Hyperparathyroidism , the symptoms and treatment of which will be discussed below, is a violation of the function of the parathyroid glands. At the same time, there is an increase in the production of parathyroid hormone by them. This hormone regulates the level of calcium and phosphorus in the blood, its absorption in the intestines, and excretion by the kidneys. With hyperparathyroidism , blood pressure may increase, and there is increased fragility of bones and teeth. Cardiac arrhythmias, possibly psychomotor agitation, are noted .

Symptoms

Symptoms of hyperparathyroidism may include frequent bone fractures and deterioration of teeth. After all , parathormone washes out minerals from hard tissues. There is also pain in the muscles and heart, a violation of its rhythm, increased nervous excitability, convulsions. Characterized by nausea and bloating, abdominal cramps. Hypercalcemic syndrome is manifested by an increase in body temperature. The condition is life-threatening.

In this case, there is an increase in the level of calcium in the blood, a decrease in the amount of phosphorus in it, while the level of phosphate in the urine increases. The person feels thirsty. When sand or kidney stones occur, the patient experiences pain and cramps when urinating.

Osteodystrophy in hyperparathyroidism manifests itself in two forms:

1. Fibrocystic osteitis.
2. Pagetoid form.

Bone damage in hyperparathyroidism develops in two stages: osteoporotic , characterized by a decrease in the density of hard tissue, then cystic skeletal deformities occur.

Origin

Primary hyperparathyroidism is caused by hypertrophic processes or tumors in the parathyroid glands.

Secondary hyperparathyroidism is caused by calcium deficiency during pregnancy, diseases of the gastrointestinal tract and kidneys. It can also be caused by impaired absorption of vitamin D in chronic pathologies of the liver and gallbladder. Insufficient production of this substance is observed in renal failure, as is the loss of calcium in the urine. In gastrointestinal diseases (Crohn’s disease), there is a decrease in the absorption of the mineral itself.

Alimentary hyperparathyroidism is caused by a decrease in the intake of calcium and vitamin D from food. This is observed with starvation, poor nutrition with a deficiency of fats.

Tertiary hyperparathyroidism occurs against the background of a chronic lack of calcium in the blood. Due to the increased load on the parathyroid glands, hyperplastic processes occur in them. Perhaps the development of an adenoma.

There are three forms of hyperparathyroidism :

1. Bone form, characterized by the resorption of minerals from the skeleton. Manifested by fractures, often with the formation of false joints.
2. visceral form. The internal organs are affected – the kidneys, intestines and nervous system.
3. With a mixed form, violations are observed in all of the above structures of the body.

Diagnostics

A patient with increased parathyroid function is usually seen by a nephrologist with an increase in the level of phosphates in the urine and the occurrence of urolithiasis. It is also possible the formation of calcareous stones in the gallbladder.

The patient complains of increased thirst and frequent urination.

On examination, the doctor discovers a duck gait, curvature of the spine. Checking muscle tone shows muscle weakness. A barrel-shaped chest is noted.

Diagnosis includes a blood test for the level of parathormone , as well as the content of calcium and phosphorus in the blood, phosphate in the urine.

Ultrasound examination of the parathyroid glands and kidneys, computed tomography of the organs is necessary. Densitometry will reveal a decrease in bone density and osteoporosis.

To check the functional activity of the parathyroid glands, scintigraphy with selenium and methionine, as well as technetium-thallium, is prescribed.

X-ray of the hands will allow you to judge the severity of the process of osteodystrophy.

Treatment

Hyperfunction of the parathyroid glands needs treatment aimed at the cause of the disease and the prevention of complications.

Primary hyperparathyroidism requires surgery to remove the hormonally active neoplasm. Treatment is indicated when the level of calcium in the blood exceeds 3.5 mmol / l with the occurrence of neurological symptoms, cardiac arrhythmias.

To correct secondary and tertiary hyperfunction of the parathyroid gland, patients are prescribed calcium and vitamin D supplements to eliminate their deficiency. A diet with a high content of butter, fish oil, dairy products is shown.

Renal hyperparathyroidism in CRF should be treated with hemodialysis or a kidney transplant from a donor. In this case, it is necessary to compensate for the deficiency of vitamin D, caused by a decrease in its synthesis in the body.

With a hypercalcemic crisis, the introduction of plasma-substituting solutions with increased diuresis with the help of diuretics – furosemide is indicated. Bisphosphonates are prescribed to reduce the intensity of resorptive processes in the bones.
Primary hyperfunction of the parathyroid glands with the development of a hypercalcemic crisis can lead to coma and even death. A complication of the disease is calcification of organs, kidney damage. Therefore, in the case of the above symptoms, you should urgently consult an endocrinologist who will give recommendations on treatment.