There are a lot of diseases and pathological conditions, which are based on violations of the parathyroid glands. This endocrine organ plays an important role in regulating the level of calcium and phosphorus in the body. The main substance that corrects the content of salts in the body and maintains their balance is parathyroid hormone. Increased secretion of this active substance causes a condition called hyperparathyroidism , and the opposite disease associated with low levels of parathyroid hormone – hypoparathyroidism .
Hyperparathyroidism
The basis of this pathology is a violation of the function of the parathyroid glands, which is characterized by increased production of parathyroid hormone in the blood, regardless of its need. The cause of the disease is a defect in the endocrine organ itself and in this case they speak of primary hyperparathyroidism . This condition develops as a result of:
- hereditary factor (Wermer’s syndrome, Sipple’s syndrome );
- multiple benign neoplasms in the gland;
- hyperplasia (growth) of the tissue of the endocrine organ;
- parathyroid carcinomas.
Secondary hyperparathyroidism is said to be in cases where it is the result of the inclusion of a compensatory mechanism in response to chronic calcium deficiency in the body. This condition can develop when:
- renal failure;
- malabsorption (not complete absorption) of calcium in the gastrointestinal tract;
- low intake of calcium from food;
- vitamin D deficiency;
- softening of the bones (osteomalacia).
Against the background of secondary hyperparathyroidism , a tertiary form of the disease may occur, characterized by the presence of independently functioning hyperplasia or adenoma of the parathyroid glands. There is a dissonance between the level of calcium necessary for the body and its production. Such conditions can develop, for example, when a kidney is transplanted to a patient with chronic renal failure with secondary hyperparathyroidism .
Clinical picture of hyperparathyroidism
It is important to consider that hyperparathyroidism at an early stage may not make itself felt for a long time. There are some non-specific symptoms of the disease that are not always identified as a parathyroid disorder. These include:
- fatigue;
- chronic fatigue;
- muscle weakness;
- pain in the musculoskeletal system;
- headache;
- bad mood, depression.
With the progression of the disease, disorders can occur, both on the part of the skeletal system and on the part of the organs (kidneys, gastrointestinal tract, nervous system). There are also mixed forms of the disease.
From the musculoskeletal system:
- pain in the joints, which increases with movement and palpation;
- curvature and deformation of bones;
- increased fragility of bones and teeth;
- cystic formations of the jaw.
From the organs:
- thirst, accompanied by polyuria;
- loss of appetite and body weight;
- nausea, vomiting, gastrointestinal dysfunction;
- development of peptic ulcer of the stomach and duodenum;
- pancreatitis;
- decrease in neuromuscular excitability, which is accompanied by increased muscle weakness and adynamia;
- with severe damage to the nervous system – mental disorders.
Diagnostics
If this pathology is suspected, the endocrinologist prescribes a comprehensive diagnosis, which allows to identify an increased amount of calcium in the body. First, a blood test is performed, and if kidney failure is suspected, a urinalysis is performed. Secondly, with the help of X-rays, the bones and kidneys are examined. To identify such disorders of the parathyroid glands as an adenoma, ultrasound diagnostics or computed tomography are performed.
Treatment
When making a diagnosis of hyperparathyroidism , etiological treatment should be carried out, that is, the problem that caused the increase in parathyroid hormone in the blood should be eradicated. It is important to understand that today, the most successful way to treat hyperparathyroidism is surgery. This method is routine, and according to statistics, its effectiveness is 98%. By surgical intervention, benign tumors that caused violations of the parathyroid glands are removed, and if indicated, the endocrine organ itself can be removed. In this case, the patient is prescribed replacement therapy.
Hypoparathyroidism
This lesion of the parathyroid glands is characterized by a reduced level of parathyroid hormone in the blood, which leads to hypocalcemia , and as a result, to an increase in phosphorus. The causes of the disorder of this organ are:
- autoimmune factor;
- surgical operation of the parathyroid glands;
- radiation therapy;
- infectious agents;
- severe intoxication.
Clinical picture of hypoparathyroidism
The disease is manifested by a characteristic complex of symptoms, the main of which are convulsions and prolonged muscle tension, called tetanic syndrome. The disease manifests itself:
- pain in the muscles of the limbs;
- spasm of mimic and chewing muscles of the face;
- violation of swallowing and breathing;
- dysfunction of the excretory system;
- neuropsychiatric disorders;
- pain in the region of the heart.
In mild forms of hypoparathyroidism , pain and other symptoms do not appear as often, and may be associated with provoking factors such as stress, hypothermia, infections, etc. If left untreated, the mild form can go into a severe stage of the disease, in which symptoms may appear spontaneously, those. without triggers.
Diagnostics
Blood tests are ordered to check for parathyroid hormone levels. Radiography allows you to assess bone density. With complaints of convulsions, Khvosteko and Trousseau tests are performed .
Treatment
They carry out complex therapy aimed, firstly, at stopping seizures, and secondly, they introduce replacement therapy that increases the level of calcium and vitamin D in the body. Physiotherapy treatment is possible.
Pseudohypoparathyroidism
A very rare genetic disease of the parathyroid glands. With this pathology, patients have a normal or even elevated level of parathyroid hormone in the blood, but symptoms of hypoparathyroidism are noted . This is due to the fact that the cells of organs and tissues are not susceptible to the hormone produced by the parathyroid glands.
Clinical picture of pseudohypoparathyroidism
- tetanic muscle contractions;
- low growth of patients;
- violation of the development of the skeleton: short limbs, deformation of the bones;
- mental disorders;
- mental retardation.
Diagnostics
The diagnosis is made in childhood, on the basis of external manifestations: defects in the musculoskeletal system. In the blood test, there is an increased or normal level of parathyroid hormone, with reduced calcium and increased phosphorus. Tests are being carried out to detect tissue resistance to parathyroid hormone.
Treatment
In this situation, the use of replacement therapy in the form of taking endogenous parathyroid hormone is an ineffective treatment. Assign drugs containing calcium and vitamin D, maintaining their normal level in the blood. A diet low in phosphorus is recommended.