Evolving clinical profiles of primary hyperparathyroidism; a global perspective

Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by the overproduction of parathyroid hormone (PTH), leading to disrupted calcium metabolism and hypercalcemia. Previously, PHPT was recognized as a symptomatic disease with severe skeletal, renal and neuromuscular manifestations. However, the advent of routine calcium screening has shifted the clinical profile toward milder, often asymptomatic presentations, particularly in developed countries. Despite this evolution, significant global disparities persist in the prevalence, clinical presentation and management of PHPT. In developing regions, symptomatic cases with advanced complications remain prevalent, driven by limited access to diagnostic resources, nutritional deficiencies and genetic factors. Exploring the evolving clinical profiles of this disease from a global perspective emphasizes regional variations in epidemiology, etiology and treatment approaches, examines the impact of socioeconomic, environmental, and genetic factors on the disease’s presentation and outcomes and addresses the challenges of diagnosis and management in resource-limited settings.