Symptoms of hyperparathyroidism, diagnosis and treatment

Quite often in patients after diagnosis, abnormalities in parathyroid glands are found. Symptoms of hyperparathyroidism can often not cause any concern. Lethargy, weakness, decreased efficiency, constipation - all these violations people often write off for general fatigue and improper nutrition. Therefore, they turn to the doctor already at the late stages of the development of the disease.

In this regard, many people are now interested in the question of what is hyperparathyroidism. Symptoms and treatment, causes and exacerbation are important points to consider. So what is the patient facing this ailment and what kind of treatment can modern medicine offer?

Brief information about parathyroid glands and their functions

Hyperparathyroidism, symptoms and treatment in women, secondary hyperparathyroidism, hypercalcemic crisis are terms that patients often face. But before you deal with the causes and symptoms of the disease, it is worth considering some of the anatomical features of the human body.

Most people have two pairs of parathyroid glands, which are usually located on the posterior surface of the thyroid (sometimes they are even immersed in her tissues). By the way, 15-20% of the population has from 3 to 12 glands. Their number and location can vary. The glands are small, a few millimeters in size, weighing from 20 to 70 mg.

Parathyroid glands secrete an active biological substance, namely, parathyroid hormone, which regulates the metabolism of phosphorus and calcium in the body. With insufficient amount of calcium in the blood, the hormone starts the process of its release from the bones, improves the absorption of this mineral by the tissues of the intestine, and also reduces the amount that is usually excreted in the urine. Parathyroid hormone also increases the release of phosphorus from the body.

What is hyperparathyroidism? Epidemiology

Hyperparathyroidism is a disease in which there is an increase in the secretion of parathyroid hormone by the parathyroid glands. This is a chronic disease of the endocrine system, which is often associated with hyperplasia of the glands or the formation of tumors in their tissues.

It should be said that the symptoms of hyperparathyroidism in women are registered three times more often than in the stronger sex. For today the pathology is considered very widespread. If we talk about endocrine diseases, then hyperparathyroidism is the third most common (after hyperthyroidism and diabetes mellitus).

Pathological changes in the background of the disease

As already mentioned, when the level of parathyroid hormone in the blood increases, there is a violation of calcium metabolism in the body - this mineral begins to wash out of the bones. At the same time, the level of calcium in the blood also increases. Skeletal tissues of the skeleton are replaced by fibroids, which, naturally, leads to deformation of the support apparatus.

Symptoms of hyperparathyroidism are associated not only with the violation of the structure of bones. Increasing the level of calcium in the blood often leads to the formation of calcifications in the tissues of internal organs. First of all, vascular walls and kidneys suffer from the appearance of such neoplasms. In addition, against the background of calcicemia, there is an increase in blood pressure, increased secretion in the stomach (often leads to the formation of ulcers) and impaired conduction in the nerve tissues, which is accompanied by memory impairment, muscle weakness and depressive states.

Hyperparathyroidism: symptoms and causes of primary form

In modern classification, several groups of this pathology are distinguished. Often, patients are diagnosed with primary hyperparathyroidism. Symptoms of it are associated with primary lesions of glands, and in 85% of cases the cause of the development of the disease is adenoma (benign tumor).

Much less often in diagnosis, multiple tumors are found. Occasionally, the cause of the violation of secretion is cancer, which in most cases develops after irradiation of the neck and head. The initial stages of the disease are accompanied by nonspecific signs - weakness, fatigue, drowsiness, irritability. This is why patients rarely seek help. The disease can develop over the years. According to statistics, the primary form of the disease in most cases develops in women against the background of menopause, as well as in older people.

Secondary form of the disease and its features

Secondary hyperparathyroidism is a disease that develops in the initially healthy glands. Increased secretion of parathyroid hormone occurs against the background of a decrease in the level of calcium in the blood, which is usually associated with other pathologies.

In most cases, hypocalcemia is associated either with severe chronic kidney disease, or with a violation of absorption of nutrients (including calcium) by the walls of the intestine. The level of parathyroid hormone rises after resection of the stomach, as well as against hemodialysis. The reasons include rickets and severe liver damage, which are accompanied by a violation of the metabolism of vitamin D.

Tertiary form of the disease

Tertiary hyperparathyroidism occurs in patients who undergo a kidney transplant, and the transplantation was successful.

As already mentioned, kidney diseases are often accompanied by an increase in the level of parathyroid hormone. The fact is that such pathologies are accompanied by an increased excretion of calcium from the body. Prolonged hypocalcemia can lead to non-reversal changes in parathyroid glands. Even after complete restoration of renal parameters, patients still observe a breach of the glands and increased secretion of parathyroid hormone.

The clinical picture of hyperparathyroidism

Symptoms of hyperparathyroidism are diverse, because it affects many organ systems. Moreover, the clinical picture depends on the variety of the disease, the stage of its development, the presence of accompanying pathologies, the age and even the sex of the patient.

The first symptoms are usually nonspecific. Patients note the appearance of lethargy and weakness, a decrease in appetite, the periodic occurrence of nausea. There is soreness in the joints. As the increase in the level of calcium changes the transmission of the neuromuscular pulse, the patients also have muscle pains - this is how hyperparathyroidism develops. Symptoms of elderly patients, as a rule, include also muscular weakness. Patients are hard to get up from the chair, they stumble during walking, often fall.

Due to the weakness of the foot muscles, flat feet often develop, pains in the legs appear when walking. Because of damage to the renal tubules, other disorders are possible, in particular, an increase in the amount of urine. In severe cases, patients lose weight sharply due to poor appetite and dehydration. Lack of fluid in the body affects the skin condition - it becomes dry, acquires an earthy color. Loss of calcium often leads to loosening and loss of healthy teeth.

Bones constantly lose calcium and phosphorus. Moreover, against the background of this ailment, activation of osteoclasts, cells, which are capable of dissolving bones, is observed. The consequence of increasing the level of parathyroid hormone is progressive osteoporosis.

Because of the reduction in bone density, fractures for patients are not uncommon. And even small physical exertion or strikes can injure the bone. Bones often do not fully fuse, forming the so-called "false joints". There are also deformations of the skeleton, in particular, the spine (kyphosis, scoliosis), chest and pelvis. This, of course, affects the well-being and mobility of a person. Hyperparathyroidism is often accompanied by the deposition of uric acid crystals in the joints (gout).

Excess of calcium affects the work of the kidneys. Often the formation of coral stones occurs inside the cup-pelvis system. In the absence of treatment, kidney failure often develops, which, alas, is irreversible - often the patient needs a kidney transplant.

The disease affects the digestive tract. Patients complain of a decrease in appetite, flatulence, constipation, nausea, abdominal pain. With an excess of calcium in the blood, it is not impossible to form stones in the gallbladder and pancreatic ducts, which leads to the development of cholecystitis and pancreatitis. By the way, the symptoms of hyperparathyroidism in women are often exacerbated during pregnancy, which is very dangerous not only for the mother, but also for the child.

Increase in the level of calcium affects the work of the nervous system and often causes changes in the psyche. Patients can notice apathy, anxiety, and sometimes depression of varying severity. There is drowsiness, impaired memory and cognitive abilities. In the most severe cases, the ailment is accompanied by confusion and acute psychosis.

Often parents are interested in questions about how hyperparathyroidism looks like in children. Symptoms, treatment and complications are the same in this case. But if it is a primary form of the disease, then it is usually associated with genetic inheritance. If the disease has appeared in the first months or years of life, there is a delay in the child's physical and mental development.

Hyperparathyroidism: diagnosis

In this case, diagnostics is extremely important. Symptoms of hyperparathyroidism grow slowly, and sometimes completely absent. That is why laboratory tests of blood and urine are carried out for the beginning. During studies in blood samples, you can see an increase in the level of calcium and a decrease in the amount of phosphate. When analyzing urine, an increased amount of both elements is found. This study is carried out twice - if they give the same results, a blood test for parathyroid hormone is performed.

Increasing the level of the hormone indicates the presence of hyperparathyroidism, but it is important not only to establish the presence of the disease, but also to determine its cause. To begin with, an ultrasound is performed that helps the specialist see the increase in the size of the parathyroid gland or the presence of neoplasms. In addition, magnetic resonance imaging and computed tomography are performed - these procedures provide more accurate information.

It is necessary to examine the kidneys and the bone system to find out if the patient has complications.

Hypercalcemic crisis and its treatment

Hypercalcemic crisis - an acute condition that develops with a sharp increase in the level of calcium in the blood. This pathology leads to dangerous lesions of the body and in 50-60% of cases leads to death.

Fortunately, the crisis is considered a rare complication of hyperparathyroidism. Provoke it can various factors, including infection, massive bone fractures, infection, intoxication. The risk factors include the period of pregnancy, dehydration of the body, as well as taking certain medications, including calcium and vitamin D, thiazide diuretics. Patients with hyperparathyroidism need to carefully monitor the diet, excluding foods with a high content of calcium and vitamin D. Not the least role in the development of the crisis is the lack of adequate therapy and erroneous diagnosis.

The hypercalemic crisis develops rapidly. First, patients develop disorders of the digestive system, including acute abdominal pains, intense vomiting. An increase in body temperature is noted. Patients complain of bone pain and muscle weakness. There are also disorders from the nervous system, from depression and depression to psychosis. The skin of a sick person becomes dry, itching appears.

Due to a clotting disorder, the development of DIC syndrome is possible. Perhaps the development of a shock state. Death of the patient occurs as a result of cardiac arrest or paralysis of the respiratory muscles.

Methods of treatment of hyperparathyroidism

We have already considered questions about what constitutes hyperparathyroidism. Symptoms and treatment in this case are closely related. If it is a primary form of the disease associated with the formation of a tumor, it is possible to surgically remove the neoplasm. The operation is not always carried out. The fact that the disease can develop for decades, without causing the patient a special inconvenience. Even older people suffer from it, which creates additional difficulties.

The doctor decides whether to take the surgery. It is believed that the operation is necessary with a strong increase in the level of calcium in the blood (more than 3 mmol / l) and expressed violations in the work of the kidneys. Indications for the procedure are stones in the excretory system, a significant loss of calcium along with urine, the presence of hypercalcemic crises in the history, as well as severe osteoporosis.

If the doctor decided not to remove the tumor or gland (with its hypertrophy), the patients still need to regularly inspect them - it is important to perform at least 1-2 times a year a study of the kidneys and bone apparatus. A constant monitoring of the level of calcium in the blood and blood pressure is important.

As for the secondary form, the treatment of hyperparathyroidism is reduced to the elimination of primary diseases. Calcium deficiency in the blood can be eliminated medically - patients are prescribed medications containing this mineral, as well as vitamin D. If the drugs do not give the expected effect, surgical excision of parts of the gland can be performed.

Pseudohyperparathyroidism and its features

Modern medicine is known for the so-called pseudo-hyperparathyroidism. This is a fairly rare disease that is accompanied by the same symptoms. Nevertheless, the pathology is not connected with the work of the most parathyroid glands.

The patient has malignant neoplasms that can be localized in the kidneys, lungs, mammary glands and other organs. These tumors contain cells that are capable of producing active substances, by the mechanism of action similar to parathyroid hormone. With such a disease, the calcium level in the blood increases due to the dissolution of bone tissue. This is an extremely dangerous disease that can lead to death.

Projections for patients

Now you know how hyperparathyroidism develops. Symptoms and treatment in women, especially the course of the disease in children - these are important questions. But what kind of forecasts can you expect? The results depend on the stage of development at which the disease was found.

If it is a question of early primary hyperparathyroidism, then with timely treatment, the predictions are favorable. Symptoms from the internal organs and the nervous system disappear after a few weeks. The bone structure can be restored in a few years. In advanced cases, skeletal deformities that affect the quality of life can be preserved in patients, but they are not dangerous.

If there is damage to the kidneys, even after surgery, kidney failure may progress. In any case, you should carefully monitor your health and take preventive medical examinations.