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Chapters

0:00 Introduction
1:21 Causes of Hyperparathyroidism
2:32 Symptoms of Hyperparathyroidism
3:01 Diagnosis of Hyperparathyroidism
3:39 Treatment of Hyperparathyroidism


Hyperparathyroidism is an increase in parathyroid hormone (PTH) levels in the blood.[1][4] This occurs from a disorder either within the parathyroid glands (primary hyperparathyroidism) or outside the parathyroid glands (secondary hyperparathyroidism).[1] Symptoms of hyperparathyroidism are caused by inappropriately normal or elevated blood calcium leaving the bones and flowing into the blood stream in response to increased production of parathyroid hormone.[1] In healthy people, when blood calcium levels are high, parathyroid hormone levels should be low. With long-standing hyperparathyroidism, the most common symptom is kidney stones.[1] Other symptoms may include bone pain, weakness, depression, confusion, and increased urination.[1][2] Both primary and secondary may result in osteoporosis (weakening of the bones).[2][3]

In 80% of cases, primary hyperparathyroidism is due to a single benign tumor known as a parathyroid adenoma.[1][2] Most of the remainder are due to several of these adenomas.[1][2] Very rarely it may be due to parathyroid cancer.[2] Secondary hyperparathyroidism typically occurs due to vitamin D deficiency, chronic kidney disease, or other causes of low blood calcium.[1] The diagnosis of primary hyperparathyroidism is made by finding elevated calcium and PTH in the blood.[2]

Primary hyperparathyroidism may only be cured by removing the adenoma or overactive parathyroid glands.[5][1][2] In those without symptoms, mildly increased blood calcium levels, normal kidneys, and normal bone density monitoring may be all that is required.[2] The medication cinacalcet may also be used to decrease PTH levels in those unable to have surgery although it is not a cure.[2] In those with very high blood calcium levels, treatment may include large amounts of intravenous normal saline.[1] Low vitamin D should be corrected in those with secondary hyperparathyroidism but low Vitamin D pre-surgery is controversial for those with primary hyperparathyroidism.[6] Low vitamin D levels should be corrected post-parathyroidectomy.[2]

An overview of etiopathogenesis, clinical presentation, diagnosis, treatment and outcomes of Parathyroid Carcinoma.
Delivered for the residents of SGPGIMS, and all five institutions running MCh Endocrine surgery course in India on 31st Aug 2020.

Radioguided parathyroidectomy is a minimally-invasive technique using a small probe. This probe allows the surgeon to find the hyperactive parathyroid tumor using a small incision versus exposing both sides of the thyroid.

Presented by Shalini Reddy, MD SS21 Videos Solid Organ and Foregut: V049

It is rare to not be able to find the parathyroid gland. If this happens, your parathyroid gland is probably in an abnormal location, like very high in your neck or very low down in your chest. In those scenarios, your doctor will need more imaging to locate exactly where your parathyroid gland is.

#Parathyroid_cancer #부갑상선암 #ultrasound