Hyperparathyroïdie 3041959 30548536 2008-06-11T20:44:34Z Thijs!bot 105469 robot Ajoute: [[pl:Nadczynność przytarczyc]] {{ébauche|médecine}} {{CIM-10||ICD10=E21}} L''''hyperparathyroïdie''' associe une [[hypercalcémie]] à un taux sanguin anormalement élevé d'[[hormone parathyroïdienne]]. L'hypercalcémie chronique peut causer une [[néphrocalcinose]] et une [[insuffisance rénale]]. La résorption osseuse excessive provoque une [[ostéomalacie]]. L'hyperparathyroïdie est le plus souvent due à un [[adénome]] secrétant d'une glande [[parathyroïde]] ou à une [[hyperplasie]] de plusieurs de ces glandes. Le mauvais pronostic de l'évolution spontanée et l'existence d'un traitement chirurgical efficace justifient le travail consacré au diagnostic. On distingue une [[hyperparathyroïdie primaire]] et une [[hyperparathyroïdie secondaire]]. <!-- '''Hyperparathyroidism''' is overactivity of the [[parathyroid gland]]s resulting in excess production of [[parathyroid hormone]] (PTH). Increased PTH consequently leads to increased serum calcium ([[hypercalcemia]]) due to 1) increased bone resorption, allowing flow of calcium from bone to blood, 2) reduces renal clearance of calcium, and 3) increases intestinal calcium absorption. --> === Étiologie === * L'[[hyperparathyroïdie primaire]] est due à un dysfonctionnement au sein des glandes parathyroïdes elles-mêmes, avec hypersécrétion de PTH. <!-- ** The most common cause is a benign [[parathyroid adenoma]] that loses its sensitivity to circulating calcium levels. Usually, only one of the four parathyroid glands is affected. ** A less common cause is from [[multiple endocrine neoplasia]] (MEN). --> * L'[[hyperparathyroïdie secondaire]] est due à la résistance à l'action de la PTH, en général à cause d'une [[insuffisance rénale chronique]]. <!--The bone disease in secondary parathyroidism along with renal failure is termed [[renal osteodystrophy]]. --> == Signes et symptômes == <!-- The majority of patients with hyperparathyroidism are asymptomatic. Manifestations of hyperparathyroidism usually involves the kidney (stones) and the skeletal system (bone pain due to fibrous tissue replacement, termed [[osteitis fibrosa cystica]]) If symptomatic, hyperparathyroidism can be classically remembered by the rhyme "moans" (myalgia), "groans" (abdominal pain), "stones" (kidney), "bones" (bone pain), and "psychiatric overtones" (confusion, altered mental state, lethargy, fatigue). Other symptoms include: [[headache]]s, [[sleep disorder]]s, memory problems, [[gastroesophageal reflux disease|gastroesophageal reflux]], decreased sex drive, thinning hair, [[arterial hypertension|hypertension]], and heart palpitations. --> palpitations, vertiges, fatigue, troubles digestifs. == Diagnostic == <!-- The gold standard of diagnosis is the [[PTH immunoassay]]. Once an elevated PTH has been confirmed, goal of diagnosis is to determine whether the hyperparathyroidism is primary or secondary in origin by obtaining a serum [[calcium]] level. If the calcium level is high, then the diagnosis is very likely [[primary hyperparathyroidism]]; if low or normal, then it is most likely [[secondary hyperparathyroidism]]. --> == Traitement == <!-- Treatment is first and foremost directed at hypercalcemia, if symptomatic. (see [[hypercalcemia]]) If asymptomatic, treatment can then be directed towards the underlying cause *(see [[primary hyperparathyroidism]]) *(see [[secondary hyperparathyroidism]]) --> Intervention chirurgicale ou traitement à vie, type Mimpara.Plusieurs dosages existent. == Voir aussi == * [[Hypoparathyroïdie]] == Liens externes == * [http://www.emedicine.com/emerg/topic265.htm eMedicine] * [http://www.mayoclinic.com/health/hyperparathyroidism/DS00396 Mayo Clinic] {{portail médecine}} [[Catégorie:Terme médical commençant par H]] [[Catégorie:Maladie endocrinienne]] [[Catégorie:Calcium]] [[de:Hyperparathyreoidismus]] [[en:Hyperparathyroidism]] [[es:Hiperparatiroidismo]] [[it:Iperparatiroidismo]] [[ja:副甲状腺機能亢進症]] [[pl:Nadczynność przytarczyc]] [[pt:Hiperparatiroidismo]]