Primary Hyperparathyroidism

Primary hyperparathyroidism is autonomous PTH overproduction, usually from a single parathyroid adenoma (85%), hyperplasia (10%), or carcinoma (<1%). It causes hypercalcemia, increased bone resorption (osteitis fibrosa cystica), hypercalciuria and nephrolithiasis. Classic symptoms: 'bones, stones, abdominal groans, psychic overtones' - bone pain/fractures, kidney stones, abdominal pain/constipation, fatigue/depression. Most cases today are asymptomatic, found on routine calcium screening. Treatment: parathyroidectomy for symptomatic or selected asymptomatic patients.

Common Symptoms

Asymptomatic hypercalcemia; bone pain/fractures; nephrolithiasis; abdominal pain; constipation; fatigue; depression; polyuria/polydipsia

Causes and Pathogenesis

Autonomous parathyroid adenoma/hyperplasia secretes excess PTH, increasing bone resorption and renal calcium reabsorption, raising serum calcium and increasing urinary calcium.

Treatment

Parathyroidectomy for symptomatic/asymptomatic meeting criteria; medical: hydration, bisphosphonates, calcimimetics (cinacalcet) if surgery declined

Preventive Measures

Maintain calcium/vitamin D intake; hydration; screen serum calcium; avoid prolonged immobilization.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.