87
H N i Ti t
Map 5.7 Cư ng c n giáp
Type
Cause
Primary
Parathyroid adenoma
Parathyroid hyperplasia
Parathyroid carcinoma
Drug induced, e.g. lithium
Vitamin D deficiency
Chronic kidney injury
Prolonged secondary hyperparathyroidism
Secondary
Tertiary
Signs and symptoms
These depend on the cause.
Primary – ‘Bones, moans, groans and stones’ Secondary
Asymptomatic
Bones, e.g. pain, osteoporosis
Moans, e.g. depression, fatigue
Groans, e.g. myalgia
Stones, e.g. kidney stones
Osteomalacia
Rickets
Renal osteodystrophy
Investigations
Investigation
Primary
PTH level
Secondary
Tertiary
HYPERPARATHYROIDISM
What is it?
This occurs when too much parathyroid hormone (PTH) is produced from the
parathyroid gland. It may be categorised into primary, secondary and tertiary causes.
Causes
-
-
-
Serum calcium
Serum phosphate
Other investigations include:
•
Bloods: FBC, U&Es, LFTs, creatinine.
•
Urine calcium level.
•
Dual energy X-ray (DEXA) scan.
•
Radiology:
○
Ultrasound scan of kidneys and neck.
○
Plain X-ray (for bone changes).
○
Parathyroid gland biopsy.
-
-
-
¯
¯
¯
Phân lo i đi u tr
Tiên phát
B o t n
Th phát
B c 3
Thu c
Ngo i khoa
Theo dõi
U ng nhi u nư c
Bisphosphonates
C t tuy n c n giáp
Ch đ ăn ít
phosphate và giàu
calci
Calcimimetics, e.g.
cinacalcet
C t tuy n c n giáp
n u không đáp ng
đi u tr n i khoa
C t tuy n c n
giáp
–
–
Bi n ch ng
•
S i th n.
•
Viêm t y c p.
•
Loét d dày.
•
Vôi hóa giác m c.
Đi u tr
MAP 5.7
Cư ng c n giáp
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