Hyperparathyroidism
CASE 7: HYPERPARATHYROIDISM
This is the case of a 53 year old violinist.
Signs and Symptoms presented by the patient: * Pain that came in waves which started in his right flank and radiated into the groin * Bright red urine * Ureteral stones * Parathyroid adenoma
Laboratory Findings: Patient’s Laboratory Values | Serum Ca2+ | 11.5 mg/dl (normal, 10mg/dl) | Serum phosphate | 2mg (normal, 3.5 mg/dl) | Serum parathyroid hormone | 125pg/ml (normal, 10-65 pg/dl) | Serum albumin | Normal | Alkaline phosphatase | Elevated | Urinary Ca2+ | Elevated | Urinary stone composition | Calcium oxalate |
Diagnosis: PRIMARY HYPERPARATHYROIDISM Primary hyperparathyroidism is a disorder of the parathyroid glands wherein people with this disorder have one or more enlarged, overactive parathyroid glands that secrete too much parathyroid hormone (PTH).The parathyroid glands are located behind the thyroid gland. The effects of parathyroid hormone on serum calcium are mediated by increasing renal tubular resorption of calcium, increasing calcium absorption from the intestines (via vitamin D) and increasing release of calcium from bone. Through their secretion of parathyroid hormone (PTH), the parathyroid glands are primarily responsible for maintaining extracellular calcium concentrations. Hence, overproduction of parathyroid hormone results in elevated levels of plasma calcium. Hyperparathyroidism is a disease characterized by excessive secretion of parathyroid hormone which is an 84–amino acid polypeptide hormone. The secretion of parathyroid hormone is regulated directly by the plasma concentration of ionized calcium.
ANSWERS TO QUESTIONS 1. What are the forms of Ca2+ in serum? Which forms are biologically active?
Calcium has various functions in human metabolism. In the blood stream, calcium has a normal value of 10mg/dl. Total serum Calcium is made up of three components: calcium that is bound to albumin which comprises 40% of
This is the case of a 53 year old violinist.
Signs and Symptoms presented by the patient: * Pain that came in waves which started in his right flank and radiated into the groin * Bright red urine * Ureteral stones * Parathyroid adenoma
Laboratory Findings: Patient’s Laboratory Values | Serum Ca2+ | 11.5 mg/dl (normal, 10mg/dl) | Serum phosphate | 2mg (normal, 3.5 mg/dl) | Serum parathyroid hormone | 125pg/ml (normal, 10-65 pg/dl) | Serum albumin | Normal | Alkaline phosphatase | Elevated | Urinary Ca2+ | Elevated | Urinary stone composition | Calcium oxalate |
Diagnosis: PRIMARY HYPERPARATHYROIDISM Primary hyperparathyroidism is a disorder of the parathyroid glands wherein people with this disorder have one or more enlarged, overactive parathyroid glands that secrete too much parathyroid hormone (PTH).The parathyroid glands are located behind the thyroid gland. The effects of parathyroid hormone on serum calcium are mediated by increasing renal tubular resorption of calcium, increasing calcium absorption from the intestines (via vitamin D) and increasing release of calcium from bone. Through their secretion of parathyroid hormone (PTH), the parathyroid glands are primarily responsible for maintaining extracellular calcium concentrations. Hence, overproduction of parathyroid hormone results in elevated levels of plasma calcium. Hyperparathyroidism is a disease characterized by excessive secretion of parathyroid hormone which is an 84–amino acid polypeptide hormone. The secretion of parathyroid hormone is regulated directly by the plasma concentration of ionized calcium.
ANSWERS TO QUESTIONS 1. What are the forms of Ca2+ in serum? Which forms are biologically active?
Calcium has various functions in human metabolism. In the blood stream, calcium has a normal value of 10mg/dl. Total serum Calcium is made up of three components: calcium that is bound to albumin which comprises 40% of