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The parathyroid glands are located immediately behind the thyroid gland. Most people have four parathyroid glands (two on each side). These glands regulate the level of calcium in the blood by producing a hormone called PTH (parathyroid hormone) which stimulates the release of calcium from bones and the reabsorption of calcium by the kidneys.
When one or more of the parathyroid glands is overactive, the result is a condition called hyperparathyroidism. In hyperparathyroidism, the glands secrete too much PTH, causing the blood level of calcium to become elevated. A high blood calcium level (hypercalcemia) places a person at risk for developing kidney stones, osteoporosis, bone fractures, and pancreatitis.
Other symptoms may include: muscle cramping and weakness, abdominal discomfort and constipation, depression, memory loss, anxiety, loss of appetite, and lethargy.
Causes and risk factorsThe most common causes of primary hyperparathyroidism are adenoma and hyperplasia. An adenoma is a benign tumor that develops in one of the glands and accounts for about 85% of the cases of hyperparathyroidism. Ten to 15% of the cases are caused by four-gland hyperplasia (abnormal growth of all of the glands) .
The diagnosis of hyperparathyroidism is quite common The incidence increases with age and is most common among postmenopausal women.
Treatment
The treatment of choice for hyperparathyroidism is surgery (parathyroidectomy). At UCSD Medical Center, Dr. Kevin Brumund uses a minimally invasive approach to perform a parathyroidectomy.
Prior to surgery, localization studies such as a neck ultrasound or a sestamibi scan are done to determine which parathyroid gland is overactive.
The studies allow for a focused, directed surgery, through a 3 cm (1 inch) incision. In the majority of cases, only a solitary adenoma needs to be removed. Less commonly, in cases of hyperplasia, all four glands are removed. The patient's parathyroid hormone levels are monitored intraoperatively to document normalization during the surgery.
Dr. Brumund performs parathyroidectomy as an outpatient procedure, with minimal incision size allowing for faster recovery and significantly less scarring.
Make an appointment
For more information on this procedure, to arrange an appointment or to refer a patient, please call (858) 822-6197 or email Eddy Orona, eorona@ucsd.edu.
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