Hyperparathyroidism history and symptoms
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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 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 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, 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 burning, constipation, indigestion, nausea, and vomiting
- Feeling tired, ill, and weak
- Depression and memory disturbances
- Vitamin D deficiency
- 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 our nervous system, 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 and tiredness. Other symptoms include lethargy, memory disturbances, depression, problems with concentration, and problems sleeping. Other manifestations of hyperparathyroidism usually 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 problems).
Less common symptoms
- Confusion
- Constipation
- Decreased libido
- Hypertension
- Headaches
- Heart palpitations which are often due to bouts of atrial fibrillation
- Gastroesophageal reflux
- Loss of appetite
- Left ventricular hypertrophy
- Nausea and vomiting
- Peptic ulcers
- Polydipsia
- Polyuria
- Thinning of hair