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Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

The Parathyroid Glands

The Parathyroid Glands

The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...

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Lithium-induced parathyroid dysfunction: A new case.

C Gopalakrishnan Nair¹, Riju Menon, Pradeep Jacob

¹Department of Surgery, Surgical Endocrinology Division, Amrita School of Medicine, Kochi, Kerala, India.

Indian Journal of Endocrinology and Metabolism

|October 2, 2013

Summary

Lithium carbonate use can rarely cause hyperparathyroidism, leading to bone and muscle issues. This case highlights the importance of monitoring parathyroid function in patients on long-term lithium therapy.

Keywords:

Atypical adenoma calcium sensing receptor hyperparathyroidism lithium

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Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging

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Area of Science:

Endocrinology
Pharmacology
Nephrology

Background:

Lithium salts are common psychiatric medications, frequently causing thyroid dysfunction.
Lithium-induced parathyroid dysfunction is an uncommon but significant adverse effect.

Observation:

A 28-year-old female on lithium carbonate for 2 years presented with osteopenia and muscle weakness.
Biochemical tests revealed hyperparathyroidism and a low calcium creatinine clearance ratio, suggesting altered calcium sensing.

Findings:

The patient was diagnosed with hyperparathyroidism, likely secondary to lithium use.
Parathyroidectomy was performed, and histological examination of the parathyroid gland revealed atypical features.

Implications:

This case underscores the rare risk of lithium-induced hyperparathyroidism.
Monitoring parathyroid function and calcium metabolism is crucial for patients on long-term lithium treatment.
Atypical parathyroid histology warrants further investigation in lithium-treated patients.