Prevalence ca 2.7% UK in females, ca 0.3% in males. Overall ca 1 : 1000 in females
With globalization and immigration, TPP is no longer confined to certain geographic areas and has been increasingly reported throughout the world.
T3 thyrotoxicosis mainly seen in XXX US scan helps to differentiate between AIT, Graves`, and toxic adenoma adenomas that produce overt hyperthyroidism generally are ≥ 3 cm
Increase of TSH with metoclopramide (Scanlon JCEM 1980)
tonic inhibitory role for DA in the control of TSH secretion
PTU: also fulminant hepatitis But evl smaller risk of XXX
PTH results came back later, hence initially thought to have multiple myeloma
Clinical correlates may include bone pain and tenderness, bowing of the shoulders, kyphosis and loss of height, collapse of lateral ribs and pelvis with pigeon breast and triradiate deformities, respectively
Moosgaard Denmark 81% vs 60% in controls Ca 20% (McDermott p 136) Subjects with primary hyperparathyroidism were 3.34 kg (95% confidence interval, 1.97-4.71; P < 0.00001) heavier than controls in 13 studies reporting body weight. In four studies reporting body mass index, subjects with primary hyperparathyroidism had an increased body mass index of 1.13 kg/m(2) (-0.29 to 2.55; P = 0.12) compared with controls.
? non- 1,25(OH) 2 D induced effects of 25(OH)D and other metabolites on PTH production
? stimulation of VitD receptor in parathyroid tissue by VitD deficiency
? intracrine action of parathyroid-derived 1,25(OH) 2 D to reduce PTH
Interactions with magnesium low magnesium levels blunt the stimulation of parathyroid glands induced by low Vit D levels often normal PTH levels even when 25-OH VitD below 20 ng/mL unknown effects of hypomagnesia in patients with pHPT Sahota et al. Osteoporos Int 2006