Tertiary hyperparathyroidism
Encyclopedia
Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone
(PTH) after a long period of secondary hyperparathyroidism
and resulting hypercalcemia. It reflects development of autonomous (unregulated) parathyroid function following a period of persistent parathyroid stimulation.
The basis of treatment is still prevention in chronic renal failure, starting medication and dietary restrictions long before dialysis treatment is initiated. Cinacalcet
has greatly reduced the number of patients who ultimately require surgery for secondary hyperparathyroidism
; however, approximately 5% of patients do not respond to medical therapy.
When secondary hyperparathyroidism is no longer responsive to treatment by medication, it is called tertiary hyperparathyroidism. The treatment of choice is surgical removal of three and one half parathyroid glands.
Parathyroid hormone
Parathyroid hormone , parathormone or parathyrin, is secreted by the chief cells of the parathyroid glands as a polypeptide containing 84 amino acids...
(PTH) after a long period of secondary hyperparathyroidism
Secondary hyperparathyroidism
Secondary hyperparathyroidism refers to the excessive secretion of parathyroid hormone by the parathyroid glands in response to hypocalcemia and associated hypertrophy of the glands. This disorder is especially seen in patients with chronic renal failure...
and resulting hypercalcemia. It reflects development of autonomous (unregulated) parathyroid function following a period of persistent parathyroid stimulation.
The basis of treatment is still prevention in chronic renal failure, starting medication and dietary restrictions long before dialysis treatment is initiated. Cinacalcet
Cinacalcet
Cinacalcet is a drug that acts as a calcimimetic by allosteric activation of the calcium-sensing receptor that is expressed in various human organ tissues. It is sold by Amgen under the trade name Sensipar in North America and Australia and as Mimpara in Europe...
has greatly reduced the number of patients who ultimately require surgery for secondary hyperparathyroidism
Secondary hyperparathyroidism
Secondary hyperparathyroidism refers to the excessive secretion of parathyroid hormone by the parathyroid glands in response to hypocalcemia and associated hypertrophy of the glands. This disorder is especially seen in patients with chronic renal failure...
; however, approximately 5% of patients do not respond to medical therapy.
When secondary hyperparathyroidism is no longer responsive to treatment by medication, it is called tertiary hyperparathyroidism. The treatment of choice is surgical removal of three and one half parathyroid glands.
See also
- Primary hyperparathyroidismPrimary hyperparathyroidismPrimary hyperparathyroidism causes hypercalcemia through the excessive secretion of parathyroid hormone , usually by an adenoma of the parathyroid glands.-Epidemiology:...
- Secondary hyperparathyroidismSecondary hyperparathyroidismSecondary hyperparathyroidism refers to the excessive secretion of parathyroid hormone by the parathyroid glands in response to hypocalcemia and associated hypertrophy of the glands. This disorder is especially seen in patients with chronic renal failure...