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Parathyroid Hormone: DR Pramod Kumar Asstt. Professor Department of Veterinary Physiology Bihar Veterinary College, Patna

The parathyroid glands are small endocrine glands located behind the thyroid gland that secrete parathyroid hormone (PTH). PTH regulates calcium and phosphate levels in the blood by increasing their resorption from bone and kidneys and absorption from the intestines. Conditions of excessive or deficient PTH secretion can lead to hypercalcemia or hypocalcemia respectively and impact multiple organ systems.

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31 views

Parathyroid Hormone: DR Pramod Kumar Asstt. Professor Department of Veterinary Physiology Bihar Veterinary College, Patna

The parathyroid glands are small endocrine glands located behind the thyroid gland that secrete parathyroid hormone (PTH). PTH regulates calcium and phosphate levels in the blood by increasing their resorption from bone and kidneys and absorption from the intestines. Conditions of excessive or deficient PTH secretion can lead to hypercalcemia or hypocalcemia respectively and impact multiple organ systems.

Uploaded by

sanath
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Parathyroid Hormone

Dr Pramod Kumar
Asstt. Professor
Department of Veterinary Physiology
Bihar Veterinary College, Patna
Functional Anatomy of Parathyroid
Glands

o Two pairs of small endocrine glands


situated beyond the thyroid gland
o size as of a split pea
Histological structure
o Parenchyma of gland and arranged in
cords.

o Types of cells:

o Chief cells - principal cells, more


numerous and secrete PTH or
parathormone.
o Oxyphil cells - larger than chief cells
and appears at puberty and their
function is still not clear.
Structure, Synthesis and
Secretion
o Structure - single chain polypeptide containing
84 amino acids and having MW 9500.

o Synthesis- precursor molecule called prepro-PTH,


contains 115 amino acids.

o Secretion - released from chief cells by exocytosis


in response to decrease in plasma-ionized
calcium concentration.
Secretion
Endocrine system
Regulation

o Role of plasma-ionized calcium.

o Role of serum Mg concentration.

o Role of plasma phosphate concentration.

o Role of vitamin 1,25(OH)2D3.


o Plasma level is about l30 pg/mL

o Half-life in plasma is 5–8 min

o Degradation occurs rapidly in the


peripheral tissues

o PTH is predominantly split in the liver.


Mechanism of action
Actions on bone - stimulates calcium and
phosphate reabsorption from the bones
o Rapid phase of demineralization: osteocytic
osteolysis In this process, the calcium is
transferred from the bone canalicular fluid into
the osteocytes and then into the ECF.
Phosphate is not mobilized along with ca.
o Slow phase of demineralization: stimulates the
formation of new osteoclasts from the
osteoprogenitor initiate process of bone
resorption
Ca and phosphate are released from bone and
transferred to the ECF.
Actions on kidney:
o Increase in calcium reabsorption from the ascending
limb and the distal tubules which helps to prevent
hypocalcaemia.

o Inhibition of phosphate reabsorption in the proximal


tubule, produces phosphaturia and hypophosphataemia.

o Stimulation of reabsorption of Mg2+ by the renal tubules.

o Stimulation of synthesis of 1,25- dihydroxy-


cholecalcifrol.
Actions on intestines
o Enhances Ca and
phosphate
absorption from
intestine by ↑ing
synthesis of 1,25-
dihydroxy-
cholecalciferol in
the kidney
Hyperparathyroidism
Primary hyperparathyroidism: occurs due to
excessive secretion by single autonomous
parathyroid adenoma.

Clinicobiochemical features:
o Hypercalcaemia may produce muscle weakness,
lethargy and constipation.

o Ca stimulate release of gastrin to occur


hyperchlorhydria and peptic ulceration.

o Hypercalcaemia cause hypertension, cardiac


arrhythmias and ECG changes
Secondary hyperparathyroidism:
o Excessive secretion occur to persistent
hypocalcaemia causes continued
stimulation of parathyroid gland.

o Aetiology: typically seen in slowly


developing renal failure.

o Clinicobiochemical features: Bone pains,


fractures and deformity may result.
Alkaline phosphatase and osteocalcin
levels are elevated.
Hypercalcaemia can be divided into
two groups:
o Conditions associated with
hypercalcaemia and raised PTH levels
o Conditions associated with
hypercalcaemia and low or
undetectable PTH levels are:
 Hypercalcaemia of malignancy
 Multiple myeloma
 Familial hypercalcaemia
 Hyperthyroidism
Hypo-parathyroidism refers to a clinical
condition characterized by low level of
plasma calcium either due to deficient
production of PTH or its
unresponsiveness.
It can be classified into two main groups:
 True hypoparathyroidism - deficient
production due to heritable or acquired
causes.
 Post-operative hypoparathyroidism -
most common cause is due to damage to
glands or their blood supply
Pseudohypoparathyroidism - congenital
condition in which PTH production is
normal but target tissues are resistant
to its effects.

Defect may lie in parathyroid receptors


or there may be post-receptor defect.

Clinical and biochemical features are


similar to hypoparathyroidism but PTH
levels are elevated
Tetany
It refers to a clinical condition resulting from
increased neuromuscular excitability.

Causes of tetany include:


Hypocalcaemia – Extracellular Ca plays an
important role in membrane integrity and
excitability.

Hypomagnesaemia - causes tetany because Mg


ions are associated with neuromuscular irritability.

Alkalosis reduces ionic Ca and can produce tetany.

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