Primary Hyperparathyroidism in Iran and Other Developing Countries

Primary Hyperparathyroidism in Iran and Other Developing Countries

Amir Bahrami MD

Tabriz University of Medical Sciences

§ Primary Hyperparathyroidism (PHPT)

     is characterized by:

1.  unregulated parathyroid hormone

    (PTH) secretion and

b) resulting hypercalcemia.

§ Excess PTH leads to the potential for major complications at the level of   target tissues mainly bones and kidneys.

Actions of parathyroid hormone (PTH) on the kidney and bone.

§ Albright and Reifenstein originally described primary hyperparathyroidism as a disease of "bones and stones".

§ Osteitis  fibrosa cystica reported to be the hallmark of hyperparathyroid bone disease.

§ kidney disease manifested by nephrolithiasis or rarely nephrocalcinosis was present in more than three fourth of patients at the time of diagnosis.

Albright F,et al. JAMA 102: 1276 – 1287, 1934.

Albright F,et al. Baltimore, Williams and Wilkins, 1948.

Cope O. N Engl J Med 21: 1174 – 1182, 1966.

Mallette LE,et al. Medicine (Baltimore) 53: 127 – 147, 1974.

§ In the West, the disease today bears little resemblance to the originally described severe disease of bones and stones.

• Indeed PHPT has evolved over the last four decades from a severe disease to:
•  an asymptomatic condition or
•  a disorder with more subtle manifestations