Hyperparathyroid

More PTH increases serum calcium

Symptoms from hypercalcaeimia: moans, groans, stones, and bones

Polydipsia, polyuria and hypertension are common too. Other important associations are renal stones and pancreatitis.

 

Primary

Increased PTH, increased calcium

• Uncontrolled parathyroid hormone production by a tumour of the parathyroid gland - leading to hypercalcaemia
• Treatment is to remove the tumour surgically

Secondary

Low calcium, increased PTH

• Insufficient vitamin D or kidney disease reduces calcium absorption from the intestines, kidneys and bones
• Results in a low blood calcium
• The parathyroid glands are correctly reacting to the low calcium
• Treatment is to correct the underlying vitamin D deficiency or chronic kidney disease

Tertiary

Increased calcium, increased PTH

• Gland hyperplasia from chronic secondary hyperparathyroidism
• With recent treatment of vitamin D replacement