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Thyroid Diseases

Primary Hyperparathyroidism: Relapse and Inheritance

06/19/2006

Question:

After developing kidney stones in 2004 I had an adenoma removed in April 2005. Although blood tests show a normal serum calcium level I constantly anticipate a relapse. I am 39 and have four children. I still suffer from back pain. My urine dip sticks react positively for lymphocytes and haemolysed blood, and my blood pressure is apparently borderline high. Having this condition was such an awful experience for which there was little support or empathy, and now I am dogged by paranoia. Are my children at risk of developing primary hyperparathyroidism? Will I now be prone to developing kidney stones? Will the primary hyperparathyroidism return? Also, is it unusual to gain weight whilst suffering from primary hyperparathyroidism? Does primary hyperparathyroidism deplete calcium from your teeth? Can primary hyperparathyroidism affect fertility?

Answer:

There is such a thing as familial hyperparathyroidism, but it is rare.  There are no guarantees in medicine, but it is unlikely that your hyperparathyroidism will ever come back again.  Once the adenoma is removed and the calcium level returns to normal, that should be the end of it - no more kidney stones (assuming the hyperparathyroidism was the sole cause of the kidney stones), no weight gain, no problems with fertility.  Parathyroid hormone can cause some bone erosion around the teeth, but this should improve after the adenoma is removed.  Tooth problems are not typically seen as a part of hyperparathyroidism.

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University