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Secondary Hyperparathyroidism

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Hyperparathyroidism

Abstract

Elevated parathyroid hormone (PTH) levels in the presence of normal concentrations of serum calcium and phosphorus more often represent physiologic compensation or secondary hyperparathyroidism (SHP) than primary parathyroid gland hyperfunction. In such scenarios, mild disorders of calcium or phosphorus homeostasis due to inadequate intake, absorption, mobilization, or excretion should be suspected clinically but may yet require comprehensive testing of nutritional status, organ function, or hormonal status to detect or confirm. Treatment of factors suspected of causing SHP can be therapeutic and diagnostic or, if ineffective, raise the possibility of parathyroid gland autonomy or impaired PTH action. In contrast, premature pursuit of parathyroid imaging or surgical management designed to evaluate and manage primary hyperparathyroidism may yield inaccurate diagnoses, lead to ineffective therapy, or further derange mineral homeostasis by compromising a necessary, compensatory increase in serum PTH concentration.

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Conflict of Interest

All authors state that they have no conflicts of interest.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo College of Medicine, Mayo Clinic, Rochester, MN, USA

    Nishanth Vallumsetla MBBS, Manpreet S. Mundi MD & Kurt A. Kennel MD

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  1. Nishanth Vallumsetla MBBS
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  2. Manpreet S. Mundi MD
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  3. Kurt A. Kennel MD
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Correspondence to Kurt A. Kennel MD .

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Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Ann E. Kearns

  2. Mayo Clinic, Rochester, Minnesota, USA

    Robert A. Wermers

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© 2016 Mayo Foundation for Medical Education and Research

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Vallumsetla, N., Mundi, M.S., Kennel, K.A. (2016). Secondary Hyperparathyroidism. In: Kearns, A., Wermers, R. (eds) Hyperparathyroidism. Springer, Cham. https://doi.org/10.1007/978-3-319-25880-5_19

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  • DOI: https://doi.org/10.1007/978-3-319-25880-5_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25878-2

  • Online ISBN: 978-3-319-25880-5

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