Hyperparathyroidism Treatment: Everything You Need to Know
Hyperparathyroidism is a disease caused by a dysfunction of the parathyroid glands. These four small glands are located at the base of the neck, at the back of the thyroid gland. In this article, learn about hyperparathyroidism and treatment options.
What is hyperparathyroidism?
Hyperparathyroidism is an endocrine disease that affects the parathyroid glands. These glands produce a hormone called parathyroid hormone (PTH), which regulates the level of calcium in the blood. Hyperparathyroidism is caused by an abnormal and uncontrolled production of parathyroid hormone, leading to an increase in blood calcium levels.
There are three types of hyperparathyroidism:
- Primary hyperparathyroidism (PHPT) is a disorder of one or more of the parathyroid glands.
- Secondary hyperparathyroidism is due to the dysfunction of another organ, often the kidney, which usually affects all the parathyroid glands.
- Tertiary hyperparathyroidism can occur as a result of secondary hyperparathyroidism. The parathyroid glands develop an autonomous function.
The symptoms of hyperparathyroidism are very diverse and vary from one person to another. They can include kidney stones, loss of bone density, bone pain or more general symptoms such as abdominal pain, severe thirst and fatigue. In some cases, the disease is asymptomatic (no apparent symptoms).
The diagnosis of hyperparathyroidism can be confirmed by measuring the parathyroid hormone levels in relation to the blood calcium level.
Hyperparathyroidism can lead to hypercalcemia, that is an excess of calcium in the blood. This can affect bones, causing bone damage, loss of bone mass and bone and joint pain. Hyperparathyroidism can also provoke osteoporosis, which is an excessive fragility of the skeleton increasing the risk of fractures.
In some cases, hyperparathyroidism can cause acute hypercalcemia, a serious life-threatening complication. Acute hypercalcemia is characterized by fevers, impaired alertness, abdominal pain and severe dehydration. Immediate hospitalization is required to avoid the risk of death from heart rhythm disorders.
Hyperparathyroidism is also a risk factor for other diseases such as parathyroid cancer.
Hyperparathyroidism is estimated to affect 25 out of every 100,000 people. Women are twice as affected as men. The average age at diagnosis is 60.
How is hyperparathyroidism treated?
While some medications can help control hypercalcemia, treatment is mainly based on surgery. Surgery is required for primary hyperparathyroidism occurring before the age of 50 and for patients with a large number of symptoms. For secondary hyperparathyroidism, the first treatment is that of the disease causing the disorder.
Hyperparathyroidism Surgical Treatment Objectives
The surgical treatment of primary hyperparathyroidism is called parathyroidectomy. This procedure aims to remove the affected parathyroid gland(s). The operation is performed under general anaesthesia. The hospital stay is usually short (24 to 48 hours).
The surgical technique depends on the number of glands that need to be removed. If only one parathyroid gland is affected, minimally invasive surgery can be performed with an incision of 2 to 2.5 centimetres. The scar will usually be very small. If several glands are affected, then the conventional procedure has to be followed, with a larger incision to remove the glands.
Hyperparathyroidism Surgical Treatment Risks
Parathyroid surgery is a common but delicate procedure. There are potential risks such as damage to the parathyroid glands, the paralysis of a vocal cord or bleeding. An accidental injury can also lead to hypoparathyroidism, a pathological condition caused by insufficient parathormone (low PTH levels).
The risks are minimized when the operation is performed by a specialized team. In addition, the use of state-of-the-art technology such as the FLUOBEAM® LX imaging solution facilitates the surgery.
Benefits of FLUOBEAM®LX for Parathyroid Surgery
The first step of parathyroid surgery is to identify the dysfunctional parathyroid glands causing hyperparathyroidism.
FLUOBEAM® LX allows easy identification and visualization of the parathyroid glands through autofluorescence. It helps to differentiate healthy parathyroid glands from abnormal parathyroid glands, based on the observed autofluorescence signal from the gland.
Surgeons can operate with confidence and precision, without fear of causing accidental injury to a healthy parathyroid gland. Surgery is safe and effective.
Dr. Fares Benmiloud, an Endocrinology Surgeon at the European Hospital in Marseille, France, explains: “Compared to the conventional technique without imaging, the benefit is significant. […] This technique can significantly reduce postoperative hypoparathyroidism”.
After the operation, it is essential to rest to allow recovery. A sick leave may be necessary. A postoperative visit confirms the success of the operation and the long-term follow-up required.
Hyperparathyroidism is therefore a disease that can have serious consequences if it is not adequately treated. Surgical treatment is effective, allowing patients to improve their quality of life. The use of innovative technologies, such as fluorescence imaging, can make it possible to minimize the risks associated with this surgical procedure.