U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Tertiary hyperparathyroidism

MedGen UID:
488837
•Concept ID:
C0271858
•
Disease or Syndrome
Synonyms: Tertiary Hyperparathyroidism; tertiary hyperparathyroidism
SNOMED CT: Tertiary hyperparathyroidism (78200003)
 
HPO: HP:0011770
Monarch Initiative: MONDO:0021132

Definition

A type of hyperparathyroidism that occurs following kidney transplantation, which is a treatment for secondary hyperparathyroidism. Although kidney transplantation leads to a normalization of serum calcium and parathyroid hormone in most patients. The state of persistent hypercalcemia and hyperparathyroidism is referred to as tertiary hyperparathyroidism. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVTertiary hyperparathyroidism

Professional guidelines

PubMed

Treatment of Secondary Hyperparathyroidism and Posttransplant Tertiary Hyperparathyroidism.
Egan CE, Qazi M, Lee J, Lee-Saxton YJ, Greenberg JA, Beninato T, Zarnegar R, Fahey TJ 3rd, Finnerty BM
J Surg Res 2023 Nov;291:330-335. Epub 2023 Jul 26 doi: 10.1016/j.jss.2023.06.031. PMID: 37506432
Advances in the treatment of secondary and tertiary hyperparathyroidism.
Zhang LX, Zhang B, Liu XY, Wang ZM, Qi P, Zhang TY, Zhang Q
Front Endocrinol (Lausanne) 2022;13:1059828. Epub 2022 Dec 6 doi: 10.3389/fendo.2022.1059828. PMID: 36561571Free PMC Article
X-Linked Hypophosphatemic Rickets: Multisystemic Disorder in Children Requiring Multidisciplinary Management.
Baroncelli GI, Mora S
Front Endocrinol (Lausanne) 2021;12:688309. Epub 2021 Aug 6 doi: 10.3389/fendo.2021.688309. PMID: 34421819Free PMC Article

Recent clinical studies

Etiology

Is preoperative parathyroid localization necessary for tertiary hyperparathyroidism?
Wang R, Abraham P, Lindeman B, Chen H, Fazendin J
Am J Surg 2022 Sep;224(3):918-922. Epub 2022 May 6 doi: 10.1016/j.amjsurg.2022.05.002. PMID: 35581031
Endoscopic parathyroidectomy using a three-port submental approach.
Piromchai P
Langenbecks Arch Surg 2020 Mar;405(2):241-246. Epub 2020 Mar 13 doi: 10.1007/s00423-020-01861-8. PMID: 32170404
Challenges and controversies in the surgical management of uremic hyperparathyroidism: A systematic review.
Cabo J, Gallagher KC, Baregamian N
Am J Surg 2018 Oct;216(4):713-722. Epub 2018 Jul 24 doi: 10.1016/j.amjsurg.2018.07.030. PMID: 30057108
Hypertension is a characteristic complication of X-linked hypophosphatemia.
Nakamura Y, Takagi M, Takeda R, Miyai K, Hasegawa Y
Endocr J 2017 Mar 31;64(3):283-289. Epub 2016 Dec 27 doi: 10.1507/endocrj.EJ16-0199. PMID: 28025445
Tertiary excess of fibroblast growth factor 23 and hypophosphatemia following kidney transplantation.
Seeherunvong W, Wolf M
Pediatr Transplant 2011 Feb;15(1):37-46. Epub 2010 Oct 8 doi: 10.1111/j.1399-3046.2010.01405.x. PMID: 20946192Free PMC Article

Diagnosis

Endoscopic parathyroidectomy using a three-port submental approach.
Piromchai P
Langenbecks Arch Surg 2020 Mar;405(2):241-246. Epub 2020 Mar 13 doi: 10.1007/s00423-020-01861-8. PMID: 32170404
Secondary and Tertiary Hyperparathyroidism.
Messa P, Alfieri CM
Front Horm Res 2019;51:91-108. Epub 2018 Nov 19 doi: 10.1159/000491041. PMID: 30641516
Hypercalcemic Disorders in Children.
Stokes VJ, Nielsen MF, Hannan FM, Thakker RV
J Bone Miner Res 2017 Nov;32(11):2157-2170. Epub 2017 Nov 2 doi: 10.1002/jbmr.3296. PMID: 28914984Free PMC Article
Secondary and tertiary hyperparathyroidism.
Jamal SA, Miller PD
J Clin Densitom 2013 Jan-Mar;16(1):64-8. Epub 2012 Dec 23 doi: 10.1016/j.jocd.2012.11.012. PMID: 23267748
Vitamin D and primary hyperparathyroidism (PHPT).
Souberbielle JC, Bienaimé F, Cavalier E, Cormier C
Ann Endocrinol (Paris) 2012 Jun;73(3):165-9. Epub 2012 Jun 5 doi: 10.1016/j.ando.2012.04.008. PMID: 22677209

Therapy

Challenges and controversies in the surgical management of uremic hyperparathyroidism: A systematic review.
Cabo J, Gallagher KC, Baregamian N
Am J Surg 2018 Oct;216(4):713-722. Epub 2018 Jul 24 doi: 10.1016/j.amjsurg.2018.07.030. PMID: 30057108
Secondary and tertiary hyperparathyroidism.
Jamal SA, Miller PD
J Clin Densitom 2013 Jan-Mar;16(1):64-8. Epub 2012 Dec 23 doi: 10.1016/j.jocd.2012.11.012. PMID: 23267748
Post-transplantation tertiary hyperparathyroidism.
Gioviale MC, Bellavia M, Damiano G, Lo Monte AI
Ann Transplant 2012 Jul-Sep;17(3):111-9. PMID: 23018263
Vitamin D and primary hyperparathyroidism (PHPT).
Souberbielle JC, Bienaimé F, Cavalier E, Cormier C
Ann Endocrinol (Paris) 2012 Jun;73(3):165-9. Epub 2012 Jun 5 doi: 10.1016/j.ando.2012.04.008. PMID: 22677209
Tertiary excess of fibroblast growth factor 23 and hypophosphatemia following kidney transplantation.
Seeherunvong W, Wolf M
Pediatr Transplant 2011 Feb;15(1):37-46. Epub 2010 Oct 8 doi: 10.1111/j.1399-3046.2010.01405.x. PMID: 20946192Free PMC Article

Prognosis

Successful management of tertiary hyperparathyroidism associated with hypophosphataemic rickets in an adult.
Anagnostis P, Vamvakidis K, Tournis S
J Musculoskelet Neuronal Interact 2019 Sep 1;19(3):370-373. PMID: 31475945Free PMC Article
Secondary and Tertiary Hyperparathyroidism.
Messa P, Alfieri CM
Front Horm Res 2019;51:91-108. Epub 2018 Nov 19 doi: 10.1159/000491041. PMID: 30641516
Parathyroid surgery: from inception to the modern day.
Sethi N, England RJA
Br J Hosp Med (Lond) 2017 Jun 2;78(6):333-337. doi: 10.12968/hmed.2017.78.6.333. PMID: 28614027
Hyperparathyroidism.
Fraser WD
Lancet 2009 Jul 11;374(9684):145-58. doi: 10.1016/S0140-6736(09)60507-9. PMID: 19595349
1alpha-hydroxyvitamin D3 in primary hyperparathyroidism.
Boyle IT, Fogelman I, Boyce B, Thomson JE, Beastall GH, McIntosh WB, McLennan I
Clin Endocrinol (Oxf) 1977 Dec;7 Suppl:215s-222s. doi: 10.1111/j.1365-2265.1977.tb03384.x. PMID: 606419

Clinical prediction guides

Is preoperative parathyroid localization necessary for tertiary hyperparathyroidism?
Wang R, Abraham P, Lindeman B, Chen H, Fazendin J
Am J Surg 2022 Sep;224(3):918-922. Epub 2022 May 6 doi: 10.1016/j.amjsurg.2022.05.002. PMID: 35581031
How radical is total parathyroidectomy in patients with renal hyperparathyroidism?
Burgstaller T, Selberherr A, Brammen L, Scheuba C, Kaczirek K, Riss P
Langenbecks Arch Surg 2018 Dec;403(8):1007-1013. Epub 2018 Dec 5 doi: 10.1007/s00423-018-1739-1. PMID: 30519885Free PMC Article
Parathyroid surgery: from inception to the modern day.
Sethi N, England RJA
Br J Hosp Med (Lond) 2017 Jun 2;78(6):333-337. doi: 10.12968/hmed.2017.78.6.333. PMID: 28614027
Vitamin D in Chronic Kidney Disease and Dialysis Patients.
Jean G, Souberbielle JC, Chazot C
Nutrients 2017 Mar 25;9(4) doi: 10.3390/nu9040328. PMID: 28346348Free PMC Article
P-glycoprotein expression influences the result of 99mTc-MIBI scintigraphy in tertiary hyperparathyroidism.
Chudzinski W, Niderla J, Lasiecka Z, Wilczynski G, Gornicka B, Wasiutynski A, Maczewska J, Kobylecka M, Krolicki L, Durlik M, Nowacka E, Lazarczyk M, Dziunycz P, Milewski L, Nawrot I, Grzela T
Int J Mol Med 2005 Aug;16(2):215-9. PMID: 16012752

Recent systematic reviews

Challenges and controversies in the surgical management of uremic hyperparathyroidism: A systematic review.
Cabo J, Gallagher KC, Baregamian N
Am J Surg 2018 Oct;216(4):713-722. Epub 2018 Jul 24 doi: 10.1016/j.amjsurg.2018.07.030. PMID: 30057108
Systematic review of oral manifestations related to hyperparathyroidism.
Palla B, Burian E, Fliefel R, Otto S
Clin Oral Investig 2018 Jan;22(1):1-27. Epub 2017 Jun 14 doi: 10.1007/s00784-017-2124-0. PMID: 28616750
Parathyroidectomy for tertiary hyperparathyroidism: A systematic review.
Tang JA, Friedman J, Hwang MS, Salapatas AM, Bonzelaar LB, Friedman M
Am J Otolaryngol 2017 Sep-Oct;38(5):630-635. Epub 2017 Jun 21 doi: 10.1016/j.amjoto.2017.06.009. PMID: 28735762
Systematic review of surgical and medical treatment for tertiary hyperparathyroidism.
Dulfer RR, Franssen GJH, Hesselink DA, Hoorn EJ, van Eijck CHJ, van Ginhoven TM
Br J Surg 2017 Jun;104(7):804-813. doi: 10.1002/bjs.10554. PMID: 28518414
Outcomes of bisphosphonate therapy in kidney transplant recipients: a systematic review and meta-analysis.
Toth-Manikowski SM, Francis JM, Gautam A, Gordon CE
Clin Transplant 2016 Sep;30(9):1090-6. Epub 2016 Jul 19 doi: 10.1111/ctr.12792. PMID: 27327448

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Related information

    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...