Quite often, patients after diagnosis show abnormalities in the parathyroid glands. Symptoms of hyperparathyroidism often can cause no concern. Lethargy, weakness, decreased performance, constipation - all these disorders people often attribute to general fatigue and poor nutrition. Therefore, the doctor is consulted already in the late stages of the development of the disease.
In this regard, many people today are interested in the question of what is hyperparathyroidism. Symptoms and treatment, causes and exacerbation are important points to deal with. So what threatens the patient with this ailment and what treatment can modern medicine offer?
Brief information about the parathyroid glands and their functions
Hyperparathyroidism, symptoms and treatment in women, secondary hyperparathyroidism, hypercalcemic crisis are the terms that patients often encounter. But before you understand the causes and symptoms of the disease, it is worth considering some anatomical features of the human body.
Most people have two pairs of parathyroid glands, which are usually located on the back surface of the thyroid gland (sometimes they are even immersed in its tissue). By the way, 15-20% of the population has from 3 to 12 glands. Their number and location may vary. The glands are small, several millimeters in size, weighing from 20 to 70 mg.
The parathyroid glands secrete an active biological substance, namely parathyroid hormone, which regulates the metabolism of phosphorus and calcium in the body. With insufficient amounts of calcium in the blood, the hormone starts the process of its release from the bones, improves the absorption of this mineral by intestinal tissues, and also reduces the amount that is usually excreted in the urine. Parathyroid hormone also increases the release of phosphorus from the body.
What is hyperparathyroidism? Epidemiology
Hyperparathyroidism is a disease in which there is an increase in the secretion of parathyroid hormone by the parathyroid glands. This is a chronic disease of the endocrine system, which is often associated with hyperplasia of the glands themselves or the formation of tumors in their tissues.
It is worth saying that the symptoms of hyperparathyroidism in women are recorded three times more often than in the stronger sex. Today, pathology is considered very common. If we talk about endocrine diseases, then hyperparathyroidism prevails in third place (after hyperthyroidism and diabetes mellitus).
Pathological changes due to illness
As already mentioned, with an increase in the level of parathyroid hormone in the blood there is a violation of calcium metabolism in the body - this mineral begins to be washed out of the bones. At the same time, the level of calcium in the blood rises. Bone tissue of the skeleton is replaced by fibrous, which, of course, leads to deformation of the supporting apparatus.
Symptoms of hyperparathyroidism are associated not only with impaired bone structure. An increase in the level of calcium in the blood often leads to the formation of calcifications in the tissues of the internal organs. First of all, vascular walls and kidneys suffer from the appearance of such neoplasms. In addition, against the background of calcium, there is an increase in blood pressure, increased secretion in the stomach (often leads to ulceration) and impaired conduction in nerve tissues, which is accompanied by impaired memory, muscle weakness and depressive states.
Hyperparathyroidism: symptoms and causes of the primary form
In the modern classification, several groups of this pathology are distinguished. Patients are often diagnosed with primary hyperparathyroidism. Its symptoms are associated with a primary lesion of the glands, and in 85% of cases, the cause of the development of the disease is an adenoma (benign tumor).
Much less often, when diagnosing, multiple tumors are detected. Rarely, the cause of secretion is cancer, which in most cases develops after irradiation of the neck and head. The initial stages of the disease are accompanied by nonspecific signs - weakness, fatigue, drowsiness, irritability. That is why patients rarely seek help. A disease can develop over the years. According to statistics, the primary form of the disease in most cases develops in women against the background of menopause, as well as in older people.
The secondary form of the disease and its features
Secondary hyperparathyroidism is a disease that develops with primarily healthy glands. Increased secretion of parathyroid hormone occurs against a background of a decrease in the level of calcium in the blood, which, as a rule, is associated with other pathologies.
In most cases, hypocalcemia is associated either with severe chronic kidney disease, or with malabsorption of nutrients (including calcium) by the intestinal walls. The level of parathyroid hormone rises after a resection of the stomach, as well as against the background of hemodialysis. The causes include rickets and severe liver damage, which are accompanied by a violation of the metabolism of vitamin D.
Tertiary form of the disease
Tertiary hyperparathyroidism occurs in patients who undergo a kidney transplant, and the transplantation was successful.
As already mentioned, kidney disease is often accompanied by an increase in parathyroid hormone levels. The fact is that such pathologies are accompanied by increased excretion of calcium from the body. Prolonged hypocalcemia can lead to permanent changes in the parathyroid glands. Even after the complete restoration of the renal parameters, the patients still experience a disruption of the glands and increased secretion of parathyroid hormone.
The clinical picture with hyperparathyroidism
Symptoms of hyperparathyroidism are diverse, because it affects many organ systems. Moreover, the clinical picture depends on the variety of the disease, the stage of its development, the presence of concomitant pathologies, the age and even gender of the patient.
The first symptoms are usually non-specific. Patients note the appearance of lethargy and weakness, a decrease in appetite, the periodic appearance of nausea. There is also pain in the joints. Since an increase in the level of calcium changes the transmission of the neuromuscular impulse, patients also experience muscle pain - this is how hyperparathyroidism develops. Symptoms of elderly patients, as a rule, include muscle weakness. It is difficult for patients to get out of the chair, they stumble while walking, often fall.
Due to the weakness of the muscles of the foot, flat feet often develop, pains in the legs appear when walking. Due to damage to the renal tubules, other disorders are possible, in particular, an increase in the amount of urine. In severe cases, patients dramatically lose weight due to poor appetite and dehydration. The lack of fluid in the body affects the condition of the skin - it becomes dry, acquires an earthy color. Loss of calcium often leads to loosening and loss of healthy teeth.
Bones constantly lose calcium and phosphorus. Moreover, against the background of this ailment, activation of osteoclasts, cells that are able to dissolve bones, is observed. The consequence of increasing parathyroid hormone levels is progressive osteoporosis.
Due to a decrease in bone density, fractures are not uncommon for patients. Moreover, even small physical exertion or shock can injure the bone. The bones often do not grow together, forming the so-called "false joints". Deformations of the skeleton, in particular, the spine (kyphosis, scoliosis), chest and pelvis, are also observed. This, of course, affects the well-being and mobility of a person. Hyperparathyroidism is often accompanied by the deposition of uric acid crystals in the joints (gout).
Excess calcium affects kidney function. Often inside the pyelocaliceal system, coral-shaped stones form. In the absence of treatment, renal failure often develops, which, alas, is irreversible - often the patient needs a kidney transplant.
The disease affects the digestive tract. Patients complain of decreased appetite, flatulence, constipation, nausea, and abdominal pain. With an excess of calcium in the blood, the formation of stones in the gallbladder and pancreatic ducts is not excluded, which leads to the development of cholecystitis and pancreatitis. By the way, the symptoms of hyperparathyroidism in women often worsen during pregnancy, which is very dangerous not only for the mother, but also for the baby.
An increase in calcium levels affects the functioning of the nervous system and often causes mental changes. Patients can notice apathy, anxiety, and sometimes depression of varying severity. Drowsiness, impaired memory and cognitive abilities appear. In the most severe cases, the ailment is accompanied by confusion and acute psychoses.
Often parents are interested in questions about what hyperparathyroidism looks like in children. Symptoms, treatment and complications in this case are the same. But if we are talking about the primary form of the disease, then it is usually associated with genetic heredity. If the disease appeared in the first months or years of life, there is a delay in the physical and mental development of the child.
Hyperparathyroidism: diagnosis
In this case, it is diagnostics that are extremely important. Symptoms of hyperparathyroidism increase slowly, and sometimes completely absent. That is why, for starters, laboratory tests of blood and urine are performed. During studies in blood samples, you can notice an increase in calcium levels and a decrease in the amount of phosphates. When analyzing urine, an increased amount of both elements is detected. This study is carried out twice - if they give the same results, a blood test for parathyroid hormone is performed.
An increase in the level of the hormone indicates the presence of hyperparathyroidism, but it is important not only to establish the presence of the disease, but also to determine its cause. First, an ultrasound scan is performed that helps the specialist see an increase in the size of the parathyroid gland or the presence of neoplasms. Additionally, magnetic resonance imaging and computed tomography are performed - these procedures provide more accurate information.
Be sure to examine the kidneys and skeletal system to find out if the patient has complications.
Hypercalcemic crisis and its treatment
Hypercalcemic crisis is an acute condition that develops with a sharp increase in the level of calcium in the blood. Such a pathology leads to dangerous damage to the body and in 50-60% of cases leads to death.
Fortunately, a crisis is considered a rare complication of hyperparathyroidism. Various factors can provoke it, including infections, massive bone fractures, infections, intoxications. Risk factors include pregnancy, dehydration, and the use of certain medications, including products containing calcium and vitamin D, thiazide diuretics. Patients with hyperparathyroidism need to carefully monitor their diet, excluding foods high in calcium and vitamin D. Not the least role in the development of the crisis is played by the lack of adequate therapy and erroneous diagnosis.
Hyperkalemic crisis develops rapidly. First, patients develop digestive disorders, including sharp sharp abdominal pains, intense vomiting. An increase in body temperature is noted. Patients complain of bone pain and muscle weakness. Disorders from the nervous system also appear, starting from depression and depression, ending with psychoses. The skin of a sick person becomes dry, itching appears.
Due to bleeding disorders, it is possible to develop DIC. Perhaps the development of a shock state. The patient dies as a result of cardiac arrest or respiratory muscle paralysis.
Hyperparathyroidism Treatment Methods
We have already addressed questions about what constitutes hyperparathyroidism. Symptoms and treatment in this case are closely related. If we are talking about the primary form of the disease associated with the formation of a tumor, then surgical removal of the neoplasm is possible. The operation is not always carried out. The fact is that the disease can develop over decades, without causing the patient any particular inconvenience. Yes, and mostly elderly people suffer from it, which creates additional difficulties.
The decision on the need for surgery is made by the doctor. It is believed that surgery is necessary with a strong increase in the level of calcium in the blood (more than 3 mmol / l) and severe impairment of kidney function. Indications for the procedure are stones in the excretory system, a significant loss of calcium along with urine, a history of hypercalcemic crises, as well as severe osteoporosis.
If the doctor decided not to carry out the removal of the tumor or gland (with its hypertrophy), then patients still need to be regularly examined - it is important to carry out studies of the kidneys and bone apparatus at least 1-2 times a year. It is important to constantly monitor the level of calcium in the blood and blood pressure.
As for the secondary form, the treatment of hyperparathyroidism boils down to eliminating primary diseases. Calcium deficiency in the blood can be eliminated by medication - patients are prescribed medicines containing this mineral, as well as vitamin D. In the event that taking the drugs does not give the expected effect, surgical excision of parts of the gland can be performed.
Pseudohyperparathyroidism and its features
Modern medicine is also known for the so-called pseudohyperparathyroidism. This is a fairly rare disease, which is accompanied by the same symptoms. Nevertheless, the pathology is not associated with the work of the most parathyroid glands.
The patient has malignant neoplasms that can be localized in the kidneys, lungs, mammary glands and other organs. These tumors contain cells that are capable of producing active substances similar in their mechanism of action to parathyroid hormone. With such a disease, an increase in the level of calcium in the blood due to the dissolution of bone tissue is observed. This is an extremely dangerous ailment that can lead to death.
Predictions for Patients
Now you know how hyperparathyroidism develops. Symptoms and treatment in women, especially the course of the disease in children, are important issues. But what forecasts can be counted on? The results depend on what stage of development the disease was detected.
If we are talking about early primary hyperparathyroidism, then with timely treatment, the prognosis is favorable. Symptoms from the internal organs and nervous system disappear after a few weeks. The bone structure can be restored in a few years. In advanced cases, patients may retain skeletal deformities that affect the quality of life, but are not dangerous.
If kidney damage occurs, even after surgery, kidney failure can progress. In any case, you should carefully monitor your well-being and undergo preventive medical examinations.