Secondary hyperparathyroidism

Causes and Risks:
The parathyroid glands are at the front and base of the neck at the 4 corners of the thyroid gland. The glands produce a parathyroid hormone which regulates the calcium, phosphorus, and magnesium balance within the blood and normal bone mineralization.

With overproduction of the parathyroid hormone, the calcium level in the blood becomes elevated by removing calcium from the bones and increasing calcium absorption from the gastrointestinal (GI) tract. The kidneys attempt to compensate for the increased blood calcium level by secreting excess calcium in the urine, which can result in the formation of kidney stones .

In secondary hyperparathyroidism, an increase in the cells of the parathyroid glands, called hyperplasia , occurs. The causes of this disorder include rickets , vitamin D deficiency , or chronic renal failure . This is the most common cause of hyperparathyroidism in children.

The effects of increased parathyroid hormone are seen in the skeleton, stomach and intestines, kidneys, nervous system, and muscles. The severity of the condition can vary from mild to severe.

The incidence of mild secondary hyperparathyroidism is 1 out of 1000 people. The incidence of severe hyperparathyroidism is 1 out of 10,000 people.

Prevention:
Early detection of rickets or vitamin D deficiency may prevent secondary hyperparathyroidism.

Symptoms:

Additional symptoms that may be associated with this disease:



Signs and Tests:



Treatment:
The treatment involves correcting the underlying cause of secondary hyperparathyroidism.

Mild secondary hyperparathyroidism may be followed medically unless impaired renal function, bone demineralization, or high blood pressure is present. The treatment consists of forcing oral (by mouth) fluids to prevent kidney stone formation, avoiding sedentary lifestyle or immobilization, avoiding Thiazide diuretics, adding phosphate preparations if the kidney function is good, and giving estrogen therapy to women if they are postmenopausal.

For symptomatic , severe secondary hypercalcemia (high blood calcium levels), hospitalization may be required. Rehydration by intravenous fluid is initiated. Medications may include pamidronate disodium to inhibit bone resorption.

Prognosis:
The outcome of secondary hyperparathyroidism caused by vitamin D deficiency is usually good.

Complications:
Complications result from excess calcium deposits within the body and may include:



Call Your Healthcare Provider:
Call for an appointment with your health care provider if you have symptoms of this disorder.

Also call if you have a history of secondary hyperparathyroidism and you experience symptoms of any of the complications.


The endocrine system is the chemical control center of the body. The pituitary gland is often considered the master control; sending out hormones that regulate the function of the thyroid, adrenal glands, ovaries, and testis. Over- or under-production of hormones from any of these glands is associated with many different types of disease.