Med Bull Sisli Etfal Hosp. 2014; 48(4): 264-273 | DOI: 10.5350/SEMB.20141223051323

Normokalsemik Hiperparatiroidizm: Primer hiperparatiroidizmin yeni bir klinik tipi

Mehmet Uludað
Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýstanbul-Türkiye

Primer hiperparatiroidizm günümüzde 3. en sýk görülen endokrin hastalýk olup, ayaktan hastalarda hiperkalseminin en sýk nedenidir. 1970’li yýllarda serum kalsiyumunun otomotik olarak ölçülmeye baþlamasýndan sonra, prevalansý anlamlý olarak arttý. Buna ek olarak klinik fenotip semptomatik hastalýktan hafif semptomlu veya asemptomatik duruma geçiþ yaptý. Bu klinik profil asemptomatik hiperparatiroidizm olarak isimlendirildi. Primer hiperparatiroidizmin parathormon artýþýna sebep olacak sekonder bir sebep olmaksýzýn, parathormon artýþý olan, fakat total ve iyonize kalsiyum düzeylerinin tutarlý bir þekilde normal olduðu, daha yeni bir prezentasyonu geçen dekatta tanýmlandý. Bu yeni durum normokalsemik hiperparatiroidizm olarak isimlendirildi. Bu derleme primer hiperparatiroidizmin yeni tanýmlanan bu tipi ile iliþkili güncel bilgiyi sunmaktadýr.

Anahtar Kelimeler: Normokalsemik hiperparatiroidizm, primer hiperparatiroidizm, parathormon,total serum kalsiyum, iyonize serum kalsiyum, kemik hastalýðý.

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Normocalcemic hyperparathyroidism: A new clinical type of primary hyperparathyroidism

Mehmet Uludað
Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýstanbul-Türkiye

Primary hyperparathyroidism is the third most common endocrine disorder and the most common cause of hypercalcemia in the outpatient setting. After the introduction of automated serum calcium measurements in the 1970s, its prevalence increased significantly. In addition, the clinical phenotype had shifted from a symptomatic disorder to a less symptomatic or even asymptomatic state. This clinical profile has been called asymptomatic primary hyperparathyroidism. A newer presentation of primary hyperparathyroidism has been described over the past decade, in which parathyroid hormone is elevated but total and ionized serum calcium concentrations are consistently normal, in the absence of secondary causes for elevated parathyroid hormone concentration. This new condition has been called normocalcemic primary hyperparathyroidism. This review presents the current data in relation to this newly described type of primary hyperparathyroidism.

Keywords: Normocalcemic hyperparathyroidism, primary hyperparathyroidism, parathyroidhormone, total serum calcium, ionized serum calcium, bone disease.

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ATIF KOPYALA