Hyperparathyroidism history and symptoms: Difference between revisions
Jump to navigation
Jump to search
m (Bot: Removing from Primary care) |
|||
| (19 intermediate revisions by 4 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Hyperparathyroidism}} | {{Hyperparathyroidism}} | ||
{{CMG}} | {{CMG}};{{AE}}{{Anmol}} | ||
==Overview== | ==Overview== | ||
The majority of patients with primary hyperparathyroidism are asymptomatic. Asymptomatic primary hyperparathyroidism patient | 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 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. | The majority of patients with tertiary hyperparathyroidism have a history of [[Kidney transplantation|renal transplantation]]. | ||
==History and Symptoms== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
Although majority of patients with hyperparathyroidism have non-specific 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:<ref name="pmid8964825">{{cite journal |vauthors=Silverberg SJ, Bilezikian JP |title=Evaluation and management of primary hyperparathyroidism |journal=J. Clin. Endocrinol. Metab. |volume=81 |issue=6 |pages=2036–40 |year=1996 |pmid=8964825 |doi=10.1210/jcem.81.6.8964825 |url=https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jcem/81/6/10.1210_jcem.81.6.8964825/1/jcem2036.pdf?Expires=1503692700&Signature=ZNJlqTCdoYB5YdpmMh2WawXE72llaZteGxPuWfREgVRKpx00WZxZ-UZdwfpk6LuPTdlWsh-Elc5Alf7JEW33H8tWVcfm7I-98XhVtwcWTBJzlm1TNVCrIeJ4eHKOS7ZEXCrDbyd33oACDzrKbod5FXSntDTBDOk2wlQiFJrIoZY~qDT82PcdGRmso9OOGmCtogJWLfOPLHGc6bDwvb8zrCK~itTf5PvHhAt-VN100iBDq~NwqRCmWPpMiE3yljADv7fw8Fo58JBz~QjiVc58JWSF2fRieodJYYInHaarbeMf4atxgXh6yyET0UFtl74i4IfdFFI0RMHoZR50XfUw9g__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q}}</ref> | ||
*Kidney stones | *[[Kidney stones]] | ||
*Bone pain and tenderness | *[[Bone pain]] and [[tenderness]] | ||
*Fragile bones of the limbs and spine that can break easily | *Fragile bones of the limbs and spine that can break easily | ||
*Frequent and excessive urination | *Frequent and [[Polyuria|excessive urination]] | ||
*Gastrointestinal symptoms like epigastric | *[[Gastrointestinal]] symptoms like [[epigastric pain]], [[constipation]], [[indigestion]], [[nausea]], and [[vomiting]] | ||
*Feeling tired, ill, and weak | *Feeling [[Fatigue|tired]], ill, and weak | ||
*Depression and memory disturbances | *[[Depression]] and [[Dementia|memory disturbances]] | ||
*Vitamin D deficiency | *[[Vitamin D deficiency]] | ||
* | *[[Chronic renal failure]] in case secondary hyperparathyroidism is suspected | ||
*Renal transplant in case tertiary hyperparathyroidism is suspected | *[[Kidney transplantation|Renal transplant]] in case tertiary hyperparathyroidism is suspected | ||
*Use of medications including [[thiazide diuretics]] and [[lithium]]. | |||
*Neck [[radiation]] | |||
===Symptoms=== | ===Symptoms=== | ||
====Asymptomatic Hyperparathyroidism==== | ====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. | 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]].<ref name="MarcocciCetani2011">{{cite journal|last1=Marcocci|first1=Claudio|last2=Cetani|first2=Filomena|title=Primary Hyperparathyroidism|journal=New England Journal of Medicine|volume=365|issue=25|year=2011|pages=2389–2397|issn=0028-4793|doi=10.1056/NEJMcp1106636}}</ref> | ||
====Symptomatic Hyperparathyroidism==== | ====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 | 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 [[Hypercalcemia|high blood calcium]] levels have a direct effect on the [[nervous system]]. As a result, most of the symptoms of [[parathyroid]] diseases are [[Neurology|neurological]]. The most common symptom is [[fatigue]]. Other symptoms include [[lethargy]], [[Dementia|memory disturbances]], [[Clinical depression|depression]], lack of concentration, and [[sleep disturbances]]. Other manifestations of hyperparathyroidism may include [[kidney stone]]s and the [[musculoskeletal]] symptoms ([[bone pain]] due to the development of [[osteoporosis]]). | ||
=====Common symptoms===== | =====Common symptoms===== | ||
The symptoms of hyperparathyroidism can be remembered by the rhyme "''' | The symptoms of hyperparathyroidism can be remembered by the rhyme "'''painful bones, kidney stones, abdominal groans, psychic moans, and fatigue overtones'''":<ref name="pmid21369510">{{cite journal |vauthors=Elaraj DM, Clark OH |title=Current status and treatment of primary hyperparathyroidism |journal=Perm J |volume=12 |issue=1 |pages=32–7 |year=2008 |pmid=21369510 |pmc=3042336 |doi= |url=}}</ref> | ||
*" | *"Painful bones" ([[bone pain]]) | ||
*"groans" (abdominal pain, [[gastroesophageal reflux disease|gastroesophageal reflux | *"Kidney stones" ([[Kidney stones]]) | ||
*" | *"Abdominal groans" ([[abdominal pain]], [[gastroesophageal reflux disease|gastroesophageal reflux*"Psychic moans" ([[depression]], [[Dementia|memory disturbances]]) | ||
*" | *"Fatigue overtones" (complaints of not feeling well, [[lethargy]], [[fatigue]]) | ||
=====Less common symptoms===== | =====Less common symptoms===== | ||
*Confusion | Less common symptoms are usually present in severe disease and includes: | ||
*Constipation | *[[Confusion]] | ||
*Decreased libido | *[[Constipation]] | ||
*[[Decreased libido]] | |||
*[[arterial hypertension|Hypertension]] | *[[arterial hypertension|Hypertension]] | ||
*[[Headache]]s | *[[Headache]]s | ||
*Heart palpitations which are often due to bouts of atrial fibrillation | *Heart [[palpitations]] which are often due to bouts of [[atrial fibrillation]] | ||
*[[gastroesophageal reflux disease|Gastroesophageal reflux]] | *[[gastroesophageal reflux disease|Gastroesophageal reflux]] | ||
*Loss of appetite | *Lack of [[concentration]] | ||
*Left ventricular hypertrophy | *[[Loss of appetite]] | ||
*Nausea and vomiting | *[[Left ventricular hypertrophy]] | ||
*Peptic ulcers | *[[Nausea and vomiting]] | ||
*Polydipsia | *[[Peptic ulcer|Peptic ulcers]] | ||
*Polyuria | *[[Polydipsia]] | ||
*[[Polyuria]] | |||
*Thinning of hair | *Thinning of hair | ||
| Line 56: | Line 59: | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | | ||
[[Category:Disease]] | |||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Parathyroid disorders]] | [[Category:Parathyroid disorders]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
Latest revision as of 22:16, 29 July 2020
|
Hyperparathyroidism Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hyperparathyroidism history and symptoms On the Web |
|
American Roentgen Ray Society Images of Hyperparathyroidism history and symptoms |
|
Risk calculators and risk factors for Hyperparathyroidism history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[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]
- Kidney stones
- Bone pain and tenderness
- Fragile bones of the limbs and spine that can break easily
- Frequent and excessive urination
- Gastrointestinal symptoms like epigastric pain, constipation, indigestion, nausea, and vomiting
- Feeling tired, ill, and weak
- Depression and memory disturbances
- Vitamin D deficiency
- Chronic renal failure in case secondary hyperparathyroidism is suspected
- Renal transplant in case tertiary hyperparathyroidism is suspected
- Use of medications including thiazide diuretics and lithium.
- Neck radiation
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]
- "Painful bones" (bone pain)
- "Kidney stones" (Kidney stones)
- "Abdominal groans" (abdominal pain, [[gastroesophageal reflux disease|gastroesophageal reflux*"Psychic moans" (depression, memory disturbances)
- "Fatigue overtones" (complaints of not feeling well, lethargy, fatigue)
Less common symptoms
Less common symptoms are usually present in severe disease and includes:
- Confusion
- Constipation
- Decreased libido
- Hypertension
- Headaches
- Heart palpitations which are often due to bouts of atrial fibrillation
- Gastroesophageal reflux
- Lack of concentration
- Loss of appetite
- Left ventricular hypertrophy
- Nausea and vomiting
- Peptic ulcers
- Polydipsia
- Polyuria
- Thinning of hair
References
- ↑ 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.
- ↑ Marcocci, Claudio; Cetani, Filomena (2011). "Primary Hyperparathyroidism". New England Journal of Medicine. 365 (25): 2389–2397. doi:10.1056/NEJMcp1106636. ISSN 0028-4793.
- ↑ Elaraj DM, Clark OH (2008). "Current status and treatment of primary hyperparathyroidism". Perm J. 12 (1): 32–7. PMC 3042336. PMID 21369510.