Hyperparathyroidism - Causes, symptoms and treatment. MF.

Hyperparathyroidism is a disease associated with increased production of parathyroid hormone by altered parathyroid glands, which causes a chronic increase in calcium in the blood and is characterized by a pathological change primarily in the bones and kidneys.

Women suffer more often 2-3 times than men. The most commonly affected age is 20-50 years.

Symptoms of hyperparathyroidism

Clinical manifestations of hyperparathyroidism, depending on what is more affected( bones, kidneys, gastrointestinal tract, mental and neurological spheres), as if completed in certain groups. Against this background, the forms of hyperparathyroidism are distinguished, with a definite clinical picture.

Distinguish:

• bone;
• kidney;
• gastrointestinal;
• is a mental-neurological form.

But for any manifestation of the disease early symptoms are characteristic:

• general muscle weakness, severe weakness of the muscles of the hands and feet;fast fatigue, lethargy;patients are difficult to stand, sit, walk, climb stairs, they stumble when walking;
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• swinging "duck" gait( sick, as it were sideways,
• pains in the feet( arise in connection with the development of flatfoot due to the defeat of the muscles of the foot)
• marked thirst and frequent, profuse urination( due to excess of calcium,which blocks the work of the hormone regulating urination - antidiuretic)
• loosening and loss of healthy teeth
• significant weight loss( down to exhaustion)

Bone form x is characterized by three main manifestations -(thinning, curvature and partial complete bone resorption), the formation of cysts( cavity with liquid contents), and pathological fractures. These form of manifestation of the disease is characterized by:

• bone pain, especially in the spine of the pulling, aching nature, intensifying with physical exertion;
• spontaneous frequent fractures with small physical exertion, after which false joints are formed( that is, which are not present in a normal human body).Fractures are most often affected by the bones of the shoulder, shins, ribs, cervical femur;
• changes the shape of various parts of the skeleton due to improper fracture fusion;
• reduction in growth due to osteoporosis and vertebral fracture;
• bones are more flexible, have lost their firmness.

In the kidneys there is a decrease in calcium absorption, and its high content in the blood, as is known, inhibits the production of antidiuretic hormone( regulates the function of urination), and this causes the following symptoms: polyuria( frequent, profuse urination), thirst, formation of stones inkidneys( nephrolithiasis), multiple deposition of crystals of calcium salts in the kidneys( nephrocalcinosis).It often proceeds secretly, with pains in the lower back.

In the gastrointestinal form of hyperparathyroidism , the following symptoms are observed: nausea, repeated vomiting, constipation, bloating, lack of appetite, leading to severe weight loss, frequent ulcers of the duodenum with severe symptoms and not healing with prolonged treatment, possiblydevelopment of acute inflammation of the pancreas.

For patients characterized by mental disorders of mental activity: rapid mental fatigue, drowsiness, decreased mental abilities, frequent depressive conditions, with acute disease, visual, auditory hallucinations, complete and partial loss of voluntary movements.

Causes of hyperparathyroidism

The most common cause of the disease is parathyroid gland tumors.

Depending on the causes of this disease, primary, secondary and tertiary hyperparathyroidism are distinguished, as well as pseudo-hyperparathyroidism.

1. Primary hyperthyroidism in most cases occurs due to the formation of an adenoma( benign tumor) of parathyroid glands - 80-85% of cases. In 10% of cases, the disease occurs due to carcinoma( malignant tumor) or hyperplasia( proliferation and increase in normal gland cells).
2. Secondary hyperparathyroidism is a secondary enhancement of function, proliferation and enlargement of glands with prolonged decreased calcium content and elevated phosphate levels in the blood. This increases the production of parathyroid hormone. This is observed in chronic renal failure.
3. Tertiary hyperparathyroidism is the development of a benign parathyroid gland tumor and increased production of parathyroid hormone due to the prolonged existence of secondary hyperparathyroidism.
4. Pseudohyperparathyroidism is the production of parathyroid hormone by tumors that originate not from parathyroid gland cells.

Diagnosis of hyperparathyroidism

The diagnosis of hyperparathyroidism is established by:

• the presence of symptoms characteristic of the disease;
• parathyroid x-ray - to detect the presence of a tumor on the gland;
• blood test data: an increase in the concentration of calcium in the blood( normal 2.25-2.75 mmol / L) will be detected, an increase in urinary excretion( a norm of 200-400 mg per day).The content of phosphorus in the blood compared to the norm is reduced, in urine - increased.
• ultrasound of the thyroid gland reveals an increase in parathyroid glands.

Treatment of hyperparathyroidism

Treatment of operative - removal of adenomas( benign tumors) or enlarged parathyroid glands. With the development of a hyperparathyroid crisis, surgery is required for emergency indications.

Conservative( treatment with medicines, diets, etc.) treatment is aimed at reducing the calcium content in the blood and includes abundant drinking, the introduction of medicines.