Currently, surgery is the treatment of choice in patients with primary hyperparathyroidism, with a cure rate of between 95 and 98% of cases in the first intervention performed by an expert surgeon. "The use of minimally invasive techniques, increasingly focused on a selective approach, as well as the greater training of professionals, makes this surgery a safe and effective treatment with less postoperative pain and an earlier incorporation to your daily life ", as explained by Dr. Pablo Moreno, coordinator of the section of Endocrine Surgery of the Spanish Association of Surgeons.
This metabolic disorder, the most common of the three types of hyperparathyroidism, is due to an alteration in the functioning of the parathyroid glands, located behind the thyroid, in the anterior part of the neck. These glands, 40 to 60 milligrams in weight each and the size of a lentil, are responsible for producing PTH, which is the hormone that regulates the level of calcium in the body.
"The excess of this hormone is related to the loss of bone tissue, which brings with it an increased risk of bone fracture and kidney damage, associated with the formation of kidney stones and even calcium deposits in renal parenchyma," he clarified. this expert.
At the neuropsychiatric level, this pathology produces a feeling of fatigue, fatigue and irritation, as well as causing depression, dementia or aggravation of a previous state of dementia. In 90% of the cases it is due to disease of a single gland (adenoma), being the following situation more frequent the affectation of all the glands (hyperplasia). Primary hyperparathyroidism is more common in people older than 60 years, especially in women, although it can also occur in young adults. In fact, seven out of ten patients over 55 are women.
Although in very few cases a clear cause can be identified, cervical radiotherapy and the presence of certain genetic mutations are associated with an increased risk of developing primary hyperparathyroidism. In the latter case, several situations can occur depending on the number and degree of involvement of the glands.
In most cases, the disease is diagnosed in the preclinical phase, that is, before manifesting symptoms, through a routine blood test performed for any other reason, in which an increase in calcium levels is detected. Once the diagnostic suspicion of hyperparathyroidism is confirmed, "starting from the premise that 90% of patients have only one diseased gland, we perform tests to locate the adenoma, such as scintigraphy with sestamibi or an ultrasound", said this expert in endocrine surgery.