Primary hyperparathyroidism
In exams, primary hyperparathyroidism is stereotypically seen in elderly females with an unquenchable thirst and an inappropriately normal or raised parathyroid hormone level. It is most commonly due to a solitary adenoma
Causes of primary hyperparathyroidism
Features - 'bones, stones, abdominal groans and psychic moans'
Associations
Investigations
Treatment
Causes of primary hyperparathyroidism
- 80%: solitary adenoma
- 15%: hyperplasia
- 4%: multiple adenoma
- 1%: carcinoma
Features - 'bones, stones, abdominal groans and psychic moans'
- polydipsia, polyuria
- peptic ulceration/constipation/pancreatitis
- bone pain/fracture
- renal stones
- depression
- hypertension
Associations
- hypertension
- multiple endocrine neoplasia: MEN I and II
Investigations
- raised calcium, low phosphate
- PTH may be raised or normal
- technetium-MIBI subtraction scan
Treatment
- total parathyroidectomy
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| © Image used on license from Radiopaedia | |
Bilateral hand radiographs in a middle-aged woman demonstrating generalised osteopenia, erosion of the terminal phalangeal tufts (acro-osteolysis) and subperiosteal resorption of bone particularly the radial aspects of the 2nd and 3rd middle phalanges. These changes are consistent with a diagnosis of hyperparathyroidism.