Abstract
The objective of this study is to determine the prevalence of primary hyperparathyroidism in a referred sample of fibromyalgia patients. Consecutively, referred patients with confirmed fibromyalgia (FM group) had measurements of serum levels of vitamin D, alkaline phosphatase, total calcium, magnesium, phosphate, creatinine, total protein, albumin, and parathyroid hormone. The same measurements were also conducted in a group of patients with widespread pain (WP group) who did not meet the 2010 Modified ACR criteria for fibromyalgia and a group with localized musculoskeletal pain (MSK group). A case of primary hyperparathyroidism was defined as a subject whose results showed any of the following: (1) parathyroid hormone levels above 6.8 pmol/L; (2) an ionized calcium above 1.25 mmol/L; or (3) both elevated, in the presence of normal range creatinine, alkaline phosphatase, vitamin D, phosphate, and magnesium. The mean age and the proportion of subjects who met the case definition of primary hyperparathyroidism were calculated for all groups. There were 125 subjects in the FM group, 127 in the WP group, and 138 in the MSK group. The prevalence rates of primary hyperparathyroidism were 6.4, 5.5, and 6.1 %, respectively, for these groups. Comparison of these prevalence rates to published figures for general clinical and non-clinical populations reveals no differences. The prevalence of primary hyperparathyroidism in fibromyalgia patients is not different than that in other patients with WP or those with localized pain, nor is it likely different than that seen in the general population.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fraser WD (2009) Hyperparathyroidism. Lancet 374:145–158
Eufrazino C, Veras A, Bandeira F (2013) Epidemiology of primary hyperparathyroidism and its non-classical manifestations in the City of Recife, Brazil. Clin Med Insights Endocrinol Diabetes 6:69–74
Cusano NE, Maalouf NM, Wang PY, Zhang C, Cremers SC, Haney EM, Bauer DC, Orwoll ES, Bilezikian JP (2013) Normocalcemic hyperparathyroidism and hypoparathyroidism in two community-based nonreferral populations. J Clin Endocrinol Metab 98:2734–2741
Blackburn M, Diamond T (2007) Primary hyperparathyroidism and familial hyperparathyroid syndromes. Aust Fam Phys 36:1029–1033
Marcocci C, Cetani F (2011) Clinical practice. Primary hyperparathyroidism. N Engl J Med 365:2389–2397
Felger EA, Kandil E (2010) Primary hyperparathyroidism. Otolaryngol Clin North Am 43:417–432
Helliwell M (1983) Rheumatic symptoms in primary hyperparathyroidism. Postgrad Med J 59:236–240
Rubin MR, Silverberg SJ (2002) Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy. Curr Rheumatol Rep 4:179–185
Turken SA, Cafferty M, Silverberg SJ, De La Cruz L, Cimino C, Lange DJ et al (1989) Neuromuscular involvement in mild, asymptomatic primary hyperparathyroidism. Am J Med 87:553–557
Cusano NE, Silverberg SJ, Bilezikian JP (2013) Normocalcemic primary hyperparathyroidism. J Clin Densitometr 16:33–39
Heath H III, Hodgson SF, Kennedy M (1980) Primary hyperparathyroidism: incidence, morbidity and potential economic impact in a community. N Engl J Med 302:189–193
Melton LJ III (1991) Epidemiology of primary hyperparathyroidism. J Bone Miner Res Suppl 6(Suppl 2):25–30
O’Riordan JLH (1978) Hormonal control of mineral metabolism. In: O’Riordan JLH (ed) Recent advances in endocrinology& metabolism (No. I). Churchill Livingstone, Edinburgh, p 194
Lundgren E, Rastad J, Thurfjell E, Akerstrom G, Ljunghall S (1997) Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery 121:287–294
Lundgren E (1999) Primary hyperparathyroidism of postmenopausal females. Prospective case–control analysis on prevalence, clinical characteristics and treatment. Compr Sum Upps Fac Med 820:1–51
Lindstedt G, Nystrom E, Lundberg P-A, Johansson E, Eggertsen R (1992) Screening of an elderly population in primary care for primary hyperparathyroidism. Scand J Prim Health Care 10:192–197
Sorva A, Valvanne J, Tilvis RS (1992) Serum ionized calciumand the prevalence of primary hyperparathyroidism in age cohorts of 75, 80 and 85 years. J Intern Med 231:309–312.1
Tsoukas M, Ste-Marie PA, Shir Y, Fitzcharles MA, Mitmaker E. URL: https://ww2.rheumatology.org/apps/MyAnnualMeeting/Abstract/37362
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P et al (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62:600–610
Adami S, Marcocci C, Gatti D (2002) Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 17(Suppl 2):N18–N23
Bilezikian JP, Khan A, Potts JT Jr (2009) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Third International Workshop. J Clin Endocrinol Metab 94:335–339
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ferrari, R., Russell, A.S. Prevalence of primary hyperparathyroidism in a referred sample of fibromyalgia patients. Clin Rheumatol 34, 1279–1283 (2015). https://doi.org/10.1007/s10067-014-2735-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2735-7