Hyperparathyroidism (HPT) is an endocrine disorder characterized by excessive production of parathyroid hormone (PTH) by the parathyroid glands. This leads to increased calcium levels in the blood (hypercalcemia) and various metabolic disorders, including osteoporosis, nephrolithiasis, and cardiovascular disorders. Hyperparathyroidism can be either primary, resulting from pathological changes in the parathyroid glands themselves, or secondary, developing as a response to other diseases, such as renal failure or vitamin D deficiency.
History of the disease and interesting historical facts
The history of hyperparathyroidism goes back more than a century. The first mentions of this disease can be found in medical texts of the late 19th century. In 1925, surgical treatment of hyperparathyroidism was described, which was a significant event in the field of endocrine surgery. The parathyroid glands were discovered only in 1880, and their function remained unclear until the connection between their disorders and metabolic disorders such as osteoporosis and hypercalcemia was established. The development and improvement of diagnostic methods, such as measuring PTH and calcium levels, contributed to more timely detection and treatment of this disease.
Epidemiology
The prevalence of hyperparathyroidism varies among populations, but averages 1-4 cases per 1000 people. Secondary hyperparathyroidism is more common in high-risk groups, such as patients with chronic renal failure, and may occur in 30% such patients. Interestingly, the disease is more common in women, especially those aged 50 years and older, due to menopause and decreased calcium levels in the body.
Genetic predisposition to this disease
It is important to note that some forms of hyperparathyroidism have a genetic predisposition. For example, hereditary hyperparathyroidism is observed in multiple endocrine neoplasia (MEN) syndrome types 1 and 2, associated with mutations in the MEN1 and RET genes, respectively. Patients with hereditary hyperparathyroidism are also known to have an increased risk of developing other endocrine diseases, such as thyroid adenomas and pheochromocytomas.
Risk factors for the development of this disease
There are several risk factors that may predispose you to developing hyperparathyroidism:
- Age: More common in older people.
- Gender: The disease is more common among women.
- History of kidney disease or osteoporosis.
- Family history of hyperparathyroidism.
- Vitamin D deficiency.
- Chronic inflammatory bowel disease.
Diagnosis of this disease
Several methods are used to diagnose hyperparathyroidism. The main symptoms of the disease are:
- Fatigue and weakness.
- Frequent bone fractures.
- Stomach ache.
- Mental disorders such as depression.
Laboratory tests include blood calcium and PTH levels. Radiological tests (X-rays, CT scans) may reveal osteoporosis and bone lesions. Other diagnostic tests may include ultrasound to evaluate the parathyroid glands. The differential diagnosis includes ruling out other causes of hypercalcemia, such as malignancy or kidney disease.
Treatment
Treatment of hyperparathyroidism can be either conservative or surgical. The main approaches to treatment include:
- General treatment includes correction of calcium and vitamin D levels.
- Pharmacological treatment may include bisphosphonates to lower blood calcium levels.
- Surgical treatment is indicated in cases of primary hyperparathyroidism, especially in the presence of parathyroid adenomas.
- Other treatments may involve the use of new drugs such as denosumab.
List of medications used to treat this disease
Some of the main medications used for hyperparathyroidism are:
- Bisphosphonates – alendronate, risedronate.
- Calcitonin.
- Selective calcium receptor modulators.
- Denosumab.
- Vitamin D (calcidiol, ergocalciferol).
Disease monitoring
Monitoring of hyperparathyroidism includes regular blood tests to assess PTH and calcium levels, as well as bone health monitoring with X-rays and densitometry. Prognosis depends on the type of hyperparathyroidism and the adequacy of treatment. Potential complications include osteoporosis, kidney stones, and cardiovascular disorders.
Age-related features of the disease
Hyperparathyroidism can manifest itself differently depending on the age group. In older people, the disease is often asymptomatic, while younger people may suffer from severe symptoms, including pain and multiple fractures. In children and adolescents, the disease is rare, but in the presence of hereditary factors, it can manifest itself more violently.
Questions and Answers
- What is hyperparathyroidism? Hyperparathyroidism is a condition in which there is excess secretion of parathyroid hormones, resulting in elevated levels of calcium in the blood.
- What are the main symptoms of hyperparathyroidism? Symptoms may include fatigue, although the disease is often asymptomatic, especially in older people.
- How is hyperparathyroidism diagnosed? Diagnosis includes blood tests for calcium and PTH levels, as well as radiological examination to assess the condition of the bones.
- What treatment is recommended for hyperparathyroidism? Treatment can be surgical and pharmacological, aimed at correcting calcium and PTH levels.
- What are the consequences of untreated hyperparathyroidism? Untreated hyperparathyroidism can lead to serious complications such as osteoporosis, cardiovascular disease, and nephrolithiasis.
Advice from Dr. Oleg Korzhikov
Dear patients, hyperparathyroidism is a disease that requires attention and a comprehensive approach. Always pay attention to changes in your body and do not delay imaging with a doctor. A healthy diet with sufficient calcium and vitamin D is key in the prevention and treatment of the disease. Regular medical examinations will help to identify problems at an early stage. Do not ignore the symptoms and it is important to follow the recommended schematic treatment plans. Your active position and awareness contribute to successful control of the disease.
