Hyperparathyroidism: causes, symptoms, diagnosis and treatment of the disease

Hyperparathyroidism is a disease that is caused by the pathology of the endocrine system, in which there is an increased production of parathyroid hormone by the parathyroid glands. With this disease, phosphorus-calcium metabolism is disrupted.

An increase in the amount of calcium in the blood causes changes in bone tissue, as the work of osteoclasts - the cells responsible for the destruction of bone tissue - starts. Due to the violation of calcium metabolism and increased phosphorus release, such a pathological process in the kidneys as hyperphosphaturia. At the same time, the amount of phosphates in the blood drops sharply.

According to statistics, this disease affects people over the age of 50 years. Women are sick more often than men. A factor that can provoke hyperparathyroidism may be ionizing radiation.

The causes of hyperparathyroidism are usually hyperplastic processes or tumors in the parathyroid gland.

Classification of hyperparathyroidism

Classification of the following types of hyperparathyroidism is distinguished:

• Primary hyperparathyroidism - there is an increased function of parathyroid glands due to hyperplasia or the presence of a tumor( benign or malignant).
• Secondary hyperparathyroidism - occurs as a compensatory mechanism in response to a decrease in phosphates and an increase in calcium in the blood. In this case, there is an even greater strengthening of the parathyroid gland function and the growth of its tissue.
• Tertiary hyperparathyroidism - characterized by the formation of parathyroid adenoma, as a response to a long-term secondary hyperparathyroidism.
• Pseudohyperparathyroidism - in this case all the symptoms of hyperparathyroidism develop, but the cause is different tumors in other organs and systems.

In the clinic, hyperparathyroidism can occur in various forms. Distinguish the following forms of the disease:

1. Bone form, in which there are signs such as curvature, thinning or complete resorption of bones. This process arises from the activation of a large number of osteoclasts. Clinically, it is manifested by pain in the bones, spontaneous fractures of the bones, the formation of false joints, changes in the shape and length of the skeleton due to improper fusion of bones.
2. Renal form, at which degenerative-dystrophic changes in renal tissue are observed. Developing such formidable complications, as nephrolithiasis( deposition of kidney stones) and nephrocalcinosis( multiple calcium salts in the kidneys).
3. Gastrointestinal form, in which symptoms such as nausea, vomiting, abdominal pain, a picture of a duodenal ulcer or acute pancreatitis, chronic constipation appear. Violation of the intake and processing of food leads to exhaustion and a sharp loss of weight.
4. Neurological form, in which the symptoms of central nervous system damage come to the fore - fatigue, weakness, propensity to depression, nervous breakdowns, auditory or visual hallucinations, impaired movement, ataxia.

Symptoms of hyperparathyroidism

In hyperparathyroidism, it is difficult to immediately understand which form of the disease prevails, as the symptoms described above occur in other diseases. But with the disease of hyperparathyroidism the symptoms most often occur are the following symptoms:

• A characteristic "duck" gait arises, the patients seem to swing from side to side.
• There is a syndrome of chronic fatigue, lethargy, fatigue. Patients literally do not stand on their feet and try to sit down.
• Permanent thirst and increased urination. Elevated levels of calcium in the blood begin to block the antidiuretic hormone, which is responsible for the amount of urine released.
• Muscle weakness and muscle pain. Because of the muscle pain in the feet, patients can not walk.
• Loss of healthy teeth due to their loosening.
• Indigestible vomiting and nausea, and a tendency to constipation may appear.
• A sudden rise in temperature to 40 degrees and loss of consciousness in severe cases.
• Growing deficiency of weight and a strong depletion of the body.
• In the kidneys there are stones or sand.

It is noted that hyperparathyroidism in children can arise as a secondary disease, that is, it is a reaction to a reduced amount of calcium in the blood. Such conditions as rickets( with vitamin D deficiency), chronic kidney diseases( hyperphosphataemia), malabsorption syndrome lead to hypocalcemia.

Diagnosis and treatment of hyperparathyroidism

Modern medicine considers it important to conduct early diagnosis of the disease. When diagnosed, primary hyperparathyroidism is diagnosed on the basis of examination, complaints and patient analyzes. The earlier the diagnosis is made, the easier it will be to treat.

When the disease is hyperparathyroidism, the treatment is only surgical and consists in the removal of the parathyroid glands. Hyperparathyroidism is also treated surgically and gives good long-term results.

With the advent of secondary hyperparathyroidism, treatment involves not only the removal of the parathyroid gland, but also symptomatic therapy. In the blood, it is necessary to reduce the amount of calcium( abundant drinking, the introduction of infusion solutions and potassium preparations).If necessary, hormone treatment and irradiation with radiation therapy for the parathyroid gland( in severe cases of the disease) are carried out.

The prognosis of the disease depends on the form and degree of lesions of the parathyroid gland, as well as on the stage of the disease. With a primary hyperparathyroidism, the prognosis is always favorable if an operation is performed. With secondary and tertiary hyperparathyroidism, the prognosis depends on the condition of the kidneys. With severe kidney damage, the prognosis of the disease is not always favorable.