Hyperparathyroïdie
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30548536
2008-06-11T20:44:34Z
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{{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]].
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'''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.
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=== Étiologie ===
* L'[[hyperparathyroïdie primaire]] est due à un dysfonctionnement au sein des glandes parathyroïdes elles-mêmes, avec hypersécrétion de PTH.
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** 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).
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* 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]].
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== Signes et symptômes ==
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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.
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palpitations, vertiges, fatigue, troubles digestifs.
== Diagnostic ==
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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]].
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== Traitement ==
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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]])
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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]]