Hyperplasia of the parathyroid glands is a pathology in which they greatly increase in size. This condition leads to an increase in the function of the organ. This is fraught with serious consequences.
Why does this pathology arise? What is the reason, what are the premises? What symptoms can I find out about the problem? And most importantly, how to deal with it? All this will be discussed now.
Development mechanism
Hyperplasia of the parathyroid glands occurs due to a decrease in the sensitivity of cell receptors of this organ to calcium. Because of this, a compensatory increase in the release of parathyroid hormone occurs.
What happens in the end? This hormone accumulates in the blood in excessive concentration. In such quantity, it negatively affects various tissues and organs.
Changes in the body
With hyperplasia of the parathyroid glands, they, of course, occur. And here are the changes observed:
- Increased osteoclast function and bone resorption. This leads to the formation of new bone tissue. However, there is a nuance. The bone itself is absorbed slowly, but because calcium is washed out of it. The result is a high level of this element in the blood and the development of osteoporosis. Itβs just that the bone becomes very fragile, loses resistance to external influences. Perhaps the development of fibro-bone dysplasia and chondrocalcinosis.
- Calcitriol synthesis is increasing. It also provokes the action of parathyroid hormone. As a result, hypercalcemia is enhanced and calcium absorption in the intestine is stimulated.
- Calcium reabsorption in the renal tubules is increased, and phosphate absorption is weakened. The glomerular filtration of calcium also increases. Because of this, the excretion of this element and phosphorus increases.
- The high concentration of calcium observed in the blood leads to damage to the epithelium of the renal tubules. This also leads to stone formation. Salt is often deposited in the kidneys.
- The sensitivity experienced by the body to antidiuretic hormone decreases. As a result, there is a violation of the reabsorption of water. Often polydipsia or polyuria develops, urine density decreases.
- In the digestive tract, the production of pepsin and hydrochloric acid is enhanced. Their increased content aggressively affects the wall of the stomach.
- Due to the high concentration, calcium salts are deposited on the walls of internal organs and blood vessels.
In addition, hyperplasia of the parathyroid glands often causes mental disorders. Because stably disturbed calcium balance negatively affects the central nervous system.
Clinical manifestations
Symptoms of parathyroid hyperplasia are specific. As a rule, they are nephrological and bone, even if the spectrum of lesions of systems and organs is much wider. We can distinguish the following list of clinical manifestations:
- Frequent fractures.
- Pain in the bones, as well as their deformation.
- Disorders observed in bone microarchitectonics. Their airiness rises, resorptive cavities appear.
- Muscle weakness.
- Attacks of pseudogout. Represent acute pain in the joints, swelling and redness.
- "Duck" gait.
- Loss and loosening of perfectly healthy teeth.
- Sharp weight loss.
- Nephrolithiasis
- Stomach ulcer.
- Impaired renal function.
- Pancreocalcinosis, pancreatitis and other ailments of pancreatic tissue.
- Heart rhythm problems.
- Increased blood pressure.
In especially severe cases, there is even paralysis that chills the muscles of the pelvic day. Depressive disorders, memory impairment, and other mental changes are also found.
Diagnostics
Only an endocrinologist can detect the presence of hyperplasia of the parathyroid gland on the right or left. Of course, you will need to pass tests, the results of which will help to identify elevated levels of calcium and parathyroid hormones.
In addition, you will need to undergo such procedures:
- MRI and CT.
- Scintigraphy (the most accurate method).
- Ultrasound
Additional measures are prescribed to identify the consequences and complications. This may be an electrocardiogram or radiological diagnosis.
Hyperparathyroid crisis
This disease can not be given special attention. Because it often becomes a complication of parathyroid hyperplasia that occurs on the right or left.
This disease is characterized by critically high levels of calcium in the blood. Indicators exceed 3.5 ΞΌmol / L. The characteristic features include the following manifestations:
- Abdominal pain.
- Sharp pain.
- Fever.
- Nausea preceding repeated vomiting.
- Decrease in blood pressure.
- Drowsiness and confusion.
- Urinary retention and cramps.
- Rapidly developing renal failure.
Therapy
The treatment of parathyroid hyperplasia, like any other disease, is determined by the doctor individually.
If the course is asymptomatic, the patient should be under the supervision of an endocrinologist. The question regarding the need for treatment is further resolved.
Here in what cases conservative therapy is appropriate:
- Light bone disorders.
- Not pronounced hypercalcemia.
- Lack of remission after surgery.
- The presence of contraindications for surgical intervention.
- Manifested hyperparathyroidism.
Prescribe such drugs:
- Calcitonin. Minimizes parathyroid hormone levels.
- Bisphosphonates. They help reduce the amount of calcium in the blood, strengthen bones.
- Calcimimetics. These drugs inhibit the production of parathyroid hormone.
Operation
It is also necessary to tell about the need for it, since there is a discussion of the symptoms and treatment of parathyroid hyperplasia (left or right).
Surgical intervention is necessary if target organ damage is diagnosed. Indications also include:
- Inability to observe the patient for a long time and provide him with care.
- The development of serious complications (osteoporosis, nephrocalcinosis, renal failure).
- Hypercalcemia.
Be that as it may, a person learns about the need for surgery at consultations with an endocrinologist, nephrologist and orthopedist.
Rehabilitation
After surgery, the patient is also prescribed treatment. Therapy is aimed at eliminating a lack of calcium, normalizing kidney function, as well as correcting osteopenia.
What is shown to man? The regular use of calcium preparations and, of course, medical supervision. A doctor may also prescribe vitamin D, but that is if the disease suddenly worsens.
When the patient is a woman undergoing menopause, sex hormone therapy may be prescribed.
Forecast
The pathology discussed above is a serious endocrine disease. But if it was detected at an early, initial stage - the patient has every chance of a successful outcome of therapy. Recovery is real.
However, if hyperplasia has already affected the condition and functioning of other organs and systems, the likelihood of recovery is reduced significantly. Health is difficult to restore, especially if the disease affects the bone tissue and kidneys.
Be that as it may, a person in any case will have to adjust his lifestyle and diet. It will be necessary to switch to a fractional diet, drink more clean liquid, and also diversify the menu with healthy products (fresh vegetables, berries, fruits, products with omega-3, sour milk, cereals, rye bread). However, the endocrinologist will also present all recommendations regarding prevention to the patient.