Abstract
Parathyroid hormone (PTH) is an important hormone possessing critical physiologic functions, including neuromuscular conduction, coagulation and bone mineralisation. Its protein sequence includes 84 amino acids. 1
Primary hyperparathyroidism is the most frequent cause of hypocalcaemia, which does not depend on malignancies in patients referred to policlinics. Hypocalcaemia is caused by excessive parathyroid hormone production. Most parathyroid masses are sporadic adenomas (85%), whereas less frequent masses include hyperplasia (10%), multiple adenoma (4%) and carcinoma (1%).2–4
Vitamin D deficiency and chronic renal disease are the common causes of secondary hyperparathyroidism. However, specific groups of patients, namely asymptomatic patients referred to policlinics for routine control and patients referred to policlinics with specific symptoms such as fatigue, nausea, loss of appetite and weight loss, require special attention. In these patients, measuring serum Ca is extremely important because several studies revealed that concomitant parathyroid masses and thyroid carcinoma are commonly found in these patients.
These patients, who can receive various diagnoses, do not experience improvement of their condition despite treatment. Consequently, their condition deteriorates, and their parathyroid lesions become inoperable. Additionally, these patients experience hypercalcaemic crises because of the delayed diagnosis.
Therefore, we want to emphasise the importance of studying serum electrolytes, especially Ca, and using simple imaging modalities such as ultrasonography in patients with indistinct complaints.
