
Common symptoms
The symptoms of hyperparathyroidism can be remembered by the rhyme "moans, groans, stones, bones, and psychiatric overtones":
- "moans" (complaints of not feeling well)
- "groans" (abdominal pain, gastroesophageal reflux)
- "stones" (kidney)
- "bones" (bone pain)
- "psychiatric overtones" (lethargy, fatigue, depression, memory disturbances)
Less common symptoms
- Confusion
- Constipation
- Decreased libido
- Hypertension
- Headaches
- Heart palpitations which are often due to bouts of atrial fibrillation
- Gastroesophageal reflux
- Lack of concentration
- Loss of appetite
- Left ventricular hypertrophy
- Nausea and vomiting
- Peptic ulcers
- Polydipsia
- Polyuria
- Thinning of hair