Clinical Presentation

The differential diagnosis between severe benign HPT and parathyroid carcinoma is difficult. Therefore, every case involving the rapid onset of symptoms of HPT should be considered suspect for carcinoma. The target organs for HPT-induced hypercalcemia are the skeleton (40% to 70%), the kidneys (30% to 60%), and to a lesser extent the digestive system (i.e., pancreas and stomach-duodenum) (15%). In addition, general symptoms such as nausea, anorexia, constipation, polydipsia and polyuria, muscle weakness, fatigue, and depression are common findings. A palpable cervical mass is encountered in approximately 5%.101517"20 Marked hypercalcemia, low serum phosphorus if renal function is not impaired, and a substantial elevation of serum parathyroid hormone (PTH) are common findings. With today's assays, which measure intact PTH, the diagnosis of PHPT is quickly established, and hypercalcemia caused by other malignancies can be ruled out. Moreover, there is no evidence that PTH-related peptide (PTHrP) regulates serum calcium levels in adults, although PTH and PTHrP have a similar sequence of amino acids near the aminoterminus.21 Nonfunctioning parathyroid carcinomas, with a normal serum level of PTH, do occur but only in 5% of all parathyroid carcinomas.22

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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