SECONDARY HYPERPARATHYROIDISM
Secondary hyperparathyroidism (SHPT) is excessive secretion of parathyroid hormone (PTH) as a result of partial resistance to PTH in response to hypocalcemia (low blood calcium levels) and associated hyperplasia of the glands. SHPT is a frequent complication of chronic renal failure. SHPT occurs also in patients with osteomalacia (Vit D deficiency) and pseudo hipoparatiroidizm (decreased response to PTH). The common factor of SHPT caused by this disorders is hypocalcemia.
Diseases leading to SHPT are shown in table 1.
Table 1: SHPT causing diseases
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1. Chronic renal failure |
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2. Osteomalacia |
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3. Pseudo hypoparathyroidism |
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4. Hypercalciuria or Vit D deficiency |
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5. Hypomagnesemia |
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6. Rickets |
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7. Gastrointestinal Disorders Primary bowel disease Short bowel syndrome Post-gastrectomy syndrome |
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8. Drugs causeing rickets and osteomalacia Phenobarbital Cholestyramine Laxatives |
Diagnosis
Diagnosing secondary hyperparathyroidism it is necessary to specifie abnormalities of bivalent ions, hormones ensuring calcium regulation and bone metabolism markers. The intensitivity of this abnormalities, depends on the severity and duration of the underlying disease.
Treatment
Conventionally, in patients followed due to chronic renal failure the treatment should be initiated when iPTH value exceeds the upper limit.
There is three ways of secondary hyperparathyroidism treatment:
1-Medical treatment
2-Surgery
3-Interventional radiology
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