parathyroid gland ( hyperparathyrodism) dr/ abd elghany hefnawy
TRANSCRIPT
Parathyroid gland(Hyperparathyrodism)
Dr/ Abd Elghany Hefnawy
PTH
Kidney-Decrease P reabsorption
from PCT-Increase Ca reabsorption
from DCT causing increase plasma Ca level
Intestine
Increase formation of 1,25 DHCC causing
increase Ca absorption from intestine
Bone Increase Ca resorption from bone causing increase plasma Ca level
PTH
Hyperparathyrodism
Autonomous
Secondary
Primary-HPTPseudo-HPT
Renal-HPTNutritional-HPT
Autonomous HPTSecretion of PTH is autonomous i.e. not related to the existing Ca level
Pseudo-HPTPrimary-HPT
Excessive production of other bone resorbing substances (Non-parathyroid tissues) as mammary
glands
-Parathyroid neoplasm-Hyperplasia
-Ectopic parathyroid neoplasm
Hypercalcemia including
Primary HPT Pseudo HPT Hypervitaminosis-D
Autonomous HPT
Clinical SignsAnorexia and
general depression
Constipation and vomiting
Muscular weakness
Rubber jaw(softness of mandible bone)
Easily fractured bonePolyueria and
polydepsia
Calcium urolithiasis
Cardiac arrhythmia
Loss teeth
DiagnosisHistory and clinical
signs Lab diagnosis
-High level of calcium and PTH
-Low level of phosphorous
Radiography -Decrease bone
density and increase bone cysts
-Ultrasonography of PTH glands -Surgical diagnosis
Steroid(Dexamethazon) suppression test
To differentiate between PHPT and PsHPT
By injection of Dexamethazon (0.5-1mg/kg IM)
Calcium level decreased IfPsHPT
Calcium level remain high
PHPT
Treatment
Surgical interference
Renal Hyperparathyroidism
Renal failure
Low production of vit-D (Active
form 1.25DHCCF)
Excessive Execretion of calcium
Protein catabolism with excess release of
phosphorous
Hypocalcemia
Hypertrophy of parathyroid gland
Renal hyperparathyrodism
Diagnosis
Low calcium
High PTH
Abnormal kidney function tests
Treatment
Calcium borogluconate
Vitamin-D IM
Treatment of renal failure
Nutritional Hyperparathyroidism
DietCalcium Phosphorous
Young animal with signs of rickets
Diagnosis
Low calcium
High PTH
High phosphorous (In rickets the P is low)
Treatment
Calcium borogluconate
Reduction using of corticosteroid because it reduces serum calcium
Correction of the dietary supplementation
Almunium hydroxide gel To inhibit P++ absorption
Hypoparathyroidism
Congenital
Autoimmune reaction in lymphatic parathyroditis
Destruction of parathyroid gland by neoplasm
Atrophy of parathyroid gland
High number of puppies
Usually in lactating bitch or queen
Clinical Signs
Increase the neuromuscular
excitability
Hyperesthesia (Hypersensitivity against external
stimuli)
Ataxia and weakness
-Tetany-Convulsion
-Muscular spasm
TreatmentCalcium
borogluconat 10% (0.5-1 ml/kg)
Admisteration of vitamin-D 50,000-100,000 IU /Day
QUESTIONS
وسائل التواصل
Email: [email protected]@bu.edu.egFacebook abdelghany hefnawy
حفناوي. الغني عبد دWeb site to download lectures
www.bu.edu.eg/staff/abdelghanyhefnawy(Courses)
Tel 01011676482