HYPERPARATHYROESIS AND KIDNEYS
Introduction. Primary hyperparathyroidism is an excessive secretion of parathyroid hormone due to a defect in the cells of the parathyroid glands. There are several clinical forms: bone, kidney, gastrointestinal (gastric ulcer, pancreatitis, cholecystitis), cardiovascular (hypertension) and others. Increased secretion of parathyroid hormone is the cause of increased osteolysis and movement of calcium into the blood, increased absorption of calcium from the gastrointestinal tract and increased excretion of calcium and phosphate in the urine. In 50% of cases, the disease is asymptomatic and only detected hypercalcemia suggests hyperparathyroidism.
The purpose. Describe the clinical manifestations of hyperparathyroidism, analyze the dynamics of laboratory and instrumental parameters in a patient with high levels of parathyroid hormone, differentiate between primary and secondary hyperparathyroidism.
Materials and methods. Review of modern and foreign sources, analysis and discussion of a specific clinical case; methods – description, analysis, abstracting.
Results. On the basis of sudden onset, thirst, nausea, uncontrollable vomiting not associated with food intake, joint and muscle pain, spastic abdominal pain, massive multiorgan calcification, neuropsychiatric disorders, elevated calcium levels, elevated levels of parathyroid hormone, osteoporosis, the presence of kidney stones, elevated levels of alkaline phosphatase, hypovolemia, hypokalemia, metabolic alkalosis, moderate proteinuria and hematuria, as well as, given the presence of a provoking factor (psycho-emotional stress), the patient was diagnosed with primary hyperparathyroidism. After hyperparathyroid crisis.
Conclusion. Subjective (general weakness, depression, bone and joint pain, etc.) and objective (renal and skeletal) should draw the doctor’s attention to the presence of hyperparathyroidism. A nephrologist should be involved in the differentiation of primary or secondary hyperparathyroidism.
This work is licensed under a Creative Commons Attribution 4.0 International License.