Parathyroid disorders: Difference between revisions
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==Overview== | ==Overview== | ||
The parathyroid glands are small endocrine glands in the neck, usually located behind the thyroid gland, which produce parathyroid hormone. These glands were first discovered in the Indian Rhinoceros by Richard Owen in 1852. The sole function of the parathyroid glands is to maintain the body's calcium level within a very narrow range, so that the nervous and muscular systems can function properly. When blood calcium levels drop below a certain point, calcium-sensing receptors in the parathyroid gland are activated to release hormone into the blood. [[Parathyroid hormone]] (PTH, also known as parathormone) is a small protein that takes part in the control of calcium and phosphate homeostasis, as well as bone physiology. Parathyroid hormone has effects antagonistic to those of calcitonin. It increases blood calcium levels by stimulating osteoclasts to break down bone and release calcium. It also increases gastrointestinal calcium absorption by activating vitamin D, and promotes calcium uptake by the kidneys. Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). Overactivity of one or more of the parathyroid glands causes high calcium levels (hypercalcemia) and low levels of phosphorus in the blood. Hyperfunction of the parathyroid glands could be due to adenoma, hyperplasia or, rarely, carcinoma of the parathyroid glands. Hyperparathyroidism may present with symptoms of hypercalcemia, such as painful bones, kidney stones, abdominal groans, psychic moans, and fatigue overtones. An elevated concentration of serum calcium with elevated parathyroid hormone level is diagnostic of primary hyperparathyoidism. Surgical therapy is preferred over medical therapy in primary hyperparathyroidism. Hypoparathyroidism is a disorder characterized by hypocalcemia due to insufficient secretion of PTH. | |||
==Classification== | ==Classification== | ||
Revision as of 15:24, 10 October 2017
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Parathyroid disorders |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Synonyms and keywords:
Overview
The parathyroid glands are small endocrine glands in the neck, usually located behind the thyroid gland, which produce parathyroid hormone. These glands were first discovered in the Indian Rhinoceros by Richard Owen in 1852. The sole function of the parathyroid glands is to maintain the body's calcium level within a very narrow range, so that the nervous and muscular systems can function properly. When blood calcium levels drop below a certain point, calcium-sensing receptors in the parathyroid gland are activated to release hormone into the blood. Parathyroid hormone (PTH, also known as parathormone) is a small protein that takes part in the control of calcium and phosphate homeostasis, as well as bone physiology. Parathyroid hormone has effects antagonistic to those of calcitonin. It increases blood calcium levels by stimulating osteoclasts to break down bone and release calcium. It also increases gastrointestinal calcium absorption by activating vitamin D, and promotes calcium uptake by the kidneys. Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). Overactivity of one or more of the parathyroid glands causes high calcium levels (hypercalcemia) and low levels of phosphorus in the blood. Hyperfunction of the parathyroid glands could be due to adenoma, hyperplasia or, rarely, carcinoma of the parathyroid glands. Hyperparathyroidism may present with symptoms of hypercalcemia, such as painful bones, kidney stones, abdominal groans, psychic moans, and fatigue overtones. An elevated concentration of serum calcium with elevated parathyroid hormone level is diagnostic of primary hyperparathyoidism. Surgical therapy is preferred over medical therapy in primary hyperparathyroidism. Hypoparathyroidism is a disorder characterized by hypocalcemia due to insufficient secretion of PTH.
Classification
| Parathyroid disorders | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hyperparathyroidism | Familial hypocalciuric hypercalcemia | Hypoparathyroidism | Parathyroid hormone resistance diseases | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Secondary | Tertiary | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Post-surgical | Autoimmune | Genetic defects associated | Functional | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pseudohypoparathyroidism | Acrodysostosis | Blomstrand chondrodysplasia | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pseudohypoparathyroidism type 1 | Pseudohypoparathyroidism type 2 | Acrodysostosis type 1 | Acrodysostosis type 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Type 1A | Type 1B | Type 1C | Pseudopseudohypoparathyroidism | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnosis
| Disorder | Laboratory findings | ||||
|---|---|---|---|---|---|
| Parathyroid hormone | Serum calcium | Serum phosphate | Other findings | ||
| Hyperparathyroidism | Primary hyperparathyroidism | ↑ | ↑ | ↓/Normal |
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| Secondary hyperparathyroidism | ↑ | ↓/Normal | ↑ | -- | |
| Tertiary hyperparathyroidism | ↑ | ↑ | ↑ | -- | |
| Familial hypocalciuric hypercalcemia | Normal/↑ | Normal/↑ | -- |
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| Hypoparathyroidism | ↓ | ↓ | ↑ |
| |
| Pseudohypoparathyroidism | Type 1A | ↑ | ↓ | ↑ | |
| Type 1B | ↑ | ↓ | ↑ | ||
| Type 1C | ↑ | ↓ | ↑ | ||
| Pseudopseudohypoparathyroidism | Normal | Normal | Normal | -- | |
| Type 2 | ↑ | ↓ | ↑ |
| |
| Acrodysostosis | Acrodysostosis type 1 | ↑ | ↓ | ↑ |
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| Acrodysostosis type 2 | ↑ | ↓ | ↑ |
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| Blomstrand chondrodysplasia | ↑ | ↓ | ↑ | ||
Differentiating Parathyroid Disorders
- Parathyroid disorders usually cause an symptoms due to derangement in serum calcium. So, parathyroid disorders are differentiated within themselves and others on the basis of serum calcium levels.