Parathyroid gland response to low serum calcium level by releasing PTH. ❖PTH has direct action on bone and kidney. ❖At a bone PTH inhibit osteoblas activity and stimulates osteoclast activity leading to bone breakdown and calcium Release.

1. University of Chakwal, Pakistan

2. DEPARTMENT OF ZOOLOGY
PRESENTED BY : MUSARFA NOOR
REG. NO. : 20M-UOC/ZOL-32
BS ZOOLOGY
SESSION 2020-24
SUBJECT: ENDOCRINOLOGY
SUBMITTED TO: DR. SYEDA NADIA AHMAD
TOPIC : PARATHYROIDABNORMALITES

3. CONTENTS
INTRODUCTION TYPES OF
ABNORMALITES
SYMPTOMS TREATMENT
REFERENCES

4. INTRODUCTION
o Parathyroid gland dysfunction.
o Hyperparathyroidism
or Hypoparathyroidism develop.
o Calcium and Phosphorous levels are
affected.
o Hormone is to low and to high , it can lead
to health problems such as muscle cramps,
nerve and bone disorder(Acr, 2022).

5. o Normal range of parathyroid hormone
blood test is 14- 65pg/ml.
o PTH Concentration supressed into low
normal range in the 1st trimester of the
pregnancy and concentration increase to
reach a mid normal range by the 3rd
trimester.
o Parathyroid Disorder may be inherited.

6. MECHANISM OF ACTION OF
PTH
❖Parathyroid gland response to low
serum calcium level by releasing
PTH.
❖PTH has direct action on bone and
kidney.
❖At a bone PTH inhibit osteoblas
activity and stimulates osteoclast
activity leading to bone breakdown
and calcium Release.
Figure #1: Mechanism of action of
PTH
https://www.timeofcare.com/parat
hyroid-hormone-action/

7. ❖At the kidney PTH increase calcium reabsorption and
blocks phosphate reabsorption from tubules.
❖PTH stimulates the synthesis of 1,25 dihydroxyvitamin D.
❖Calcium and vitamin D provide negative feedback to inhibit
PTH Release(Md & Md, 2018).

8. HYPERPARA
THYROIDISM
HYPOPARATH
YROIDISM
PARATHYROID
CANCER
TYPES OF ABNORMALITES

9. HYPERPARAT
HYROIDISM
❖Over Production of PTH.
❖Cause the release of calcium from
bone to blood.
❖Most common hormonal disorder.
❖Nearly 100,000
people in U.S developing the
primary hypothyrodism in each year.
(Insogna, 2018).
Three main types:
Primary hypothyroidism
Secondary hypothyroidism
Tertiary hypothyroidism

10. PRIMARY
❖Overproduction of
PTH by parathyroid
gland.
❖High calcium level and
low phosphorous level
in blood.
❖It occurs randomly but
some people inherit a
gene that causes the
disorder.
SECONDARY
❖Parathyroid gland to
become enlarge and
hyperactive.
❖Common causes are
kidney failure and
vitamin D deficiency.
❖Kidney is no longer
able to make enough
vitamin D
❖Parathyroid gland enlarge
❖PTH release on their own.
❖Hormone level doesn't go
down with medical
treatment.
❖This is called teritary
hypothyroidism
❖Surgically
remove parathyroid tissues
TERTIARY

11. PRIMARY
❖It also occurs bc of a
problem with one or
more of the four parathyroid
glands.
❖A noncancerous growth
adenoma on a gland.
❖Enlargment hyperplasia of
two or more parathyroid
glands.(Walker& Silverberg
2018).
SECONDARY
❖remove all phosphorous made by
body which lead to low calcium level
❖It stimulate PG to make more PTH.
❖Calciphylasis where calcium deposits form in
skin and muscle causing painful skin leshions.
❖Managed with calcium and vitamin D
Replacement and reduction of high phosphate
level.(Slatopolsky & Brown,2019)

12. HYPOPARATH
YROIDISM
❖Loss of direct and indirect effects of PTH on
bone, kidney and gut.
❖Impaired release of calcium and phosphate
from bone.
❖Limited calcium absorption in gut.
❖Low level of calcium in blood(Hypocalcemia)
❖Hyperphosphatemia
❖Long term hypoparathyroidism
cause hypercalciuria and
osteopenia.(Lewis,2023).

13. TRANSIENT HYPOPARATHYROIDISM
❖Occure during the neonatal period.
❖Hypocalcemia is noted in 10-20% of infant of diabetic
mother.
❖Infant may be born prematurely.
❖PTH Secreation is supressed in fetus bc of
high placental transefer of calcium in third trimister.
❖Calcium transfer abruptly stops
❖Calcium concentrations decrease rapidly and PTH
Secreation triggered.

14. AUTOIMMUNE HYPOPARATHYROIDISM
❖Autoantibodies attack the cell of parathyroid gland.
❖Autoimmune condition may be isolated or part of
polyglandular syndrome.
❖APS-1 consist of skin infection and primary adrenal problem
❖It is inherited and usually occur in childern
❖APS-2 Present in adults.
❖It may addison's disease and combination with type 1 diabetes.
❖75% cases occur in women(Parathyroid UK, 2022).

15. PSEUDOHYPOPARATHYROIDISM
❖ Genetic Disorder.
❖Body fail to response PTH.
❖Body does not make enough PTH.
❖PHP Caused by abnormal genes.
❖Three different form of PHP.
❖ Type-1a
❖ Type-1b
❖ Type-2
❖Rare and usually diagnosed in children(Linglart,2020).

16. PARATHYROID CANCER
❖Rare cancer that develop in parathyroid tissue.
❖Affects men and women equally.
❖Often occur in people older.
❖Cause of parathyroid cancer is unknown(Fang,2019).

17. • It mean cancer found in PG and
spread to surrounding tissues.
• It means cancer has spread to other
part of your body such as Lymph
nodes,liver lungs.
• Cancer come back after initial
treatment such as surgical removal of
gland.(Koea,2021).
Figure #2:Types of parathyroidCancer
https://actchealth.com/parathyroid-cancer-
treatment

18. SYMPTOMS
Hyperparathyroidism
• Fatigue
• Loss of appetite
• Constipation
• Muscle weakness
• Hypertension
Hypoparathyroidism
• Tingling in the
fingers, toes around
the mouth.
• Severe muscle
cramps
Parathyroid Cancer
• Bone pain
• Nausea and
vomiting
• Depression
• Difficulty speaking
and swallowing

19. TREATMENT
Treatment can include:
• Surgery
• Medication
• Radiation(Hueston,2021).

21. REFERENCES
• Koea, J. B., & Shaw, J. H. (2021). Parathyroid cancer: biology and
management. Surgical oncology, 8(3), 155-165.
• Linglart, A., Levine, M. A., & Jüppner, H. (2020).
Pseudohypoparathyroidism. Endocrinology and Metabolism Clinics,
47(4), 865-888.
• Hueston, W. J. (2021). Treatment of hypoparathyroidism. American
family physician, 64(10), 1717-172