Primary parathyroid hyperplasia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords:

Pathophysiology

Associated Conditions

• Multiple endocrine neoplasia I (MEN I)
• Multiple endocrine neoplasia II A (MEN IIA)
• Isolated familial hyperparathyroidism

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• A...
• Z...

Make sure that each diagnosis is linked to a page.

Risk Factors

• Multiple endocrine neoplasia I
• Multiple endocrine neoplasia II A
• Isolated familial hyperparathyroidism

Natural History, Complications and Prognosis

• Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as excellent.

Complications

• Kidney stones
• Osteitis fibrosa cystica

Diagnosis

Diagnostic Criteria

If available, the diagnostic criteria are provided here.

History

A directed history should be obtained to ascertain

Symptoms

• Constipation
• Bone fractures or bone pain
• Nausea
• Lethargy
• Muscle pain

Past Medical History=

Social History

Alcohol

The frequency and amount of alcohol consumption should be characterized.

Laboratory Findings

• Calcium
• Phosphorus
• Magnesium
• PTH
• Vitamin D levels
• A 24-hour urine test

Chest X Ray

• Bone x-rays

Other Imaging Findings

• Bone density test (DXA)

Treatment

Surgery

• Surgery is the mainstay of treatment for parathyroid hyperplasia. Three and a half part of the glands are removed during surgery.

Secondary Prevention

• Genetic screening for patients with family history of MEN syndrome.