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Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels), with resultant hyperplasia of these glands. This disorder is primarily seen in patients with chronic kidney failure.
Hyperparathyroidism is an increase in parathyroid hormone (PTH) levels in the blood. [1] [4] This occurs from a disorder either within the parathyroid glands (primary hyperparathyroidism) or as response to external stimuli (secondary hyperparathyroidism). [1]
5741 19226 Ensembl ENSG00000152266 ENSMUSG00000059077 UniProt P01270 Q9Z0L6 RefSeq (mRNA) NM_000315 NM_001316352 NM_020623 RefSeq (protein) NP_000306 NP_001303281 NP_065648 Location (UCSC) Chr 11: 13.49 – 13.5 Mb Chr 7: 112.98 – 112.99 Mb PubMed search Wikidata View/Edit Human View/Edit Mouse Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone secreted ...
Tertiary hyperparathyroidism develops when the hyperplastic gland of secondary hyperparathyroidism constantly releases PTH, independent of the regulation systems. [2] Another condition is hypercalcemia, which refers to a calcium level above 10.5 mg/dL.
Tertiary hyperparathyroidism is defined by autonomous release of parathyroid hormone while in a hypercalcaemic state. Unlike primary hyperparathyroidism, hypercalcemia in the tertiary form is thought to be the result of resolution of secondary hyperparathyroidism rather than adenoma formation alone. [4] [11] [10]
High levels of fibroblast growth factor 23 seem to be the most important cause of decreased calcitriol levels in CKD patients. [citation needed] In CKD, the excessive production of parathyroid hormone increases the bone resorption rate and leads to histologic bone signs of secondary hyperparathyroidism. [16]
Lab work: Lab work must be done to diagnose milk-alkali syndrome. Lab workup includes serum calcium levels, parathyroid hormone (PTH), phosphorus, creatinine, blood urea nitrogen (BUN), magnesium, and vitamin D levels. Primary hyperparathyroidism has to be excluded. [12] Diagnosis is made by looking at past medical history and laboratory studies.
Hyperparathyroidism is confirmed by blood tests such as calcium and PTH levels. A specific test for parathyroid adenoma is sestamibi parathyroid scintigraphy, often referred to as sestamibi scan or, more colloquially, MIBI scan. This nuclear imaging technique reveals the presence and location of pathological parathyroid tissue. [7]
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