E21.3

Approximate Synonyms

• Hyperparathyroidism

• Hyperparathyroidism high parathyroid hormone level)

Clinical Information

• A condition in which the parathyroid gland one of four pea-sized organs found on the thyroid) makes too much parathyroid hormone. This causes a loss of calcium from the bones and an increased level of calcium in the blood. Symptoms include bone pain and kidney problems.

• A condition of abnormally elevated output of parathyroid hormone or pth) triggering responses that increase blood calcium. It is characterized by hypercalcemia and bone resorption, eventually leading to bone diseases. Primary hyperparathyroidism is caused by parathyroid hyperplasia or parathyroid neoplasms. Secondary hyperparathyroidism is increased pth secretion in response to hypocalcemia, usually caused by chronic kidney diseases.

• A disorder characterized by an increase in production of parathyroid hormone by the parathyroid glands. This results in hypercalcemia abnormally high levels of calcium in the blood).

• Abnormally increased activity of the parathyroid glands, which may be primary or secondary; primary hyperparathyroidism is associated with neoplasia or hyperplasia; excess of parathyroid hormone leads to alteration in function of bone, renal tubules, and gastrointestinal mucosa.

• Hyperfunction of the parathyroid glands resulting in the overproduction of parathyroid hormone. It may be primary or secondary; primary hyperparathyroidism is caused by parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma, and multiple endocrine neoplasia. It is associated with hypercalcemia and hypophosphatemia. Signs and symptoms include weakness, fatigue, nausea, vomiting, constipation, depression, bone pain, osteoporosis, cystic bone lesions, and kidney stones. Secondary hyperparathyroidism is caused by the chronic stimulation of the parathyroid glands in patients with chronic renal failure, rickets, and malabsorption syndromes.

• What: hyperparathyroidism. Hyperparathyroidism: a condition due to an increase in the secretion of the parathyroids, causing generalized osteitis fibrosa cystica, elevated serum calcium, decreased serum phosphorus, and increased excretion of both calcium and phosphorus. Why: several rheumatological disorders are associated with hyperpara- thyroidism. First, hyperuricemia and gouty arthritis which may mimic hyperparathyroidism with renal stone formation and colic) have an increased incidence in patients with hyperparathyroidism. Second, patients with primary hyperparathyroidism show an increased incidence of chondrocalcinosis with episodes of calcium pyrophosphate crystal induced synovitis. Approximately 25% of patients with hyperparathyroidism will show radiographic evidence of calcification of articular cartilage and joint capsules. Finally, there can be a synovial and cartilaginous lesion “osteogenic synovitis”) in patients with hyperparathyroidism which may mimic other primary rheumatic diseases such as rheumatoid arthritis. In osteogenic synovitis there is softening and collapse of subchondral bone. Eventually the cartilage overlying this area erodes and is replaced by an irregular fibrocartilage. Eventually the articular surface of the joint is destroyed and secondary degenerative arthritis may develop. Refs: 1) zvaifler, nj; reefe, we and black, rl: articular manifestations in primary hyperparathyroidism. Arthritis rheum 5:237, 1962. 2) scott, jt; dixon, asj and bywaters, egl: association of hyperuricemia and gout with hyperparathyroidism. Br med j 1:1070, 1964. 3) bywaters, egl and scott, jt : joint lesions of hyperparathyroidism. Ann rheum dis 22:171-87, 1963.

Details

• E21.3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

• The 2023 edition of ICD-10-CM E21.3 became effective on October 1, 2022.

• This is the American ICD-10-CM version of E21.3 – other international versions of ICD-10 E21.3 may differ.