Navigation Home Contact us Hyperparathyroidism and parathyroidectomy Hyperparathyroidism is the most common cause of hypercalcemia. Primary hyperparathyroidism results from autonomous PTH secretion by adenomas, hyperplasia, or carcinoma. The paired upper glands arise from the fourth branchial pouch and the lower glands and thymus arise from the third branchial pouch.
Aberrant migration produces ectopic parathyroid glands.
Excess PTH causes bony calcium mobilization, stimulation of renal calcium reabsorption, and inhibition of renal phosphate absorption. Primary hyperparathyroidism is associated with pancreatitis, ephrolithiasis, nephrocalcinosis, gout, pseudogout, hypertension, and peptic ulcer disease. Secondary and tertiary hyperparathyroidismm occur in patients with renal disease. Pseudohyperparathyroidism occurs in oat cell and squamous carcinomas that produce PTH like proteins. Hyperparathyroidism occurs in MEN I and MEN IIa.