The fact that the thyroid gland is of great importance for life is known to almost everyone. After all, pathologies of this organ of the endocrine system are very common. Sometimes thyroid surgery is the only treatment. For a long time, such surgical intervention was excessively radical in nature, leading to serious complications. The fact is that the organ was removed along with other important anatomical structures, namely with the parathyroid glands. More recently, scientists began to attach greater importance to these endocrine organs and realized what important functions they have. Diseases of the parathyroid gland lead to serious disorders of calcium and phosphorus metabolism. This affects the functioning of the bone, muscle, and also the nervous system.
Characterization of diseases of the parathyroid gland: symptoms, causes
Parathyroid (parathyroid) glands are responsible for important functions for the body. They secrete a special hormone, without which regulation of phosphorus-calcium metabolism is impossible. On average, a person has 4 parathyroid glands. In some, their number reaches 8-10 pieces. Unlike other endocrine glands, these anatomical structures do not have a lobular structure. Outside they are covered by a capsule, and inside they are composed of glandular parenchyma. These organs secrete parathyroid hormone. This biological substance is necessary for exposure to the nervous and musculoskeletal system. Parathyroid hormone is considered an antagonist of calcitonin. Its function is to produce osteoclasts. These cells help remove calcium from the bones and direct it into the bloodstream.
The causes of parathyroid diseases include endogenous and exogenous factors. Among them - chronic renal and endocrine pathologies, malabsorption in the digestive tract, neoplasms, harmful chemical and physical effects. How does parathyroid gland malfunction? Symptoms of the disease in men and women have some differences. Nevertheless, the main manifestations of pathologies in individuals of both sexes are the defeat of the skeletal system, disorders of the heart, muscle tissue. In some cases, neurological changes are noted.
Etiology and risk factors
The main cause of parathyroid diseases is the excessive production of the hormone or, on the contrary, its insufficiency. In the first case, an excessive amount of calcium accumulates in the bloodstream, which leads to disturbances in the body. This condition is called hyperparathyroidism. The following causes of this pathology are distinguished:
- Genetic disorders.
- Cancer of the parathyroid gland.
- Benign formations: adenoma or cyst.
- Lack of vitamin D and calcium in the body.
- Impaired absorption of beneficial substances in the intestines.
With insufficient production of the hormone, hypoparathyroidism develops. This disease develops against a background of chronic renal failure or high phosphorus levels. An autoimmune disorder in the body can also lead to a deficiency of parathyroid hormone. Less commonly, the cause of the pathology is surgical intervention, namely, thyroidectomy.
There are a number of risk factors that can lead to diseases of the parathyroid gland. These include:
- Infectious processes leading to tissue necrosis.
- Rickets.
- Endocrine disorders, in particular - thyroid disease.
- Pathology of the kidneys and gastrointestinal tract.
In addition, an ailment can provoke malnutrition. This is especially true for young children who need to receive a daily dose of vitamin D and calcium.
The mechanism of development of pathologies of the parathyroid gland
The pathogenesis of hyperparathyroidism depends on the etiology of the disease. An increase in hormone production may be associated with benign and malignant formations. In both cases, the tissue of the parathyroid gland grows, and there are more endocrine cells. All of them produce the hormone, as a result of which its concentration in the body increases dramatically. Secondary hyperparathyroidism occurs against a background of calcium deficiency. Since endocrine organs function according to feedback rules, a deficiency of this chemical element leads to a compensatory increase in the work of the parathyroid glands.
Primary hypoparathyroidism is most often associated with autoimmune cell damage. The reason for the production of antibodies may be a lack of thyroid hormones, diseases of the adrenal glands, ovaries, and liver. Autoimmune aggression can also cause fungal infections of the skin or mucous membranes. Secondary parathyroid hormone deficiency develops due to impaired absorption of calcium in the intestines and renal tubules. This leads to hyperphosphatemia and metabolic disorders.
Epithelial body. What symptoms can a disease have?
Since the parathyroid gland is one of the regulators of calcium-phosphorus metabolism, the symptoms of pathologies are associated with disorders of the bone, muscle and nervous system. Consider the manifestations of hyperparathyroidism. Regardless of the etiology of the disease, excessive secretion of the hormone is accompanied by the following symptoms:
- Bone softening - osteomalacia.
- Pain in the back and lower back.
- Hair and teeth loss.
- The appearance of sand or kidney stones.
- Increased thirst and frequent urination.
- Nausea and vomiting.
- Emotional instability.
Often, these symptoms are observed with parathyroid disease in women. Among the male population, an increase in hormone production is 3 times less common.
How does parathyroid insufficiency manifest itself? Symptoms of the disease in the initial stages, despite the opposite mechanism of development, are largely similar. People suffering from hypoparathyroidism also have hair loss, chronic fatigue and rapid destruction of tooth tissue. Later, tachycardia, convulsive syndrome (in the calf muscles, feet) and parasthesia join. Patients complain of such sensations as crawling, numbness of the skin, a feeling of chills. Hypoparathyroidism is often accompanied by conjunctivitis and keratitis.
Features of diseases in men
Symptoms of pathologies of the parathyroid glands in men do not differ much from the signs of the disease in women. The initial manifestations of the disease are the same in both sexes. However, women suffer ailment harder than men. This applies to both hypo- and hyperparathyroidism. In the clinical picture in men, myalgia and symptoms of urolithiasis predominate. Emotional lability among representatives of the strong half is less pronounced. Also, men are not so susceptible to osteoporosis and softening of bone tissue.
Symptoms of the disease in women
Among the female population, secondary hyperparathyroidism is most common. In most cases, it develops at a young and middle age - from 20 to 50 years. Hyperparathyroidism is associated with thyroid insufficiency, which occurs against the background of autoimmune inflammation or iodine deficiency. In addition, a pathological condition may develop due to ovarian dysfunction, menopause or taking contraceptives. Hormonal instability leads to diseases of the parathyroid gland. Symptoms in women begin unnoticed. In the initial stages, the ailment is accompanied only by increased fatigue. Then nervousness and increased muscle excitability are added. Patients complain of headache, recurrent muscle spasms, decreased memory and performance.
A marked increase in the content of parathyroid hormone leads to destruction of bone tissue. In women, this symptom is more pronounced than in men. This is due not only to hyperparathyroidism, but also to the insufficiency of sex hormones that occurs during menopause and postmenopause. The manifestations of the disease include osteomalacia, that is, softening of bone tissue. As a result of this violation, patients become susceptible to fractures. In addition, women are more likely to complain of back pain and muscle weakness. Another manifestation is urolithiasis, diagnosed with hyperparathyroidism.
Features of the pathology in children
In addition to possible genetic disorders and autoimmune pathologies, a lack of calcium and vitamin D is the main cause of parathyroid disease in children. Deficiency of these elements leads to disruption of the exchange between calcium and phosphorus. Unlike adults, the disease in children is more severe and more dangerous. Indeed, at an early age, bone tissue is not fully formed.
Symptoms of hyperparathyroidism resemble the clinical picture of rickets. Signs of pathology include tearfulness, sleep disturbance, muscle hypotension and gastrointestinal upset, the appearance of kidney stones. Children with hyperparathyroidism gain weight more slowly. With severe violations of mineral metabolism, a delay in physical development is possible. A lack of calcium in bone tissue leads to impaired gait and hallux valgus deformity of the knee joints. If treatment is not started in time, hyperparathyroidism in a child will lead to disability.
Possible complications of pathologies
The main complication of hyperparathyroidism is considered an increased level of calcium in the blood. If the content of this element reaches 15 mg, a serious condition develops for the body. Hypercalcemic crisis leads to acute renal failure and coma. Another dangerous complication is bone fragility. People with hyperparathyroidism are often prone to injury and disability.
The opposite condition is hypocalcemia. Her danger lies in convulsions. If the level of calcium in the blood is reduced slightly, then the patient is only concerned about involuntary contractions of the muscles of the limbs. With severe hypocalcemia, the convulsive syndrome can cover the respiratory and vascular muscles, leading to bronchial and laryngospasm, renal colitis, and cardiac abnormalities.
Diagnostic criteria for parathyroid pathologies
How to identify diseases of the parathyroid gland? Diagnosis consists of a survey, examination of the patient and laboratory tests. The criteria of pathologies include characteristic complaints (of fatigue, nausea, cramps, damage to the teeth), weakness, or, conversely, increased muscle tone. To confirm the diagnosis, it is required to check the level of parathyroid hormone, as well as calcium and phosphorus in the venous blood. To visualize the bones and identify violations of their structure, radiography and CT are performed.
Disease Treatment Methods
To improve the patient's condition, it is necessary to normalize the level of hormones. Treatment of diseases of the parathyroid glands pursues this goal. Wellness activities include:
- Proper nutrition.
- Replacement therapy.
- Surgical treatment.
- The right way of life.
Treatment should be comprehensive and ongoing. Surgery is required if the gland tissue produces an excessive amount of the hormone.
Hypoparathyroidism replacement therapy
In order for the calcium level in the body to reach normal, a balanced diet and replacement therapy are required. Dairy products should prevail in the diet: hard varieties of cheese, cottage cheese, kefir. It is also recommended to eat eggs, liver and saltwater fish. As a substitution therapy, drugs “Calcium D 3 ”, “Vitamin D”, “Aquadetrim”, etc. are prescribed. With pronounced muscle contractions, anticonvulsant treatment is performed.
To improve the absorption of preparations containing calcium and vitamin D, you need to take walks in the fresh air and stay in the sun. In the winter season, procedures are prescribed, accompanied by ultraviolet radiation in the required doses.
Guidelines for the treatment of hyperparathyroidism
Surgical diseases of the parathyroid gland primarily include cysts, hyperplasia, adenoma and cancer. To normalize the level of the hormone, an operation should be performed. Surgical treatment consists in the partial removal of the parathyroid glands. After surgery, patients are recommended to be exposed to sunlight and other radiation as little as possible.