Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH).
The parathyroid hormone regulates calcium and phosphate levels and helps to maintain these levels. Excessive PTH secretion may be due to problems in the glands themselves, in which case it is referred to as ''primary'' hyperparathryroidism and which leads to hypercalcemia (raised calcium levels).
It may also occur in response to low calcium levels, as encountered in various situations such as vitamin D deficiency or chronic kidney disease; this is referred to as ''secondary'' hyperparathyroidism. In all cases, the raised PTH levels are harmful to bone, and treatment is often needed.
Recent evidence suggests that Vitamin D deficiency/insufficiency plays a role in the development of hyperparathyroidism. Lithium continues to be the gold standard for the treatment of bipolar disorder. It is used for related diagnoses, such as schizoaffective disorder and cyclic major depression.
In addition to watching out for the well-known complications of lithium treatment—hypothyroidism and decreased renal function—health care providers should be aware of hyperparathyroidism.
Hyperparathyroidism was first described and treated in the 1930s by
Fuller Albright of Massachusetts General Hospital, working at the
Mallinckrodt General Clinical Research Center. The oldest known case
was found in a cadaver from an Early Neolithic cemetery in southwest
Primary hyperparathyroidism results from a hyperfunction of
the parathyroid glands themselves. There is oversecretion of PTH due to
adenoma, hyperplasia or, rarely, carcinoma of the parathyroid glands.
Secondary hyperparathyroidism is the reaction of the
parathyroid glands to a hypocalcemia caused by something other than a
parathyroid pathology, e.g. chronic renal failure.
Tertiary hyperparathyroidism result from hyperplasia of the
parathyroid glands and a loss of response to serum calcium levels. This
disorder is most often seen in patients with chronic renal failure.
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Last Updated: Feb 1, 2011