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 occur? What is the reason, what are the prerequisites? By what symptoms can you find out about the problem? And most importantly, how do you deal with it? All this will now be discussed.
Development mechanism
Hyperplasia of the parathyroid glands occurs due to a decrease in the sensitivity of the receptors of the cells of this organ to calcium. Because of this, there is a compensatory increase in the release of parathyroid hormone.
What happens in the end? This hormone accumulates in the blood in excess 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 that are observed:
- Increased osteoclast function and bone resorption. This leads to the formation of new bone tissue. However, there is a nuance here. The bone itself dissolves slowly, and therefore calcium is washed out of it. The result is a high level of this element in the blood and the development of osteoporosis. It's just that the bone becomes very fragile, loses its resistance to external influences. Possible development of fibro-osseous dysplasia and chondrocalcinosis.
- The synthesis of calcitriol is increased. It also provokes the action of parathyroid hormone. As a result, hypercalcemia increases and calcium absorption in the intestine is stimulated.
- Calcium reabsorption in the renal tubules increases and phosphate absorption decreases. It also increases glomerular filtration of calcium. 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. S alts are often deposited in the kidneys.
- Reduces the body's sensitivity to antidiuretic hormone. As a result, there is a violation of water reabsorption. Often polydipsia or polyuria develops, urine density decreases.
- In the digestive tract, the production of pepsin and hydrochloric acid increases. Their increased content aggressively affects the stomach wall.
- Calcium s alts due to high concentration are deposited on the walls of internal organs and blood vessels.
In addition, parathyroid hyperplasia often causes mental disorders. Because a persistently 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, although the range 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 deformity.
- Violations observed in the microarchitectonics of bones. Their airiness increases, resorptive cavities appear.
- Muscle weakness.
- Pseudogout attacks. They are acute joint pain, swelling and redness.
- Duck walk.
- Loss and loosening of perfectly he althy teeth.
- Sharp weight loss.
- Nephrolithiasis.
- Stomach ulcer.
- Impaired kidney function.
- Pancreocalcinosis, pancreatitis and other diseases of the pancreas tissue.
- Heart rhythm problems.
- High blood pressure.
In especially severe cases, even paralysis is observed, which binds the muscles of the pelvic floor. There are also depressive disorders, memory impairment and other mental changes.
Diagnosis
Only an endocrinologist can detect the presence of parathyroid hyperplasia on the right or left. Of course, you will need to take tests, the results of which will help detect elevated levels of calcium and parathyroid hormones.
In addition, you will need to go through the following procedures:
- MRI and CT.
- Scintigraphy (the most accurate method).
- Ultrasound.
To identify the consequences and complications, additional measures are prescribed. This can be an electrocardiogram or an X-ray diagnosis.
Hyperparathyroid crisis
This disease cannot be ignored. Because it often becomes a complication of right or left parathyroid hyperplasia.
This disease is characterized by a critically high level of calcium in the blood. The indicators exceed 3.5 µmol / l. The characteristic features include the following manifestations:
- Abdominal pain.
- Sharp pain.
- Fever.
- Nausea preceded by repeated vomiting.
- Reducing blood pressure.
- Drowsiness and confusion.
- Urine retention and convulsions.
- Rapidly developing kidney failure.
Therapy
Treatment of parathyroid hyperplasia, like any other disease, is determined by the doctor on an individual basis.
If the course is asymptomatic, the patient should be under the supervision of an endocrinologist. The issue regarding the need for treatment is being resolved in the future.
Here are the cases in which conservative therapy is appropriate:
- Mild bone disorders.
- Not pronounced hypercalcemia.
- No remission afteroperations.
- Presence of contraindications to surgical intervention.
- Manifest hyperparathyroidism.
The following drugs are prescribed:
- Calcitonin. Minimizes parathyroid hormone levels.
- Bisphosphonates. Helps to reduce the amount of calcium in the blood, strengthen bones.
- Calcimimetics. These drugs suppress the production of parathyroid hormone.
Operation
The need for it should also be told, since there is a discussion of the symptoms and treatment of parathyroid hyperplasia (left or right).
Surgical intervention is needed if target organ damage is diagnosed. Indications also include:
- The inability to observe the patient for a long time and provide him with care.
- Development of serious complications (osteoporosis, nephrocalcinosis, renal failure).
- Hypercalcemia.
Be that as it may, a person learns about the need for an operation during consultations with an endocrinologist, nephrologist and orthopedist.
Rehab
After the operation, the patient is also given treatment. The therapy is aimed at eliminating calcium deficiency, normalizing kidney function, as well as correcting osteopenia.
What is shown to a person? Regular intake of calcium supplements and, of course, medical supervision. The doctor may also prescribe vitamin D, but this is if the disease suddenly worsens.
When the patient is a woman going through menopause,sex hormone therapy.
Forecast
The above pathology 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 being cured is reduced significantly. It is difficult to restore he alth, especially if the disease has affected the bone tissue and kidneys.
Be that as it may, a person in any case will have to adjust their lifestyle and diet. You will need to switch to a fractional diet, drink more clean liquids, and also diversify the menu with he althy foods (fresh vegetables, berries, fruits, products with omega-3, sour milk, cereals, rye bread). However, all recommendations regarding prevention will also be presented to the patient by an endocrinologist.
