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signs and symptoms - Coggle Diagram
signs and symptoms
neuromuscular manifestations
proximal muscle weakness
easy fatigability
atrophy of muscles
it is reversed after surgical correction of hyperparathyroidism (distinguish with primary neuromuscular disorder)
gastrointestinal manifestations
vague abdomnial complaints
disorders of stomach and pancreas
duodonal ulcer in MEN1 pts (maybe in result of zollinger-ellison syndrome
pancreatitis
cardiovascular manifestations
left ventricular hypertrophy
cardiac function defects
endothelial dysfunction
it is reversible after surgery
bone manifestation
osteitis fibrosa cystica in 10 - 25 pts
pathognomonic features
an increase in the giant multinucleated osteoclasts in scalloped areas on the surface of the bone (Howship’s lacunae)
replacement of thenormal cellular and marrow elements by fibrous tissue
x - ray features:
resorption of the phalangeal tufts and replacement of the usually sharp cortical outline of the bone in the digits by an irregular outline (subperiosteal resorption)
reduced bone density specially in spine (CT scan is very sensitive)
improvements in bone density after parathyroidectomy
renal manifestations
due to
deposition of ca in renal parenchym
recurrent nephrolithiasis (calcium oxalate or calcium phosphate)
may lead to urinary tract obstruction, infection loss of renal function
in 60 - 70 of pts
guidelines
many pts asymptomatic
