Parathyroid disorders

Parathyroid Disorders encompass a range of medical conditions affecting the parathyroid glands, which are small endocrine glands located in the neck behind the thyroid. These glands play a crucial role in regulating the body's calcium levels through the secretion of parathyroid hormone (PTH). Disorders of the parathyroid glands can lead to abnormalities in calcium, phosphorus, and bone metabolism.

Types of Parathyroid Disorders

Parathyroid disorders can be broadly classified into the following categories:

Hyperparathyroidism

Hyperparathyroidism is characterized by the overproduction of parathyroid hormone, leading to elevated calcium levels in the blood (hypercalcemia). It can be further divided into:

• Primary Hyperparathyroidism: Caused by an enlargement or a tumor (adenoma) in one or more of the parathyroid glands.
• Secondary Hyperparathyroidism: Occurs as a response to low calcium levels in the blood, often due to chronic kidney disease.
• Tertiary Hyperparathyroidism: Develops after prolonged secondary hyperparathyroidism, where the glands become autonomous and overactive.

Hypoparathyroidism

Hypoparathyroidism is the condition of underproduction of PTH, leading to low levels of calcium in the blood (hypocalcemia). Causes include surgical removal of the parathyroid glands, autoimmune disease, or genetic factors.

Parathyroid Carcinoma

Parathyroid carcinoma is a rare and aggressive form of cancer affecting the parathyroid glands. It can lead to severe hypercalcemia.

Symptoms

Symptoms of parathyroid disorders vary depending on whether the condition leads to hypercalcemia or hypocalcemia. Common symptoms include:

• For hypercalcemia: Weakness, fatigue, frequent urination, kidney stones, and bone pain.
• For hypocalcemia: Muscle cramps, tingling in the fingertips, toes, and lips, and in severe cases, seizures.

Diagnosis

Diagnosis of parathyroid disorders typically involves:

• Blood tests to measure levels of calcium, phosphorus, and PTH.
• Imaging tests like ultrasound or nuclear medicine scans (sestamibi scans) to identify abnormal parathyroid glands.
• Bone density tests to assess the impact on bone health.

Treatment

Treatment depends on the type and severity of the disorder:

• For hyperparathyroidism, surgical removal of the overactive gland(s) is often recommended. Medications and monitoring may be advised for those who are not surgical candidates.
• Treatment of hypoparathyroidism usually involves calcium and vitamin D supplementation to maintain normal calcium levels.
• Parathyroid carcinoma treatment includes surgery, and possibly radiation therapy.

Prevention and Management

Preventive measures for parathyroid disorders are limited due to their often idiopathic or genetic causes. Management focuses on regular monitoring of calcium levels, dietary adjustments, and medication adherence to prevent complications.