Neglected Case of Primary Hyperparathyroidism

Background The clinical presentation of primary hyperparathyroidism (pHPT) varied noticeably from a severe disease to an asymptomatic condition in Western countries. However, the disease is completely different in Eastern countries. Bone and joint-related signs and symptoms, such as bone pain and multiple fractures, are common in these patients. The principal effect of parathyroid hormone (PTH) is to increase the concentration of plasma calcium by enhancing the release of calcium and phosphate from the bone matrix, increasing calcium reabsorption by the kidneys, and boosting renal production of 1.25 dihydroxy vitamin D-3 (Calcitriol), which elevates plasma calcium levels [1, 2]. Usually, there are four parathyroid glands located posterior to the thyroid gland in the neck. Primary hyperparathyroidism (pHPT) is a disease characterized by hypercalcemia attributable to the autonomous overproduction of PTH. Although some patients with pHPT may have normal serum calcium concentrations, most of them have hypercalcemia. Therefore, pHPT can often be detected by routine serum calcium measurement. pHPT is present in about 1% of the adult population. The incidence of the disease increases to 2% or higher after age 55.