hyperparathyroidism
HYPERPARATHYROIDISM

Hyperparathyroidism is a condition wherein there is an excessive production of parathyroid hormone (PTH).

Primary hyperparathyroidism is the most common endocrine disorder and an important cause of hypercalcemia in ambulatory patients.

Classic signs and symptoms include bone disease, kidney stones and hypercalcinosis.

Primary goal of pharmacological therapy is to normalize calcium levels.

 

Prevention

  • For patients taking thiazide diuretics, discontinue for 2 weeks before serum calcium level measurement is repeated
  • Recommended for patients who do not undergo sugery
    • Avoid hypercalcemia-aggravating factors
    • Encourage physical activity to minimize bone resorption
    • Adequate hydration is encouraged to minimize nephrolithiasis risk
    • Moderate calcium intake (1000 mg/day) should be maintained
    • Moderate calcium restriction (<800 mg/day) is warranted in patients w/ high serum calcitriol concentration
    • Maintain moderate vitamin D intake (400-800 IU 24 hrly) to maintain 25-(OH)-D level of at least 20 or 30 ng/mL (50 or 75 mmol/L)

Follow Up

  • Annual serum calcium, creatinine & eGFR assessment
  • 3-site dual energy x-ray absorptiometry scan should be done every 1-2 years
  • Bone mineral density assessment every 1-2 years in cases of chronic disorder
  • Radiograph or vertebral fracture assessment done in patients suspected w/ vertebral fracture (ie back pain, height loss)
  • 24-hour biochemical stone profile done once indicated in suspected cases of renal nephrolithiasis or nephrocalcinosis
  • Abdominal imaging w/ radiography, CT or ultrasound is recommended in patients suspected w/ renal nephrolithiasis or nephrocalcinosis
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
06 Oct 2018
Supplementation with resistant starch for 12 weeks decreases the inflammatory marker tumour necrosis factor [TNF]-α and heart rate but does not significantly improve glycaemic control and other cardiovascular disease risk factors in prediabetic adults, suggests a study.
3 days ago
Use of the feminizing hormone therapy medroxyprogesterone acetate (MPA) results in minimal side effects, unchanged oestradiol levels and a decline in testosterone in a cohort of transwomen, a study has found.
29 Sep 2019
The duration and degree of overweight in adulthood appear to have lasting influence on breast and colorectal cancer survival, a study has found.
22 Jul 2019
The risk of diabetes mellitus is higher among postmenopausal women who develop primary breast cancer, reports a new study.