Caused by parathyroid adenoma, parathyroid hyperplasia, and parathyroid carcinoma (in rare cases).
Postmenopausal women and patients who have had chronic and serious calcium or vitamin D deficiency, have a rare genetic disease, have undergone radiation therapy, or have taken lithium are at increased risk.
The disorder is most prevalent in individuals between 50-60 years of age. Females are more frequently affected.
Patients are usually asymptomatic. Symptomatic patients have variable presentations. In mild cases, common symptoms include fatigue, lethargy, depression, muscle weakness, and muscle pain. In severe cases, symptoms include anorexia, nausea, vomiting, constipation, confusion, memory impairment, frequent urination, and bone thinning and fractures.
Complications are dependent on the long-term effects of insufficient calcium in a patient's bones and excessive calcium circulating in the bloodstream. Common complications include osteoporosis, kidney stones, cardiovascular disease, and hypoparathyroidism of the neonate in pregnant women with untreated hyperparathyroidism.
Treatment is dependent on the course of the disease and will vary depending on individual cases. Patients who are asymptomatic may not require any treatment and should be closely monitored by their physician. Medications such as bisphosphonates may help with bone health, and estrogen therapy may benefit postmenopausal women. Patients with primary hyperparathyroidism due to familial hypocalciuric hypercalcemia may need surgery.
E21.3 – Hyperparathyroidism, unspecified
66999008 – Hyperparathyroidism
- Secondary hyperparathyroidism – serum calcium levels low or low-normal
- Hypercalcemia of malignancy and other causes of hypercalcemia (milk-alkali syndrome, granulomatous disease, vitamin D excess, etc) – typically parathyroid hormone (PTH) levels are suppressed
- Familial hypocalciuric hypercalcemia – low urine calcium excretion
- Lithium use can result in hypercalcemia with elevated PTH that may be reversible if duration of lithium use has been fairly short.