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Primary hyperparathyroidism
1. Adenomas 2. Hyperplasia 3. Carcinoma
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Hyperparathyroidism
- Polydipsia
- Polyuria
- Constipation
- Muscle weakness
- Weight loss
- Skeletal manifestations.
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Consequences of hyponatraemia
- >120mmol/L - often asymptomatic
- 110-120 - headache, agitation, disorientation, lethargy, N&V
- <110 - convulsion, coma, pseudobulbar palsy (though may be tolerated if slow onset)
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Hyponatraemia
Euvolaemia= syndrome of inappropriate anti-diuretic hormone (SIADH), high water intake, hypothyroidism.
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Hyponatraemia
Hypovolaemia= diarrhoea, vomiting, diuretics, renal tubular dysfunction
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Hyponatraemia
Hypervolaemia= cirrhosis, heart failure
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Pseudohypoparathyroidism
- Hypocalcaemia with hyperphosphataemia
- Elevated PTH due to resistance to parathormone (PTH).
- This is due to mutation of the PTH receptor.
- There are associated phenotypic signs including short stature, low IQ and shortened fourth and fifth metacarpals.
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Cretinism
- Cretinism is characterised by
- retarded bone age
- short stature
- protruding tongue
- broad flat nose
- widely set eyes
- sparse hair
- dry skin
- protuberant abdomen
- umbilical hernia.
The incidence of cretinism is about 1:5000
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