Quite often, after diagnosis, disorders in the functioning of the parathyroid glands are found in patients. Symptoms of hyperparathyroidism can often be nothing to worry about. Lethargy, weakness, decreased performance, constipation - people often attribute all these disorders to general fatigue and malnutrition. Therefore, they turn to the doctor already at the later stages of the development of the disease.
In this regard, many people today are interested in the question of what hyperparathyroidism is. Symptoms and treatment, causes and exacerbation are important points to be de alt with. So what threatens the patient with this disease 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 terms that patients often encounter. But before dealing withcauses 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, a few millimeters in size, weighing from 20 to 70 mg.
The parathyroid glands secrete an active biological substance, namely parathormone, which regulates the processes of phosphorus and calcium metabolism in the body. With an insufficient amount 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 excretion 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 representatives of the stronger sex. To date, pathology is considered very common. If we talk about endocrine diseases, then hyperparathyroidism is the third most common (after hyperthyroidismand diabetes).
Pathological changes due to illness
As already mentioned, with an increase in the level of parathyroid hormone in the blood, a violation of calcium metabolism in the body occurs - this mineral begins to be washed out of the bones. At the same time, the level of calcium in the blood also rises. The bone tissues of the skeleton are replaced by fibrous ones, which naturally leads to deformation of the supporting apparatus.
Symptoms of hyperparathyroidism are associated not only with a violation of the structure of the bones. 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, the 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 the formation of ulcers) 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. Often, patients are diagnosed with primary hyperparathyroidism. Its symptoms are associated with the 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, multiple tumors are found in the diagnosis. Occasionally, the cause of impaired secretion is cancer, which in most cases develops after irradiation of the neck and head. The initial stages of the disease are accompanied bynonspecific signs - weakness, fatigue, drowsiness, irritability. That is why patients rarely seek help. The disease can develop over the years. According to statistics, the primary form of the disease in most cases develops in women on the background of menopause, as well as in the elderly.
Secondary form of the disease and its features
Secondary hyperparathyroidism is a disease that develops in primary he althy glands. Increased secretion of parathyroid hormone occurs against the background of a decrease in the level of calcium in the blood, which is usually associated with other pathologies.
In most cases, hypocalcemia is associated either with severe chronic kidney disease, or with impaired absorption of nutrients (including calcium) by the intestinal walls. The level of parathyroid hormone increases after resection of the stomach, as well as against the background of hemodialysis. The causes include rickets and severe liver damage, which are accompanied by impaired vitamin D metabolism.
Tertiary form of the disease
Tertiary hyperparathyroidism occurs in patients who have had a kidney transplant and the transplant 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 irreversible changes in the parathyroid glands. Even after complete recovery of renal parameters, patients still experience glandular dysfunction and increased secretion of parathyroid hormone.
Clinical picture of hyperparathyroidism
The symptoms of hyperparathyroidism are varied, as it affects many organ systems. Moreover, the clinical picture depends on the type of the disease, the stage of its development, the presence of concomitant pathologies, the age and even the sex of the patient.
The first symptoms are usually non-specific. Patients note the appearance of lethargy and weakness, decreased appetite, periodic nausea. There is also pain in the joints. Because elevated calcium levels alter neuromuscular transmission, patients develop muscle pain, which is how hyperparathyroidism develops. Symptoms of older patients usually include muscle weakness. Patients have difficulty getting up from a chair, stumble while walking, and often fall.
Due to the weakness of the muscles of the foot, flat feet often develop, pain in the legs appears 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 lose weight dramatically 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 he althy teeth.
Bones constantly lose calcium and phosphorus. Moreover, against the background of this disease, activation of osteoclasts, cells that are able to dissolve bones, is observed. The consequence of an increase in the level of parathyroid hormone is progressive osteoporosis.
Because ofreduced bone density fractures for patients are not uncommon. Moreover, even small physical exertion or blows can injure the bone. Bones often do not fuse completely, forming so-called "false joints". There are also deformations of the skeleton, in particular, the spine (kyphosis, scoliosis), chest and pelvis. 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, coral-like stones form inside the pyelocaliceal system. If left untreated, kidney failure often develops, which, alas, is irreversible - often the patient needs a kidney transplant.
The disease also 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 child.
Increased calcium levels affect the functioning of the nervous system and often cause changes in the psyche. Patients may notice apathy, anxiety, and sometimes depression of varying severity. Drowsiness, impaired memory and cognitive abilities appear. In the most severe cases, the diseaseaccompanied 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 the diagnosis that is extremely important. Symptoms of hyperparathyroidism increase slowly, and sometimes they are completely absent. That is why laboratory tests of blood and urine are carried out to begin with. During research in blood samples, you can notice an increase in the level of calcium and a decrease in the amount of phosphate. Urinalysis reveals an increased amount of both elements. 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. To begin with, an ultrasound examination is performed, which helps the specialist to see an increase in the size of the parathyroid gland or the presence of neoplasms. Additionally, magnetic resonance 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 hascomplications.
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 the period of pregnancy, dehydration of the body, as well as taking certain medications, including products containing calcium and vitamin D, thiazide diuretics. Patients with hyperparathyroidism need to carefully monitor nutrition, excluding foods high in calcium and vitamin D. Lack of adequate therapy and erroneous diagnosis play an important role in the development of the crisis.
Hyperkalemic crisis develops rapidly. First, patients develop disorders of the digestive system, including acute sharp pains in the abdomen, intense vomiting. There is an increase in body temperature. Patients complain of bone pain and muscle weakness. Disorders of the nervous system also appear, ranging from depression and depression to psychosis. The skin of a sick person becomes dry and itchy.
Due to a bleeding disorder, DIC may develop. Shock may develop. The death of the patient occurs as a result of cardiac arrest or paralysis of the respiratory muscles.
Methods of treating hyperparathyroidism
We have already covered the 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 much inconvenience. And it affects mainly the elderly, which creates additional difficulties.
The doctor decides whether surgery is necessary. It is believed that the operation is necessary with a strong increase in the level of calcium in the blood (more than 3 mmol / l) and severe disorders in the kidneys. 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 remove the tumor or gland (with its hypertrophy), then patients still need to be examined regularly - it is important to conduct examinations of the kidneys and bone apparatus at least 1-2 times a year. Constant monitoring of blood calcium levels and blood pressure is important.
As for the secondary form, the treatment of hyperparathyroidism is reduced to the elimination of primary diseases. Calcium deficiency in the blood can be eliminated with 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, it can be carried outsurgical excision of parts of the gland.
Pseudohyperparathyroidism and its features
Modern medicine also knows the so-called pseudohyperparathyroidism. This is a fairly rare disease that is accompanied by the same symptoms. Nevertheless, the pathology is not connected with the work of the most parathyroid glands.
A 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 that are similar in mechanism of action to parathyroid hormone. With a similar 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 disease that can be fatal.
Prognosis 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 predictions can be expected? The results depend on at 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 the 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 quality of life but are not dangerous.
If there is kidney damage that even after surgery, kidney failuremay progress. In any case, you should carefully monitor your well-being and undergo preventive medical examinations.
