Secondary hyperparathyroidism

Secondary hyperparathyroidism is a disorder of the parathyroid glands in which they secrete excessive amounts of parathyroid hormone (PTH). This condition is often a complication of chronic kidney disease and vitamin D deficiency.

Causes

Secondary hyperparathyroidism is most commonly caused by chronic kidney disease. The kidneys play a crucial role in maintaining calcium and phosphorus balance in the body. When the kidneys are not functioning properly, they are unable to convert vitamin D into its active form, leading to a decrease in calcium absorption from the intestines. This results in low calcium levels in the blood, which stimulates the parathyroid glands to secrete more PTH.

Other causes of secondary hyperparathyroidism include vitamin D deficiency and certain medications, such as phenytoin and rifampin, which can interfere with the body's ability to convert vitamin D into its active form.

Symptoms

The symptoms of secondary hyperparathyroidism can vary depending on the underlying cause and the severity of the condition. Common symptoms include bone pain, muscle weakness, fatigue, and depression. In severe cases, the condition can lead to bone deformities and fractures.

Diagnosis

The diagnosis of secondary hyperparathyroidism is usually made based on blood tests that measure levels of calcium, phosphorus, PTH, and vitamin D. Imaging tests, such as ultrasound or computed tomography (CT) scan, may also be used to assess the size and shape of the parathyroid glands.

Treatment

The treatment of secondary hyperparathyroidism depends on the underlying cause. In cases caused by chronic kidney disease, treatment may include medications to control phosphorus levels, vitamin D supplements, and in some cases, surgery to remove the parathyroid glands. In cases caused by vitamin D deficiency, treatment typically involves vitamin D supplements.

See also

• Primary hyperparathyroidism
• Tertiary hyperparathyroidism
• Hypoparathyroidism

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