Primary hyperparathyroidism

Alternative names:

parathyroid related hypercalcemia

Treatment:

Treatment depends upon the severity and cause of the condition. Mild hypercalcemia may be followed medically unless impaired renal function, bone demineralization, or high blood pressure is present.

Treatment consists of:

• forcing fluids given by mouth to prevent kidney stone formation
• avoiding sedentary lifestyle or immobilization
• avoiding diuretics
• phosphate preparations if kidney function is good
• giving estrogen therapy to women if they are postmenopausal

For symptomatic, severe hypercalcemia, hospitalization may be required. Rehydration using intravenous fluids may be started.

Surgical removal of a tumor or excess parathyroid tissue from hyperplasia is indicated if hypercalcemia is more severe or if one or more of the following complications are present: kidney stones (nephrolithiasis), peptic ulcer, pancreatitis, psychiatric disease, hypertension, or progressive bone deterioration.

Expectations (prognosis):

The outcome is best for a mild case. The disease is usually progressive unless the parathyroid glands are removed. Skeletal damage may heal with treatment; however, kidney damage is irreversible. Parathyroid cancer tends to spread to other nearby tissues, and repetitive resections may be indicated.

Complications:

Complications that result from excess calcium deposits within the body:

• skeletal damage
• urinary tract infection due to kidney stones and obstruction
• peptic ulcer disease and pancreatitis
• pseudogout

Calling your health care provider:

Call for an appointment with your health care provider if symptoms indicate that primary hyperparathyroidism may be present.

Call your health care provider if signs of complications develop.