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Related Concept Videos

The Parathyroid Glands00:59

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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...
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Hormones and Bone Tissue01:17

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Skeleton and Calcium Homeostasis01:21

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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Synthesis and Functions of Calcitonin00:51

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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Chronic Pancreatitis I: Introduction01:24

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
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Primary hyperparathyroidism.

Manuel Muñoz-Torres1, Antonia García-Martín1

  • 1Unidad de Metabolismo Óseo, Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Campus de la Salud, Instituto de Investigación Biosanitaria de Granada, Granada, España; Departamento de Medicina, Universidad de Granada, Granada, España.

Medicina Clinica
|October 11, 2017
PubMed
Summary

Primary hyperparathyroidism (PHPT) involves high calcium and parathyroid hormone (PTH) levels. While surgery is curative, medications like cinacalcet can effectively normalize calcium in many PHPT patients.

Keywords:
CinacalcetHiperparatiroidismo primarioHormona paratiroideaParathyroid hormonePrimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Metabolic Bone Disease
  • Calcium Homeostasis

Background:

  • Primary hyperparathyroidism (PHPT) is a common endocrine disorder defined by elevated serum calcium and parathyroid hormone (PTH).
  • Historically, symptomatic presentations involved severe hypercalcemia with renal or skeletal complications; current trends show milder, often asymptomatic, hypercalcemia.
  • Normocalcemic PHPT is an emerging phenotype with incompletely understood clinical implications.

Purpose of the Study:

  • To summarize the key characteristics and management strategies for primary hyperparathyroidism.
  • To highlight the shift in clinical presentation and the role of medical therapy.

Main Methods:

  • Review of biochemical profiles in PHPT, including serum calcium and PTH levels.
  • Discussion of parathyroidectomy as the definitive surgical cure.
  • Evaluation of medical management, specifically the use of calcimimetics like cinacalcet.

Main Results:

  • The hallmark biochemical profile of PHPT includes hypercalcemia with high or inappropriately normal PTH.
  • Parathyroidectomy remains the only definitive treatment for PHPT.
  • Cinacalcet effectively normalizes serum calcium levels in a significant proportion of treated patients.

Conclusions:

  • Primary hyperparathyroidism management has evolved, with a greater prevalence of mild, asymptomatic cases.
  • While parathyroidectomy is curative, medical therapy with cinacalcet offers a viable alternative for normalizing calcemia.
  • Further research into normocalcemic PHPT is warranted to establish its clinical significance.