OBJECTIVE: To evaluate the musculoskeletal manifestations of primary hyperparathyroidism (PHP). PATIENTS AND METHODS: Clinical, with emphasis on musculoskeletal manifestations, laboratorial, and densitometric data of 21 PHP patients followed-up in our service were evaluated. RESULTS: Only post-menopausal patients, with mean age of 67.9 ± 11.2 years, of which 16 (76.2%) were Caucasian, participated in this study. Serum levels of calcium, phosphorus, 25 hydroxy vitamin D, and parathyroid hormone (PTH) at the time of diagnosis were 10.6 ± 0.9 mg/dL, 2.9 ± 0.7 mg/dL, 16.6 ± 6.6 ng/mL, and 113.7 ± 74.8 pg/mL, respectively. Thirteen (61.9%) patients had osteoarthritis, 7 (33.3%) diffuse arthralgia, 6 (28.6%) diffuse myalgia, 3 (14.3%) chondrocalcinosis, and 2 (14.3%) tendinopathy. Half of 14 (67.8%) patients with osteoporosis had a history of bone fracture (2 of the distal radius, 4 of the vertebral spine, 2 of the fingers, and 2 of the ankles). Eleven (52.4%) patients had hypertension, 5 (23.8%) hypothyroidism, 4 (18.0%) peptic ulcer, 3 (14.3%) kidney stones, 2 (9.5%) depression, and 2 (9.5%) psoriasis. Fifteen patients (71.4%) underwent parathyroidectomy, seven had a diagnosis of adenoma of the parathyroid, and an improvement of the symptoms was observed in 61.5% of those patients. CONCLUSIONS: Primary hyperparathyroidism has variable clinical manifestations in which musculoskeletal symptoms predominate. Knowledge of this disorder and its inclusion in the differential diagnosis of rheumatic diseases allows the early diagnosis, therefore minimizing clinical complications.
comorbidities; primary hyperparathyroidism; musculoskeletal manifestation; osteoporosis
