Chứng tăng calci huyết tuyến cận giáp có liên quan đến tiểu cường cận giáp: adenoma, tăng sản (MEN) cường cận giáp gia đình đại học hypocalciuric Lithium Vitamin D có liên quan đến Vitamin D nhiễm độc u hạt bệnh: | 242 Leder and Finkelstein Table 1 Causes of Hypercalcemia Parathyroid-related Vitamin D-related Malignancy-related Other causes Primary Vitamin D PTHrP producing Milk-Alkali syndrome hyperparathyroidism intoxication squamous cell tumors adenoma hyperplasia lung and head neck Immobilization MEN Granulomatous most common Disease kidney breast. Vitamin A Tertiary sarcoidosis intoxication hyperparathyroidism tuberculosis Osteolytic inflammatory metastases Aluminum Familial hypocalciuric hypercalcemia Lithium bowel disease multiple myeloma breast PTH-producing rare Other humoral factors lymphoma leukemia multiple myeloma intoxication Hyperthyroidism Thiazide use Adrenal insufficiency Phenochromocytoma Theophylline toxicity Primary Hyperparathyroidism Primary hyperthyroidism is caused by excess PTH secretion from either an autonomous adenoma in a parathyroid gland or glands or by generalized parathyroid hyperplasia. In these abnormal glands the set point for PTH suppression by calcium is shifted and the resultant increase in calcium is not sufficient to suppress PTH levels normally. The peak incidence of primary hyperparathyroidism is in the fifth and sixth decade of life and it rarely occurs prior to adolescence. Between 1983 and 1992 the overall incidence rate in both urban and rural populations was approx 21 100 000 person-yr with a female-to-male ratio of 2-3 1 7 . In 80-85 of patients with primary hyperparathyroidism the underlying cause is a single adenoma 8 9 . Most of the remaining patients have parathyroid hyperplasia. Hyperplasia is more common in younger patients and is often associated with the syndromes of multiple endocrine neoplasia MEN type I and Ila 10 . Parathyroid carcinoma is rare and is the cause of primary hyperparathyroidism in only of cases 10 11 . There are several heritable syndromes associated with primary hyperparathyroidism. MEN I also called Wermer s Syndrome is associated with parathyroid hyperplasia pancreatic islet cell tumors and
