Il trattamento medico e chirurgico nei pazienti affetti da iperparatiroidismo secondario e terziario. Revisione della letteratura

Massimo Cajozzo, Attilio Ignazio Lo Monte, Vincenzo Davide Palumbo, Salvatore Buscemi, Giuseppe Damiano, Giuseppe Buscemi, Salvatore Fazzotta, Caternicchia, Carolina Maione, Cocchiara, Attilio Ignazio Lo Monte, Vincenzo Davide Palumbo, Massimo Cajozzo, Salvatore Buscemi, Carolina Maione, Gabriele Spinelli, Gerlando Cocchiara, Silvia Ficarella

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3 Citations (Scopus)

Abstract

INTRODUCTION: Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism).AIMS: There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods.DISCUSSION: In secondary hyperparathyroidism (2HPT) there is a progressive hyperplasia of the parathyroid glands and an increased production of parathyroid hormone. Several causes are proposed: chronic renal insufficiency, vitamin D deficiency, malabsorption syndrome. The tertiary hyperparathyroidism (3HPT) is considered a state of excessive autonomous secretion of PTH due to long-standing 2HPT and it's usually the result of a lack of suppression in the production of PTH. The pathophysiological implications are both skeletal and extraskeletal: it damages the cardiovascular system, nervous system, immune, hematopoietic and endocrine system. The introduction of new drugs has improved the survival of these patients, allowing the inhibition of the synthesis of PTH. Indication for surgical treatment is unresponsive medical therapy.CONCLUSIONS: There are no large prospective studies that comparing the medical and surgical treatment. The choice is not unique and we have to consider the singolar case and the clinical condition of the patient.
Original languageItalian
Pages (from-to)158-167
Number of pages10
JournalLA CLINICA TERAPEUTICA
Volume168
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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