Parathyroid gland ( Hyperparathyrodism) Dr/ Abd Elghany Hefnawy.

Parathyroid gland(Hyperparathyrodism)

Dr/ Abd Elghany Hefnawy

PTH

Kidney-Decrease P reabsorption

from PCT-Increase Ca reabsorption

from DCT causing increase plasma Ca level

Intestine

Increase formation of 1,25 DHCC causing

increase Ca absorption from intestine

Bone Increase Ca resorption from bone causing increase plasma Ca level

PTH

Hyperparathyrodism

Autonomous

Secondary

Primary-HPTPseudo-HPT

Renal-HPTNutritional-HPT

Autonomous HPTSecretion of PTH is autonomous i.e. not related to the existing Ca level

Pseudo-HPTPrimary-HPT

Excessive production of other bone resorbing substances (Non-parathyroid tissues) as mammary

glands

-Parathyroid neoplasm-Hyperplasia

-Ectopic parathyroid neoplasm

Hypercalcemia including

Primary HPT Pseudo HPT Hypervitaminosis-D

Autonomous HPT

Clinical SignsAnorexia and

general depression

Constipation and vomiting

Muscular weakness

Rubber jaw(softness of mandible bone)

Easily fractured bonePolyueria and

polydepsia

Calcium urolithiasis

Cardiac arrhythmia

Loss teeth

DiagnosisHistory and clinical

signs Lab diagnosis

-High level of calcium and PTH

-Low level of phosphorous

Radiography -Decrease bone

density and increase bone cysts

-Ultrasonography of PTH glands -Surgical diagnosis

Steroid(Dexamethazon) suppression test

To differentiate between PHPT and PsHPT

By injection of Dexamethazon (0.5-1mg/kg IM)

Calcium level decreased IfPsHPT

Calcium level remain high

PHPT

Treatment

Surgical interference

Renal Hyperparathyroidism

Renal failure

Low production of vit-D (Active

form 1.25DHCCF)

Excessive Execretion of calcium

Protein catabolism with excess release of

phosphorous

Hypocalcemia

Hypertrophy of parathyroid gland

Renal hyperparathyrodism

Diagnosis

Low calcium

High PTH

Abnormal kidney function tests

Treatment

Calcium borogluconate

Vitamin-D IM

Treatment of renal failure

Nutritional Hyperparathyroidism

DietCalcium Phosphorous

Young animal with signs of rickets

Diagnosis

Low calcium

High PTH

High phosphorous (In rickets the P is low)

Treatment

Calcium borogluconate

Reduction using of corticosteroid because it reduces serum calcium

Correction of the dietary supplementation

Almunium hydroxide gel To inhibit P++ absorption

Hypoparathyroidism

Congenital

Autoimmune reaction in lymphatic parathyroditis

Destruction of parathyroid gland by neoplasm

Atrophy of parathyroid gland

High number of puppies

Usually in lactating bitch or queen

Clinical Signs

Increase the neuromuscular

excitability

Hyperesthesia (Hypersensitivity against external

stimuli)

Ataxia and weakness

-Tetany-Convulsion

-Muscular spasm

TreatmentCalcium

borogluconat 10% (0.5-1 ml/kg)

Admisteration of vitamin-D 50,000-100,000 IU /Day

QUESTIONS

وسائل التواصل

Email: [email protected]@bu.edu.egFacebook abdelghany hefnawy

حفناوي. الغني عبد دWeb site to download lectures

www.bu.edu.eg/staff/abdelghanyhefnawy(Courses)

Tel 01011676482