Primary Hyperpail&thyro Idism, an Overview for Insurance Medicine

The etiology of primary hyperparathyroidism is not clearly defined. There is a history of irradiation to the neck in a reportable number of cases) The radiation dose reported has been variable, but the latent period may be upwards of thirty years.2 Primary hyperparathyroidism may also arise from the long term consequences of secondary hyperparathyroidism or long standing osteomalacia. Chronic loss of calcium through the kidney may also be a stimulus to an increase in size and activity of the glands and thus an uncontrolled secretion of hormone. Genetic predisposition to primary hyperparathyroidism has also been reported. Multiple endocrine neoplasia I syndrome (MEN I) is linked to genetic disarrangements of the q13 region of chromosome 11) Parathyroid lesions are found in over 80 percent of patients with MEN I (which also includes pancreatic and pituitary abnormalities).4 MEN II, which involves medullary carcinoma of the thyroid and pheochromocytoma has over 50 percent involvement with parathyroid disease as well.