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==Overview==
==Overview==
Parathyroid adenoma usually presents as asymptomatic [[hypercalcemia]] in presence of increased [[parathyroid hormone]]. If left untreated, some of the patients with parathyroid adenoma may develop marked [[hypercalcemia]], [[hypercalciuria]], [[cortical bone]] demineralization and [[nephrolithiasis]]. Prognosis of parathyroid adenoma is generally excellent after [[parathyroidectomy]].
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==



Revision as of 14:11, 3 June 2019

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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

Parathyroid adenoma usually presents as asymptomatic hypercalcemia in presence of increased parathyroid hormone. If left untreated, some of the patients with parathyroid adenoma may develop marked hypercalcemia, hypercalciuria, cortical bone demineralization and nephrolithiasis. Prognosis of parathyroid adenoma is generally excellent after parathyroidectomy.

Natural History, Complications, and Prognosis

Natural History

Complications

Organ system specific complication caused by primary hyperparathyroidism due to parathyroid adenoma include:

Complications involving Organ system Complications due to Primary Hyperparathyroidism
Cardiaovascular complications

[3][4]

Endocrine complications[5]
Gastrointestinal complications[6]
Metabolic complications

[7][8][6][9][10][11][12]

Musculo-skeletal complications

[13][14][15][16][17][18]

Neuromuscular complications

[19][20]

Pregnancy related complications[21]
Psychiatric complications

[22][23][24]

Renal complications

[25][26][27][28]

Rheumatologic complications

[29][30][31][32]

Prognosis

  • Prognosis of parathyroid adenoma is generally excellent after parathyroidectomy.
  • The complications of parathyroid adenoma resolves after the treatment.
  • Untreated complication of parathyroid adenoma may be fatal.[33]

References

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  2. Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, Jacobs TP, Siris ES, Cafferty M, Parisien MV (1989). "Skeletal disease in primary hyperparathyroidism". J. Bone Miner. Res. 4 (3): 283–91. doi:10.1002/jbmr.5650040302. PMID 2763869.
  3. Stefenelli T, Abela C, Frank H, Koller-Strametz J, Globits S, Bergler-Klein J, Niederle B (1997). "Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up". J. Clin. Endocrinol. Metab. 82 (1): 106–12. doi:10.1210/jcem.82.1.3666. PMID 8989242.
  4. Strózecki P, Adamowicz A, Nartowicz E, Odrowaz-Sypniewska G, Włodarczyk Z, Manitius J (2001). "Parathormon, calcium, phosphorus, and left ventricular structure and function in normotensive hemodialysis patients". Ren Fail. 23 (1): 115–26. PMID 11256521.
  5. Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ (2012). "The association of primary hyperparathyroidism with pancreatitis". J. Clin. Gastroenterol. 46 (8): 656–61. doi:10.1097/MCG.0b013e31825c446c. PMC 4428665. PMID 22874807.
  6. 6.0 6.1 Corlew DS, Bryda SL, Bradley EL, DiGirolamo M (1985). "Observations on the course of untreated primary hyperparathyroidism". Surgery. 98 (6): 1064–71. PMID 3878002.
  7. Fitzpatrick LA, Bilezikian JP (1987). "Acute primary hyperparathyroidism". Am. J. Med. 82 (2): 275–82. PMID 3812520.
  8. Ahmad S, Kuraganti G, Steenkamp D (2015). "Hypercalcemic crisis: a clinical review". Am. J. Med. 128 (3): 239–45. doi:10.1016/j.amjmed.2014.09.030. PMID 25447624.
  9. Lips P (2001). "Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications". Endocr Rev. 22 (4): 477–501. doi:10.1210/edrv.22.4.0437. PMID 11493580.
  10. Saab G, Whaley-Connell A, Bombeck A, Kurella Tamura M, Li S, Chen SC, McFarlane SI, Sowers JR, Norris K, Bakris GL, McCullough PA (2011). "The Association between Parathyroid Hormone Levels and the Cardiorenal Metabolic Syndrome in Non-Diabetic Chronic Kidney Disease". Cardiorenal Med. 1 (2): 123–130. doi:10.1159/000327149. PMC 3101512. PMID 22258399.
  11. Hjelmesæth, Jøran; Hofsø, Dag; Aasheim, Erlend T; Jenssen, Trond; Moan, Johan; Hager, Helle; Røislien, Jo; Bollerslev, Jens (2009). "Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study". Cardiovascular Diabetology. 8 (1): 7. doi:10.1186/1475-2840-8-7. ISSN 1475-2840.
  12. Barbur MA, Kurjak M, Becker K (1997). "[Systematic calciphylaxis in chronic renal failure: fulminant course after kidney transplantation]". Pathologe (in German). 18 (6): 453–8. PMID 9451734.
  13. Bandeira F, Cusano NE, Silva BC, Cassibba S, Almeida CB, Machado VC, Bilezikian JP (2014). "Bone disease in primary hyperparathyroidism". Arq Bras Endocrinol Metabol. 58 (5): 553–61. PMC 4315357. PMID 25166047.
  14. Mazzuoli GF, D'Erasmo E, Pisani D (1998). "Primary hyperparathyroidism and osteoporosis". Aging (Milano). 10 (3): 225–31. PMID 9801732.
  15. Spaulding CM, Young G (1997). "Osteitis fibrosa cystica and chronic renal failure". J Am Podiatr Med Assoc. 87 (5): 238–40. doi:10.7547/87507315-87-5-238. PMID 9158318.
  16. Eastwood JB (1977). "Renal osteodystrophy--a radiological review". CRC Crit Rev Diagn Imaging. 9 (1): 77–104. PMID 328228.
  17. Adams JE (1999). "Renal bone disease: radiological investigation". Kidney Int. Suppl. 73: S38–41. PMID 10633462.
  18. Jevtic V (2003). "Imaging of renal osteodystrophy". Eur J Radiol. 46 (2): 85–95. doi:10.1016/S0720-048X(03)00072-X. PMID 12714225.
  19. Mallette LE, Patten BM, Engel WK (1975). "Neuromuscular disease in secondary hyperparathyroidism". Ann. Intern. Med. 82 (4): 474–83. PMID 47234.
  20. Gerhardt RE, Zeitlin EL (1978). "Neuromuscular disease in tertiary hyperparathyroidism". Arch. Intern. Med. 138 (6): 1013–5. PMID 646555.
  21. Poomthavorn P, Ongphiphadhanakul B, Mahachoklertwattana P (2008). "Transient neonatal hypoparathyroidism in two siblings unmasking maternal normocalcemic hyperparathyroidism". Eur. J. Pediatr. 167 (4): 431–4. doi:10.1007/s00431-007-0528-6. PMID 17569990.
  22. Walker MD, McMahon DJ, Inabnet WB, Lazar RM, Brown I, Vardy S, Cosman F, Silverberg SJ (2009). "Neuropsychological features in primary hyperparathyroidism: a prospective study". J. Clin. Endocrinol. Metab. 94 (6): 1951–8. doi:10.1210/jc.2008-2574. PMC 2690425. PMID 19336505.
  23. Espiritu RP, Kearns AE, Vickers KS, Grant C, Ryu E, Wermers RA (2011). "Depression in primary hyperparathyroidism: prevalence and benefit of surgery". J. Clin. Endocrinol. Metab. 96 (11): E1737–45. doi:10.1210/jc.2011-1486. PMID 21917870.
  24. McAllion SJ, Paterson CR (1989). "Psychiatric morbidity in primary hyperparathyroidism". Postgrad Med J. 65 (767): 628–31. PMC 2429194. PMID 2608590.
  25. Peacock M (2002). "Primary hyperparathyroidism and the kidney: biochemical and clinical spectrum". J. Bone Miner. Res. 17 Suppl 2: N87–94. PMID 12412783.
  26. Lila AR, Sarathi V, Jagtap V, Bandgar T, Menon PS, Shah NS (2012). "Renal manifestations of primary hyperparathyroidism". Indian J Endocrinol Metab. 16 (2): 258–62. doi:10.4103/2230-8210.93745. PMC 3313745. PMID 22470864.
  27. Tassone F, Gianotti L, Emmolo I, Ghio M, Borretta G (2009). "Glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism". J. Clin. Endocrinol. Metab. 94 (11): 4458–61. doi:10.1210/jc.2009-0587. PMID 19808852.
  28. Kim H, Cheigh JS, Ham HW (2001). "Urinary stones following renal transplantation". Korean J. Intern. Med. 16 (2): 118–22. PMC 4531707. PMID 11590898.
  29. Michael JW, Schlüter-Brust KU, Eysel P (2010). "The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee". Dtsch Arztebl Int. 107 (9): 152–62. doi:10.3238/arztebl.2010.0152. PMC 2841860. PMID 20305774.
  30. Hochberg, Marc (2015). "204. Primary hyperparathyroidism: rheumatologic manifestations and bone disease". Rheumatology. Philadelphia, PA: Mosby/Elsevier. p. 1668. ISBN 9780323091381.
  31. Rubin MR, Silverberg SJ (2002). "Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy". Curr Rheumatol Rep. 4 (2): 179–85. PMID 11890884.
  32. Adler JS, Cameron DC (1989). "Erosive spondylo-arthropathy and tertiary hyperparathyroidism". Australas Radiol. 33 (1): 90–2. PMID 2712794.
  33. Corlew DS, Bryda SL, Bradley EL, DiGirolamo M (1985). "Observations on the course of untreated primary hyperparathyroidism". Surgery. 98 (6): 1064–71. PMID 3878002.

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