| Introduction |
- Occurs in 0.1% of the population
- 90% result form a single adenoma
- remaining 10% from parathyroid hyperplasia
- parathyroid carcinoma accounts for less than 1% of all cases
|
| Presentation |
- 70% are asymptomatic
- Symptoms
- stones (nephrolithiasis, nephrocalcinosis)
- bones (bone pain, muscle aches, athralgias, fractures)
- groans (PUD, pancreatitis)
- psychic overtones (fatigue, depression , anxiety, irritability)
|
| Evaluation |
- Labs show classic hallmark of
- hypercalcemia
- hypophosphatemia
- hypercalciuria
| |
Serum Ca
|
Serum Phos
|
PTH
|
Common Cause |
| Hyperparathyroidism |
↑
|
↓
|
↑
|
adenoma |
| Hypoparathyroidism |
↓
|
↑
|
↓
|
parathyroidectomy |
| Ectopic PTH |
↑
|
↓
|
↓
|
malignancy |
| Vit D malabsorption |
↓
|
↓
|
↑
|
celiac disease, other GI disease |
| hypo vit D with no phosphate excretion from the kidney. |
↓
|
↑
|
↑
|
renal failure, pseudo
hypoparathyroidism |
|
| |
| Treatment |
- Acute hypercalcemia
- Treat with parathyroidectomy
|