Overactive parathyroid glands

synonym

Medical: Hyperparathyroidism

English: Hyperparathyroidism

definition

Under a Hyperparathyroidism (overactive parathyroid glands) one understands a disease of the Parathyroid with increased formation and release of parathyroid hormone (PTH).

Forms / causes

One differentiates the hyperparathyroidism in:

• primary hyperparathyroidism
• secondary hyperparathyroidism
• tertiary hyperparathyroidism

Primary overactive parathyroid glands

In principle, one can differentiate between two types of hyperparathyroidism (overactive parathyroid glands): the primary Overactive parathyroid glands caused by a disease of the cells of the parathyroid gland (Epithelial bodies).

The causes here are mostly:

• solitary (single) adenomas (80% of cases) or
• multiple (increased) adenomas (5% of cases)

of the Parathyroid.

In 15% of the cases, the cause of the primary overactive parathyroid gland is what is known as hyperplasia of the epithelial cells. Carcinoma of the parathyroid gland can trigger primary overactive parathyroid glands in only 1%.

Secondary overactive parathyroid glands

The second form of hyperparathyroidism (Overactive parathyroid glands) is the secondary variant. In the case of a healthy parathyroid gland and other underlying diseases, a regulatory release of parathyroid hormone occurs.
In principle, it can be stated that whenever the Calcium levels of the body sinks below a certain limit, the parathyroid gland releases the parathyroid hormone, which then makes calcium available to the body via appropriate mechanisms. The causes of a reduced calcium level, which is regulated by an increased release of parathyroid hormones, are of very different nature. So diseases of the kidney be responsible for an increased calcium excretion in the urine, and thus lower the calcium level to an unnaturally low level. Decreased calcium intake from food, the so-called Malabsorption syndrome, trigger a decreased level of calcium in the body and so become a secondary Overactive parathyroid glands to lead.
The Cirrhosis of the liver In rare cases, impaired calcium processing can lead to this clinical picture. Hyperparathyroidism due to reduced exposure to sunlight (also leads to incorrect calcium utilization) is very rarely seen today.

Tertiary overactive parathyroid gland

From a so-called tertiary hyperparathyroidism (Overactive parathyroid gland) is spoken when the calcium level in the blood is too high during a secondary course with increased parathyroid hormone release (hypercalcaemia).
The cause of this overactive parathyroid gland is a disproportion between the amount of parathyroid hormone and the calcium requirement. If an increased amount of calcium is made available through the increased release of parathyroid hormones, this happens through various mechanisms: through so-called Osteoclasts the calcium stored in the bones is increasingly broken down. The absorption of the calcium in the food is increased and there is an increased reabsorption of calcium in the food kidney.

frequency

Approx. 0.3% of the population suffers from an overactive parathyroid gland, with 2/3 women. The cause of this sexual distribution of overactive parathyroid glands is not clear, but is in the Lactation wanted in women. Most often the disease occurs in adults and rarely in children.

diagnosis

In addition to the patient survey, in which the doctor should find out the symptoms and the period of occurrence, the laboratory examination of the blood is a very important examination method blood To demonstrate an increased calcium level, one should consider the parathyroid hormone value. Are both calcium, and Parathyroid hormone increased, this suggests primary hyperparathyroidism (overactive parathyroid glands).

If the calcium level is decreased, but the parathyroid hormone is increased, secondary hyperparathyroidism could be to blame. And if the calcium value is increased, but the parathyroid hormone level is reduced, this speaks more for a possibly tumor-related hypercalcaemia.

In summary, one can say:
if a calcium value above 2.6mmol / l can be measured with normal kidney function, total protein and parathyroid hormone, this indicates a high probability of primary hyperparathyroidism.
If the calcium level is decreased, the phosphate normal and the parathyroid hormone increased, this indicates secondary hyperparathyroidism. If primary hyperparathyroidism (overactive parathyroid glands) is suspected, a Ultrasonic or a CT of the parathyroid gland. If a secondary form is suspected, an ultrasound of both kidneys should be performed and the creatinine level in the blood should be examined in a laboratory.
Some tumors are also able to produce high levels of calcium in the body.
In any case, an X-ray of the Rib cage (Exclusion of the Bronchial carcinoma), one X-ray of the bone skeleton (finding out foci of decalcification) and scintigraphy of the bone (exclusion of bone involvement by a tumor).