Hyperparathyroidism

Hyperparathyroidism arises due to a disorder in the control mechanism of calcium acting upon the parathyroid hormone.  Hyperparathyroidism is characterized by high levels of parathormone and calcium and low levels of phosphorus in serum.


24-hour urine Calcium levels are inspected to diagnose and differentiate it from other diseases.


Hyperparathyroidism is common in women aged over 40 years.  It is three times more common in women than men.


As a result of widespread biochemical screening tests, the rate of aymptomatic hyperparathyroidism has increased in recent years.


20% of hyperparathyroidism cases are genetic.  The pituitary gland, pancreas, thyroid, adrenal glands are examined in genetic cases.


The causes of hyperparathyroidism are parathyroid adenoma, parathyroid hyperplasia and parathyroid cancer.


80% of hyperparathyroidism patients have parathyroid adenomas.  Parathyroid hyperplasia is reported in 15-20% of cases and multiple adenoma in 3-10% of cases.  Parathyroid cancer rate is less than 1%.


Preoperative localization of parathyroid adenoma with ultrasonography and scintigraphy increases the success rate of surgery.


The localizations of some parathyroid adenomas are very difficult to reach, therefore the experience of endocrine surgery is important factor.  Advanced imaging methods are used some patients or existing imagings are repeated in order to increase the success rate of surgery.


Many adenomas that cannot be visualized by ultrasonography can be detected by ultrasonography in the experienced hands.


     

Appearance of parathyroid adenomas in MIBI scintigraphy