How do primary secondary and tertiary hyperparathyroidism differ?
Definition
- Primary hyperparathyroidism ( pHPT. ): Hypercalcemia. results from abnormally active. parathyroid glands. .
- Secondary hyperparathyroidism ( sHPT. ): Hypocalcemia. results in reactive overproduction of. PTH. .
- Tertiary hyperparathyroidism ( tHPT. ): Hypercalcemia. results from untreated. sHPT. , with continuously elevated.
Is hyperparathyroidism primary or secondary?
Hyperparathyroidism may occur because of a problem with the parathyroid glands (primary hyperparathyroidism) or because of another disease that affects the glands’ function (secondary hyperparathyroidism).
What is secondary and tertiary hyperparathyroidism?
In secondary hyperparathyroidism, the serum calcium is normal and the PTH level is elevated. Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism, in which hypercalcemia has ensued.
Why is there hypercalcemia in tertiary hyperparathyroidism?
Tertiary hyperparathyroidism usually happens after long-term secondary hyperparathyroidism when the parathyroid glands have been producing high levels of parathyroid hormone for such a long time that they become overgrown and permanently overactive. This leads to high blood calcium levels.
What is secondary hyperparathyroidism?
Secondary hyperparathyroidism occurs when the parathyroid glands become enlarged and release too much PTH, causing a high blood level of PTH. There are several reasons why this happens in patients with kidney disease: Higher blood phosphorus levels.
Why is calcium low in secondary hyperparathyroidism?
The most common causes of secondary hyperparathyroidism are kidney failure and vitamin D deficiency. In kidney failure, the kidney is no longer able to make enough vitamin D or remove all of the phosphorus that is made by the body, which leads to low calcium levels.
Why is phosphate high in secondary hyperparathyroidism?
In Secondary Hyperparathyroidism, you will have a low or normal calcium level with a raised parathyroid hormone level. In kidney disease, your blood phosphate level can be high because your kidneys cannot remove phosphate in your urine.
Do you need surgery for secondary hyperparathyroidism?
For patients with secondary hyperparathyroidism from kidney failure, the only treatment is to have a kidney transplant. If the underlying problem cannot be fixed, the best treatment is medical therapy and surgery is only done for patients in whom optimal medical therapy is not working.
What is the difference between tertiary and secondary hyperparathyroidism?
Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism. in which hypercalcemia has ensued. Tertiary hyperparathy.-oidism typically occurs in men and women with chronic kidney disease usually after kidney transplant.
Can a person with secondary hyperparathyroidism have high blood calcium?
Patients with secondary hyperparathyroidism usually have low or normal serum calcium concentrations. If there is hypercalcemia, it’s not secondary hypercalcemia anymore. It’s either tertiary hyperparathyroidism or something else altogether. Secondary hyperparathyroidism cannot ever be associated with high blood calcium.
Can a vitamin D deficiency cause secondary hyperparathyroidism?
“Secondary hyperparathyroidism is most likely due to low vitamin D intake or low serum vitamin D, often in the setting of renal disease. However, the serum vitamin D level and estimated glomerular filtration rates are normal in this patient. This rules out secondary hyperparathyroidism, as well as vitamin D deficiency and renal insufficiency.
What causes the parathyroid glands to produce extra PTH?
In secondary hyperparathyroidism, something in the body is causing the parathyroid glands to produce extra PTH. The glands are actually doing what they are supposed to do.