10 Facts About Tertiary hyperparathyroidism

Tertiary hyperparathyroidism is a condition involving the overproduction of the hormone, parathyroid hormone, produced by the parathyroid glands.

Symptoms in tertiary hyperparathyroidism are generally those seen in relation to elevated blood calcium levels.

Tertiary hyperparathyroidism is defined by autonomous release of parathyroid hormone while in a hypercalcaemic state.

Many of the mechanisms that drive the formation of tertiary hyperparathyroidism are due to outcomes of secondary hyperparathyroidism and so the tertiary from is said to be a continued progressive hyperparathyroidism.

Secondary Tertiary hyperparathyroidism occurs mainly in those who have chronic kidney disease or vitamin D deficiencies both of which lead to malabsorption of calcium and phosphate leading to decreased blood calcium levels inducing a Tertiary hyperparathyroidism.

An elevated risk of developing tertiary hyperparathyroidism exists when late stage kidney disease is not corrected timely.

Secondary hyperplasia of the parathyroid gland is more often a nodular, monoclonal growth that sustains secondary hyperparathyroidism and is the catalyst in the progression to tertiary hyperparathyroidism.

Indications for surgery in tertiary hyperparathyroidism commonly involve the development of chronic, severe conditions including osteopenia, persistent severe hypercalcemia, bone pain and pathologic fracture.

Surgical options for tertiary hyperparathyroidism include subtotal parathyroidectomy and total parathyroidectomy with autotransplatation of resected tissue.

In 1968 Davies, Dent and Watson produced a historic case study where they reviewed 200 cases of previously diagnosed primary hyperparathyroidism and found the majority of these cases should be reclassified as tertiary.