6.3 days

MEDICAL: Endocrine Disorders with CC 289

3.2 days

SURGICAL: Parathyroid Procedures

I I yperparathyroidism refers to the clinical condition that is associated with oversecretion of parathyroid hormone (PTH). Primary hyperparathyroidism, the most common form, is a gland dysfunction that originates in the parathyroid gland. Secondary hyperparathyroidism, in contrast, refers to a parathyroid gland dysfunction that is a response to a disorder elsewhere in the body, such as chronic renal failure. PTH is produced by the parathyroid glands, which are four small endocrine glands that are located on the posterior surface of the thyroid gland. The primary function of PTH is to regulate calcium and phosphorus balance by affecting gastrointestinal (GI) absorption of calcium, bone resorption (removal of bone tissue by absorption) of calcium, and renal regulation of both calcium and phosphorus. Calcium and phosphorus have a reciprocal relationship in the body; high levels of calcium lead to low levels of phosphorus.

Hypercalcemia, the identifiable result of hyperparathyroidism, also leads to the most important clinical complications. The body is able to compensate for slowly increasing calcium levels but eventually becomes overcome with calcium excess and phosphorus deficiency. Since the bones hold the majority of the body's calcium, extracellular hypercalcemia is a result of dem-ineralization of the bones. The calcium in the bones is replaced by cysts and fibrous tissue, thus leading to severe osteoporosis (reduction of bone mass per volume) and osteopenia (diminished bone tissue). Increased levels of extracellular calcium may be deposited in the soft tissues of the body and the kidney and lead to renal calculi, renal insufficiency, urinary tract infections, and eventually, renal failure. Hypercalcemia can also trigger the increased secretion of gastrin, which leads to peptic ulcer disease. Other GI dysfunctions that may result include cholelithiasis and pancreatitis.

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