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O. V. Kaminskiy, O. V. Kopylova, D. E. Afanasyev, I. G. Chikalova, I. G. Muraviova, L. O. Tsvet,
V. M. Kolodiy, O. Ya. Pleskach, Yu. O. Kaminska, I. O. Kiseliova, N. S. Dombrovska
State Institution «National Research Center for Radiation Medicine, Hematology and Oncology of the
National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
DIAGNOSTIC AND CLINICAL ASPECTS OF NORMOCALCEMIC PARATHYROID HYPERPLASIA AND NON-RENAL SECONDARY HYPERPARATHYROIDISM IN EXPOSED AND NON-EXPOSED TO IONIZING RADIATION INDIVIDUALS (LITERATURE REVIEW AND OWN RESEARCH DATA)
Parathyroids are the key regulators of calcium-phosphorus metabolism. By means of parathyroid hormone they
respond to any changes in the serum level of calcium and phosphorus ions and determine the integrity of skeleton,
affecting almost all systems and cells where calcium and phosphorus are involved in metabolism and/or signaling.
Disorders of parathyroid function are associated with significant complications accompanying secondary hyperparathyroidism. Unfortunately, most medical practitioners and scientists underestimate the impact of parathyroid
hormone excess and vitamin D deficiency. Usually, medical practitioners do not prescribe the assay of serum level of
parathyroid hormone, which should be done as a screening test, so the disease remains unnoticed for a long time.
In fact, the incidence of parathyroid disorders, namely hyperparathyroidism, is almost equal to the incidence of thyroid diseases and is more than 10 % for the entire population, depending on the observation groups (gender, age,
exposure to ionizing radiation), as demonstrated in our previous studies. Thus, according to our data, the incidence
of parathyroid hyperplasia is 24.3 % (with 50–70 % in children and adolescents) in the state of euparathyroidism,
and incidence of normocalcemic hyperparathyroidism is up to 14.3 % in the average population of Ukraine. Today,
we see much confusion in publications and available recommendations regarding diagnosis, pathogenesis, and
course of parathyroid disease. It is often not taken into account that the strain in calcium-phosphorus system usually occurs due to the lack/deficiency of vitamin D, which is very common worldwide. Often a simple administration
of vitamin D in optimal and individual dosages solves (prevents) the problem of hyperparathyroidism or reduces the
aggressiveness of its course. Review of data from literary sources and results of own research on pathogenetic patterns and clinical course of parathyroid diseases was carried out, and it was determined that the lack/deficiency of
vitamin D is the most common ground of development of hyperparathyroidism, which affects the formation of
parathyroid hyperplasia or adenoma, and the process itself is of a gradual, staged clinical development.
Key words: parathyroids; parathyroid hyperplasia; hyperparathyroidism; normocalcemic hyperparathyroidism; Chornobyl NPP accident survivors; radiation; radiation exposure.
Problems of Radiation Medicine and Radiobiology.
2024;29:44-66. doi: 10.33145/2304-8336-2024-29-44-66
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