Hyperparathyroidism

Hyperparathyroidism is classified as primary, secondary, or tertiary depending on the cause. In primary hyperparathyroidism, autonomous overproduction of parathyroid hormone (PTH) often results from a parathyroid adenoma. Secondary hyperparathyroidism occurs in response to hypocalcaemia, commonly due to chronic kidney disease. Tertiary hyperparathyroidism represents persistent PTH elevation after long-standing secondary hyperparathyroidism. Bone manifestations include osteitis fibrosa cystica, subperiosteal bone resorption, and pathological fractures. Diagnosis involves elevated serum calcium (in primary) and PTH levels. Treatment ranges from surgical parathyroidectomy to phosphate binders and vitamin D analogs, particularly in CKD patients.