Parathyroid adenoma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

Overview

The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient is expected to develop signs and symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic hypercalcemia. The classic signs and symptoms of primary hyperparathyroidism are present in a few individuals and are summarized by the mnemonic painful bones, kidney stones, abdominal groans, psychic moans, and fatigue overtones. The majority of patients with secondary hyperparathyroidism have a history of either chronic renal failure or long term vitamin D deficiency. The majority of patients with tertiary hyperparathyroidism have a history of renal transplantation.

History and Symptoms

History

Although majority of patients with hyperparathyroidism have non-specific history but a detailed and thorough history from the patient is necessary. The patient may have a positive history of:[1]

Symptoms

Asymptomatic Hyperparathyroidism

The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient was expected to dvelop signs ans symptoms, but most of the patients does not becomes symptomatic with time. The hallmark of primary hyperparathyroidism is asymptomatic hypercalcemia.[2]

Symptomatic Hyperparathyroidism

A few of patients that do present with symptoms, they are commonly associated with the effects of an increased level of calcium. Calcium is involved in trans-synaptic communication within nervous system and high blood calcium levels have a direct effect on the nervous system. As a result, most of the symptoms of parathyroid diseases are neurological. The most common symptom is fatigue. Other symptoms include lethargy, memory disturbances, depression, lack of concentration, and sleep disturbances. Other manifestations of hyperparathyroidism may include kidney stones and the musculoskeletal symptoms (bone pain due to the development of osteoporosis).

Common symptoms

The symptoms of hyperparathyroidism can be remembered by the rhyme "painful bones, kidney stones, abdominal groans, psychic moans, and fatigue overtones":[3]

Less common symptoms

Less common symptoms are usually present in severe disease and includes:

References

  1. Silverberg SJ, Bilezikian JP (1996). "Evaluation and management of primary hyperparathyroidism" (PDF). J. Clin. Endocrinol. Metab. 81 (6): 2036–40. doi:10.1210/jcem.81.6.8964825. PMID 8964825.
  2. Marcocci, Claudio; Cetani, Filomena (2011). "Primary Hyperparathyroidism". New England Journal of Medicine. 365 (25): 2389–2397. doi:10.1056/NEJMcp1106636. ISSN 0028-4793.
  3. Elaraj DM, Clark OH (2008). "Current status and treatment of primary hyperparathyroidism". Perm J. 12 (1): 32–7. PMC 3042336. PMID 21369510.