Hyperparathyroidism is a disease in which there is excess production of parathyroid hormone (parathyrin, parathyroid hormone), resulting in the blood increases the amount of calcium, while the amount of calcium in the skeletal system is reduced and there is a tendency to bone fractures. Previously it was thought that this is a rare disease, but thanks to modern methods of investigation revealed that the population of developed countries the frequency of hyperparathyroidism is 0.5-1 per thousand and are most often found hidden forms of the disease, who accidentally discovered during the examination on any other reasons.
Primary hypoparathyroidism is the result of excessive production of parathyroid adenomas single or multiple (benign tumor of glandular tissue formation), hyperplasia (an increase in the size of cancer) or less (about 1-1.5%), cancer of the parathyroid glands. In 10% of patients with this condition is combined with other endocrine tumors (pheochromocytoma, pituitary tumor, thyroid cancer). For primary giperparatirozu true hereditary giperparatiroz, which is also commonly associated with other inherited diseases of the endocrine organs.
Secondary hyperparathyroidism occurs during long-term deficiency of calcium in the blood. At the same time enhanced PTH production occurs as a compensatory reaction - the body tries to restore the normal amount of calcium in the blood. Secondary giperparatiroz failure occurs when vitamin D, for various reasons, diseases of the gastrointestinal tract accompanied by malabsorption of calcium in the intestine.
Giperparatiroz accompanied by excessive production of parathyrin under the influence of which is output from the bones of phosphorus and calcium. The consequence of this is the reorganization of bone tissue. It becomes unstable or soft. As a result, bones can break easily and bending. Excessive amounts of calcium in the blood leads to muscle weakness, kidney stones. Increases the amount of urine and secondarily reinforced craving and consumption of large amounts of fluid the patient. The stomach is enhanced production of hydrochloric acid, may cause stomach ulcers.
Quite often, as we said, hyperparathyroidism goes unnoticed for the patient and is detected by chance. The first clinical manifestation of the disease is a weakness in the muscles, fatigue on exertion, loosening and loss of teeth and hair, scattered in small bones of the pain of hands and feet especially. With long-term course of illness the patient skin gets ashy-gray. Because of changes in the skeleton may become sick shorter. Often there are broken bones during normal movements, and even in bed. Patients complain of nausea, vomiting, stomach pain. The high amount of calcium in the blood can cause heart vessels and the appearance of strokes. There is an increase in amount of urine, which is due to the large amount of salt in it takes the whitish color. Due to the defeat of the spine in the back pains, radiculitis. When palpation of the parathyroid glands in the neck can be detected only very large parathyroid adenoma.
The main symptom is an increase in calcium giperparatiroza detectable in blood chemistry. Found more reduction in the number of phosphates in the blood and increase the quantity of enzyme - alkaline phosphatase. Possible to determine the levels of PTH. Radiographs revealed multiple bone changes characteristic: osteoporosis, reducing the height of the vertebrae, cysts in bone tissue especially in the bones of the jaws and long bones.
The primary method of treatment for primary hyperparathyroidism surgery. It involves the removal of nodules and altered tissues in the parathyroid glands. In cancer of the parathyroid glands after surgery the irradiation. The operation is complex, since detection of all nodules is difficult.
Performed ultrasonography and angiography (study of blood vessels with contrast medium), followed by X-ray images. The majority of patients after surgical treatment occurs decrease the amount of calcium in the blood and they are assigned vitamin D, and in more severe cases, intravenous calcium salts. In some cases gipoparatiroz stored for a long time, and such patients are vitamin D and calcium have to take a long time. Pharmacologic treatment is given to elderly patients with mild disease. Appointed by the phosphates, the female sex hormones