Abstract
Primary hyperparathyroidism (PHPT) has been associated with bone loss most notable in the cortical bones, with osteoporosis being prevalent in up to 60 % of patients. PHPT should be evaluated as a secondary cause of osteoporosis. In addition, bone mineral density should be assessed in patients with PHPT, as the presence of osteoporosis may alter management. The diagnosis of PHPT should be based on solid biochemical evidence, and imaging studies should be reserved for patients in whom surgery is being strongly considered. Patients with PHPT who also have bone mineral density in the osteopenia/osteoporosis range should adhere to the Institute of Medicine recommendations to ensure adequate intake of calcium and vitamin D (i.e., there is no need for calcium restriction).
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References
Khan A, Bilezikian J. Primary hyperparathyroidism: pathophysiology and impact on bone. CMAJ. 2000;163(2):184–7 [Review].
Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, et al. Skeletal disease in primary hyperparathyroidism. J Bone Miner Res. 1989;4(3):283–91 [Research Support, US Gov’t, PHS].
Cipriani C, Biamonte F, Costa AG, Zhang C, Biondi P, Diacinti D, et al. Prevalence of kidney stones and vertebral fractures in primary hyperparathyroidism using imaging technology. J Clin Endocrinol Metab. 2015;100(4):1309–15 [Research Support, NIH, Extramural].
Bours SP, van den Bergh JP, van Geel TA, Geusens PP. Secondary osteoporosis and metabolic bone disease in patients 50 years and older with osteoporosis or with a recent clinical fracture: a clinical perspective. Curr Opin Rheumatol. 2014;26(4):430–9.
Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3561–9 [Consensus Development Conference].
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359–81.
Sankaran S, Gamble G, Bolland M, Reid IR, Grey A. Skeletal effects of interventions in mild primary hyperparathyroidism: a meta-analysis. J Clin Endocrinol Metab. 2010;95(4):1653–62 [Meta-Analysis Research Support, Non-US Gov’t Review].
Udelsman R, Akerstrom G, Biagini C, Duh QY, Miccoli P, Niederle B, et al. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3595–606 [Consensus Development Conference].
Marcocci C, Bollerslev J, Khan AA, Shoback DM. Medical management of primary hyperparathyroidism: proceedings of the fourth International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(10):3607–18 [Consensus Development Conference].
Dy BM, Grant CS, Wermers RA, Kearns AE, Huebner M, Harmsen WS, et al. Changes in bone mineral density after surgical intervention for primary hyperparathyroidism. Surgery. 2012;152(6):1051–8.
Rolighed L, Vestergaard P, Heickendorff L, Sikjaer T, Rejnmark L, Mosekilde L, et al. BMD improvements after operation for primary hyperparathyroidism. Langenbecks Arch Surg. 2013;398(1):113–20.
Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Clinical review: parathyroid localization and implications for clinical management. J Clin Endocrinol Metab. 2013;98(3):902–12 [Review].
Jorde R, Szumlas K, Haug E, Sundsfjord J. The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake. Eur J Nutr. 2002;41(6):258–63 [Clinical Trial Randomized Controlled Trial].
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53–8.
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© 2016 Mayo Foundation for Medical Education and Research
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Ospina, N.S., Hurley, D.L. (2016). Primary Hyperparathyroidism and Osteoporosis. In: Kearns, A., Wermers, R. (eds) Hyperparathyroidism. Springer, Cham. https://doi.org/10.1007/978-3-319-25880-5_4
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DOI: https://doi.org/10.1007/978-3-319-25880-5_4
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