parathyroid hyperplasia( %10 ) parathyroid carcinoma < %1
DESCRIPTION
Parathyroid Hyperplasia( %10 ) Parathyroid Carcinoma < %1 Hyperparathyroidism Primary Hyperparathyroidism Single Adenoma( %85 ) Multiple Adenoma(%5 ) Parathyroid Hyperplasia( %10 ) Parathyroid Carcinoma < %1TRANSCRIPT
Parathyroid Hyperplasia( %10 ) Parathyroid Carcinoma <
%1
Hyperparathyroidism Primary Hyperparathyroidism Single Adenoma( %85
) Multiple Adenoma(%5 ) Parathyroid Hyperplasia( %10 ) Parathyroid
Carcinoma < %1 Parathyroid Hyperplasia( %10 ) Parathyroid
Carcinoma < %1
Hyperparathyroidism Primary Hyperparathyroidism Single Adenoma( %85
) Multiple Adenoma(%5 ) Parathyroid Hyperplasia( %10 ) Parathyroid
Carcinoma < %1 Secondary to Hypocalcemia Renal Calcium
Leak
Hyperparathyroidism Secondary Hyperparathyroidism Tertiary
Hyperparathyroidism Secondary to Hypocalcemia Renal Calcium Leak
Dietary Calcium Malabsorption Vit D deficiency Parathroid Adenoma
CLINICAL MANIFESTATION
50-80% asymptomatic GI : loss of apetite,vometing, abdominal pain ,
constipation ,pancreatitis Central nervous system: lethargy,
drowsinesscoma , hyporeflexia Neuromuscular :easy
fatigability,proximal weakness, muscle atrophy, paresthesia ,
carpal tunnel Cardiac : HTN, arrythmias, CHF Kidney :
Nephrolithiasis (calcium oxalate and calcium phosphate )may lead to
infection and loss of renal function : Nephrocalcinosis may
decreased renal function Rheumatologic Manifestation
OfHyperparthyroidism Osteitis Fibrosa Cystica Osteoporosis Erosive
Arthritis Chondrocalcinosis Ectopic Calcification Subchondral
Fracture Myopathy Joint Laxity CTS Richets ( child ) Osteitis
Fibrosa Cystica
Most Specific pathologic Finding Number of Trabecula
GiantMultinuclearOsteoclast Replacement of BM with Fibrosis
Radiology : Bone Cyst( Brown tumor ) Pepper + Salt Subperiosteal
Resorption PATHOLOGY Decreased number of trabecula Giant
multinuclear osteoclast
Replaced bone marrow with fibrosis Osteoclastreabsorption Normal
skull Salt and pepper in Skull SALT AND PEPPER
DistalClavicularResorption SUBPERIOSTEAL RESORPTION
In radial aspect of figers (2,3) Subperiosteal Resorption Phalanx
resorption Brown Tumor BROWN TUMOR Brown Tumor Brown Tumor Brown
Tumor ( Histology) Normal sacroiliac joint Normalsacroiliac
Pseudowidening of Sacroiliac Joints Soft tissue calcification(
Hyperpara) Softtissuecalcification Normallumbosacral Osteoporosis
BONE CYST Chondocalcinosis Raggerr gersy Secondary
Hyperparathyroidism Laboratory : Imaging : Detection of Primary
hypepara
Ca,P, Alk Ph , PTH High Frequency Ultrasound TC99 Pertechnetate +
Thalium TC99 SestamibiScanning CervicalMRIScanning Intravenous
Digital Subtraction Angiography 2- Medical Estrogen Calcitonin
Biphosphonate Others
Treatment of Primary Hyperpara 2- Medical Estrogen Calcitonin
Biphosphonate Others 1- Surgical : Treatment of Primary Hyperpara
age < 50 y
ca > 1/ 6 mg / 100 ( upper limit ) age matched Clcr > %30
History of LifethreateningCa 24 h urinary Ca > 400 mg Z Score
< -2 SD