Classification of diseases caused by violation of the secretion of parathyroid hormone.
I. Primary hyperparathyroidism. 1. Pathogenetic forms:
1) hyperfunctioning adenoma (adenoma);
2) hyperplasia of the coccyx;
3) multiple endocrine neoplasia type I with hyperplasia
ratiose (Vermera syndrome);
4) multiple endocrine neoplasia II typepashyperparathyroidism (Sippl syndrome).
2. Clinical forms:
3) fibrocystic osteitis;
6) the benefits of kidney damage;
7) with a predominant lesion of the gastrointestinal tract;
8) with a primary lesion of the neuropsychic sphere;
9) mixed form.
Ii. Secondary hyperparathyroidism.
1. Renal pathology: chronic renal insufficiency
ness, tubulopathy (such as Albright — Fanconi), renal rickets. 2. Intestinal pathology (malabsorption syndrome).
3. Bone pathology (osteomalacia cyanosis, puerperal
naya, idiopathic, Paget’s disease).
4. Vitamin D deficiency diseases of the kidneys, liver,
hereditary fermentopathies (calcium and phosphopenic inherited forms of osteomalacia).
5. Malignant diseases (myeloma).
Iii. Tertiary hyperparathyroidism.
V. Hormonally inactive cystic and neoplastic
Vania parathyroid glands.
1. Congenital hypoplasia or absence of parathyroids
2. Idiopathic (autoimmune).
4. Beam damage.
5. Damage to the parathyroid glands with hemorrhage,
6. Infectious damage.
Type I – insensitivity of organs to parathyroidism
well, dependent on adenylate cyclase.
Type II – insensitivity of target organs to the parathyroid
Monu, independent of adenylate cyclase, possibly of autoimmune genesis.
Hyperparathyroidism is a disease caused by parathyroid hormone hypersecretion. According to the pathogenetic principle, hyperparathyroidism is divided into primary, secondary and tertiary.
An independent disease is primary hyperparathyroidism. Secondary and tertiary hyperparathyroidism are syndromes complicating the course of other diseases (renal insufficiency, malabsorption).
Primary hyperparathyroidism is the primary disease of the parathyroid glands, manifested by excessive production of parathyroid hormone with the development of hypercalcemia syndrome. Secondary hyperparathyroidism is a compensatory hyperplasia and hyperplasia of the parathyroid glands, which develops with prolonged hypocalcemia and hyperphosphatemia of various genesis.
In the case of tertiary hyperparathyroidism, autonomic hyperproduction of parathyroid hormone with hyperplastic parathyroid glands develops or para thyroid gland with long-existing secondary hyperparathyroidism.
Classification of hyperparathyroidism.
1. Primary hyperparathyroidism:
1) solitary adenoma (80%), multiple adenomas (5%);
2) hyperplasia of parathyroid glands (15%);
3) carcinoma parathyroid glands (<5%);
4) primary hyperparathyroidism syndromes
venous endocrine neoplasias type I and II.
2. Secondary hyperparathyroidism:
1) renal secondary hyperparathyroidism;
2) secondary hyperparathyroidism in normal renal function:
a) malabsorption syndrome with impaired calcium absorption;
b) pathology of the liver (rarely) —cirrhosis (violation of cholecalciferol transfusion), cholestasis (violation of cholecalciferol resorption));
3) Vitamin D deficiency (insufficient solar exposure). 3. Tertiary hyperparathyroidism.