Primary Hyperparathyroidism

Parathyroid adenoma usually give rise to excess secretion of PTH, this condition is recognised as primary hyperparathyroidism.

Abdominal pain, nausea, polyuria, lathergy, hematuria

Hypercalcemia: 

Grading:
 It can ne graded as mild, moderate & severe hypercalcemia.

Causes: 
with normal or elevated PTH level:
 .primary or tertiary hyperparathyroidism
.Lithium induced hyperparathyroidism
. Familial hypocalciuric hypercalcemia
With low PTH level
 .Malignancy ( lung, breast, renal,   lymphoma)
.Multiple myeloma
.Sarcoidosis
.Hypervotaminosis D
.Thyrotoxicosis
.Thiazide diuretics
.Glaucocorticoid deficiency
.Paget's disease

Clinical Features:
Clinical features of hypercalcemia include polyuria, polydipsia, dyspepsia, anorexia, nausea, lathargy, constipation, depression, drowsiness, impaired cognition, PUD, renal colic

Investigations:
Elevated PTH level along with hypercalcemia indicate primary hyperparathyroidism is the most possible diagnosis. Elevated plasma phosphate & alkaline phosphatase along with renal failure indicate tertiary hyperparathyroidism. Familial hypocalciuric hypercalcemia can be confirmed by screening family members for hypercalcemia.