Hyperparathyroidism

Hyperparathyroidism can be divided into four types: primary, secondary, tertiary and pseudo. The primary is due to excessive parathyroid hormone (PTH) synthesis and secretion caused by the parathyroid gland lesion (tumor or hyperplasia), and through its effect on bone and kidney, it leads to hypercalcemia and hypophosphatemia. Clinical features are recurrent kidney stones, peptic ulcers, mental changes, and extensive bone resorption. In recent years, many patients have been found in time due to routine determination of serum calcium. These patients are often asymptomatic, with the exception of hypercalcemia and increased serum PTH. Secondary hyperparathyroidism is caused by hypocalcemia due to various reasons. It stimulates the parathyroid glands to cause hyperplasia and hypertrophy, resulting in excessive secretion of PTH. It is common in renal insufficiency, osteomalacia, small bowel malabsorption and Vitamin D deficiency and diseases such as hydroxylation disorders. On the basis of secondary hyperparathyroidism, due to persistent stimulation of the glands, part of the proliferative tissue is transformed into adenomas, which secrete too much PTH on their own, which is called triple hyperparathyroidism, which is rare in clinical practice. Pseudoparathyroidism refers to certain malignant tumors (such as lung, liver, kidney, and ovarian tumors) that secrete PTH-like peptides and cause hypercalcemia, which is called hypercalcemia with tumors.