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Parathyroid Gland Function and Disorders

The parathyroid glands produce parathyroid hormone (PTH) which regulates calcium and phosphate levels. There are typically four parathyroid glands located behind the thyroid gland. PTH increases blood calcium levels by stimulating bone breakdown, vitamin D activation, and kidney reabsorption. It decreases kidney phosphate reabsorption. Disorders include hypoparathyroidism with low calcium and hyperparathyroidism with high calcium. Primary hyperparathyroidism is usually caused by an adenoma and results in elevated PTH and calcium levels.

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Leonard Acsinte
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232 views24 pages

Parathyroid Gland Function and Disorders

The parathyroid glands produce parathyroid hormone (PTH) which regulates calcium and phosphate levels. There are typically four parathyroid glands located behind the thyroid gland. PTH increases blood calcium levels by stimulating bone breakdown, vitamin D activation, and kidney reabsorption. It decreases kidney phosphate reabsorption. Disorders include hypoparathyroidism with low calcium and hyperparathyroidism with high calcium. Primary hyperparathyroidism is usually caused by an adenoma and results in elevated PTH and calcium levels.

Uploaded by

Leonard Acsinte
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Parathyroid glands

Parathyroid
• In normal conditions, there are 4 PTy glands, located on the posterior
faces of the thyroid lobes, two for each lobe (superior and inferior
parathyroid); sometimes – 8, developing in the upper mediastinum.
• about the size of a grain of rice.
• The parathyroid glands produce parathormone (PTH).
• PTH plays a key role in maintaining the calcium and phosphate levels
within a very narrow range.
Parathormone and calcium
• PTH is a hypercalcemiant hormone:

• Increases blood Ca level by stimulating osteoclasts to break down bone  Ca


release ;

• Activates vitamin D to increase the gastrointestinal absorption of Ca;

• Stimulates calcium reabsorption in the kidney


Parathormone and phosphate

• PTH inhibits proximal tubular reabsorption of phosphorus.

• Increases intestinal absorption of phosphorus via Vitamin D


Disorders of the parathyroids
• Hypoparathyroidism

• Hyperparathyroidism
Anamnesis

• Familial history of hyperparathyroidism (MEN syndrome)

• Familial /personal history of autoimmune diseases (autoimmune


polyendocrine syndromes)

• Personal history of thyroid surgery


• Personal history of fractures
• Personal history of kidney stones
Symptoms
Hypoparathyroidism Primary Hyperparathyroidism
• Paresthesia (unpleasant tingling sensation) Bone pain
• Muscle cramps
• Muscle spasms Polyuria
• Bone pain Polydipsia
• Fatigue
• Insomnia Nausea /Vomiting
• In case of severely low calcium level : Kidney stones
• seizures,
• arrhythmias, Cognitive impairment
• respiratory failure Osteopenia/osteoporosis
Particular conditions: Fracture history
- Pseudohypoparathyroidism – defective reception of PTH
in target cells; skeletal defects
- Pseudo-pseudo-hypoparathyroidism : normal lab tests;
skeletal defects
Chvostek’s sign
Trousseau’s sign
Opistotonus
Pseudohypoparathyroidism
Pseudohypoparathyroidism
Pseudohypoparathyroidism
Pseudohypoparathyroidism
Hyperparathyroidism
Cause Lab results Treatment
Primary Excessive PTH (adenoma, Elevated PTH  hypercalcemia, Surgery
carcinoma) hypophosphatemia Treatment of
complications

Secondary Chronic hypocalcemia (low vitamin Low calcium, low vitamin D  Vitamin D and
D) Elevated PTH calcium
administration

Tertiary Untreated secondary Similar to primary form Surgery


hyperparathyroidism 
Autonomous PTH secretion
Ostheoporosis
ostheoporosis
Ostheoporosis - DEXA
Ostheoporosis - DEXA
Parathyroid adenoma
Parathyroid adenoma
Parathyroid adenoma - scintigraphy

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