Hyperparathyroidism overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief:
Overview
Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). The parathyroid hormone monitors calcium and phosphorus levels and helps to maintain these levels. Overactivity of one or more of the parathyroid glands causes high calcium levels (hypercalcemia) and low levels of phosphorus in the blood. Hyperparathyroidism was first described and treated in the 1930s by Fuller Albright of Massachusetts General Hospital, working at the Mallinckrodt General Clinical Research Center. The oldest known case was found in a cadaver from a Early Neolithic cemetery in southwest Germany.[1]
Historical Perspective
In 1880, Ivar Sandström, a Swedish anatomist, described parathyroids in human following 50 autopsies. In 1924, James Bertram Collip, a Canadian biochemist, discovered and extracted parathormone and treated tetany with the help of parathyroid extract along with Douglous B Leitch. In 1925, Felix Mandl, a viennese surgeon performed first parathyroidectomy to treat a patient suffering from suffering from osteitis fibrosa cystica. In 1959, Howard Rasmussen and Lyman C. Craig at the Rockefeller Institute for Medical Research purified parathyroid hormone. They also isolated the active polypeptide (parathormone B) from bovine parathyroid gland and gave its tentative formula in 1961.
Classification
Hyperparathyroidism can be classified into primary, secondary and tertiary. Primary hyperparathyroidism results from a hyperfunction of the parathyroid glands themselves. There is oversecretion of PTH due to adenoma, hyperplasia or, rarely, carcinoma of the parathyroid glands. Secondary hyperparathyroidism is due to increase in secretion of parathyroid hormone from a secondary process. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone (PTH) after a long period of secondary hyperparathyroidism and resulting in hypercalcemia.
Pathophysiology
Causes
Differentiating ((Page name)) from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
CT scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Zink AR, Panzer S, Fesq-Martin M, Burger-Heinrich E, Wahl J, Nerlich AG (2005). "Evidence for a 7000-year-old case of primary hyperparathyroidism". JAMA. 293 (1): 40–2. doi:10.1001/jama.293.1.40-c. PMID 15632333.