Primary parathyroid hyperplasia
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:
Overview
Historical Perspective
Classification
Pathophysiology
Genetics
Associated Conditions
- Multiple endocrine neoplasia I (MEN I)
- Multiple endocrine neoplasia II A (MEN IIA)
- Isolated familial hyperparathyroidism
Gross Pathology
- Classically all parathyroid glands are involved; however, some may be spared making it difficult to differentiate this from parathyroid adenoma.
Microscopic Pathology
- Classically have abundant adipose tissue[1]
- +/-Water-clear cells ("water-clear cell hyperplasia").
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
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...
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Differentiating type page name here from other Diseases
Epidemiology and Demographics
Age
Gender
Race
Developed Countries
Developing Countries
Risk Factors
- Multiple endocrine neoplasia I
- Multiple endocrine neoplasia II A
- Isolated familial hyperparathyroidism
Screening
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=
Family History
Social History
Occupational
Alcohol
The frequency and amount of alcohol consumption should be characterized.
Drug Use
Smoking
Allergies
Physical Examination
Appearance of the Patient
Vital Signs
Skin
Head
Eyes
Ear
Nose
Mouth
Throat
Heart
Lungs
Abdomen
Extremities
Neurologic
Genitals
Other
Laboratory Findings
- Calcium
- Phosphorus
- Magnesium
- PTH
- Vitamin D levels
- A 24-hour urine test
Electrolyte and Biomarker Studies
Electrocardiogram
Chest X Ray
- Bone x-rays
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
- Bone density test (DXA)
Other Diagnostic Studies
Treatment
Pharmacotherapy
Acute Pharmacotherapies
Chronic Pharmacotherapies
Surgery
- Surgery is the mainstay of treatment for parathyroid hyperplasia. Three and a half part of the glands are removed during surgery.
Indications for Surgery
Pre-Operative Assessment
Post-Operative Management
Transplantation
Primary Prevention
Secondary Prevention
- Genetic screening for patients with family history of MEN syndrome.
Cost-Effectiveness of Therapy
Future or Investigational Therapies
References
- ↑ Parathyroid hyperplasia. Librepathology (2016). http://librepathology.org/wiki/index.php?title=Parathyroid_hyperplasia&redirect=no Accessed on January 7, 2016