Parathyroidism Research Paper

1972 Words8 Pages
Rachel Mandes

Hyperparathyroidism occurs when there is an excess of parathyroid hormone being produced by one or more of the body’s four parathyroid glands located on the posterior region of the thyroid gland. Parathyroid hormone (PTH) helps maintain an appropriate amount of calcium, phosphorus, and vitamin D in the bloodstream. These vitamins and electrolytes are crucial for maintaining the body’s homeostatic state. Hyperparathyroidism can be subdivided into 3 types: Primary, secondary, and tertiary. Primary hyperparathyroidism is the most common of these three variants. It is defined as unregulated overproduction of PTH resulting in abnormal calcium homeostasis. Primary hyperthyroidism affects 1 in 500 women and 1 in
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The electrolyte we are most concerned with here is calcium. I would first measure total serum calcium or ionized calcium levels. Normal levels of calcium range from 9-10 mg/dl. Abnormally high levels range from 10mg/dl-15mg/dl. After confirmation of elevated levels of calcium, I would test the parathyroid hormone level. This is a crucial part of the diagnosis because other conditions can cause elevated calcium levels as well, but only primary hyperparathyroidism shows elevated calcium levels as a result of too much PTH. I would test the parathyroid level by using an “intact” assay. This uses two different antibodies against 2 different segments of the parathyroid hormone. Normal levels of PTH range from 24.2- 78 pg/mL. Abnormal levels of PTH typically range from 67-553 ng/mL. I would then have the patient undergo a series of several other tests to check for other secondary complications. The chronic excessive reabsorption of calcium from bone caused by excessive parathyroid hormone can result in osteopenia. I would order a bone mineral test to assess bone loss and risk of fractures due to hypercalcemia. Bone loss is a common secondary factor in patients with this condition. The patient would then undergo an ultrasound to test for the presence of kidney stones. A CT scan would then be used to confirm the presence of kidney stones. A 24-hour urine collection would also show the presence of kidney damage, the risk of kidney stone formation, or the risk of familial hypocaliciuric hypercalcemia. Finally, I would have the patient take a 25-hydroxy-vitamin D blood test because vitamin D deficiency is common in people with severe cases of primary hyperparathyroidism and even more prone to patients with secondary or tertiary hyperparathyroidism. Secondary and Tertiary hyperparathyroidism are diagnosed in the same manner with clinical history in

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