Categories: Endocrinology

Hyperparathyroidism: Primary, Secondary, Tertiary

Primary: Elevated PTH that results in elevated Ca2+. Typically caused by parathyroid adenoma. 

Secondary: Elevated PTH due to Low Ca2+ (Hypocalcemia). Seen commonly in chronic kidney disease causing low Vitamin D synthesis and hyperphosphatemia. Also seen in several malabsorptive states (i.e chronic pancreatitis).

Tertiary: Elevated PTH due to hyperplasia/ hypersecretion from the paraythroid gland in the setting of long-standing secondary hyperparathyroidism (i.e CKD). This results in elevated PTH AND elevated Ca2+, even after correction of the secondary cause. 

REFERENCES

  1. Pitt SC, Sippel RS, Chen H. Secondary and Tertiary Hyperparathyroidism, State of the Art Surgical Management. The Surgical clinics of North America. 2009;89(5):1227-1239. doi:10.1016/j.suc.2009.06.011.
  2. Ahmad R., Hammond JM. Primary, secondary, and tertiary hyperparathyroidism. Otolaryngol Clin North Am. 2004 Aug;37(4):701-13, vii-viii.
  3. Russell RI. Hypoparathyroidism and malabsorption. British Medical Journal. 1967;3(5568):781-782.
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Share
Published by
Dr. C Humphreys

Recent Posts

Nocturia and OSA: Mechanism

Nocturia is a common symptom associated with obstructive sleep apnea. [1] Img Cred: Am J…

6 months ago

ASD vs. VSD Murmur Difference

ASD (Atrial Septal Defect) Wide, Fixed split S2 (in contrast to the normal variation in…

6 months ago

Mechanism of a Mixed Apnea

Mixed apneas are characterized by absent respiratory effort and airflow in the first section of…

1 year ago

How Does Hypothyroidism Cause Hypoventilation?

Although rare, the differential diagnosis of hypoventilation and hypercapnia respiratory failure includes hypothyroidism. It is…

1 year ago

Why is Pro-BNP/ BNP lower in Obesity?

B-type natriuretic peptide (BNP) is a hormone created in response to cardiac wall stretch due…

2 years ago

What is Peribronchovascular Distribution on CT imaging?

A common finding described on computed tomography (CT) imaging. A disease with a peribronchovascular distribution…

3 years ago

This website uses cookies.