Abstract
Primary hyperparathyroidism is a disorder of calcium-phosphate balance and bone metabolism, characterized by increased bone turnover, reduced bone mineral density—especially in cortical bone—and an elevated risk of fractures. The introduction of automated methods for measuring serum calcium levels, along with the widespread availability of reliable parathyroid hormone (PTH) assays, has changed the clinical presentation of PHPT. The classic form of the disease (osteitis fibrosa cystica), which used to require differentiation from bone malignancies, is now seen much less frequently. Effective surgical treatment of primary hyperparathyroidism leads to skeletal recovery ("self-repair") and an increase in bone mineral density (BMD). With the growing number of patients presenting with subclinical primary hyperparathyroidism, there is an increasing need to explore alternative—pharmacological—treatment options. Anti-resorptive drugs, such as bisphosphonates and denosumab, have attracted particular interest in the context of managing bone loss in patients with PHPT.
This article aims to present the current state of knowledge regarding bone loss in primary hyperparathyroidism.
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