Bone Abstracts

Hypoparathyroidism is a disorder characterized by hypocalcemia, low or absent parathyroid hormone (PTH), and abnormal bone remodeling. The diagnosis is made in the setting of hypocalcemia with markedly reduced or absent PTH levels. Postoperative hypoparathyroidism is the most common etiology. Other causes of hypoparathyroidism include autoimmune disease and rarely, congenital syndromes of parathyroid dysgenesis such as DiGeorge syndrome. Standard treatment of hypoparathyroidis...

The purpose of this presentation is to present the guidelines for recommending surgery for asymptomatic primary hyperparathyroidism, based on a workshop held in 2013. The indications for surgery were: i) a serum calcium more than 1 mg/dl (or 0.25 mmol/l) above the reference interval; ii) a low bone density (T-score −2.5 or less at the lumbar spine, total hip, femoral neck, or distal radius 1/3) or presence of vertebral fracture; iii) chronic kidney disease stage...

The aim of management is to normalize serum calcium and reduce PTH levels, leading to improvement in any associated symptoms. Parathyroidectomy (PTx) is the only curative treatment and should be recommended for PHPT patients with symptomatic disease, but also considered in asymptomatic patients who meet surgical criteria defined by international guidelines. Studies of the natural history of asymptomatic PHPT indicate that in the absence of PTx some patients show stability in s...

Primary hyperparathyroidism (PHPT) may occur as part of a complex syndrome or as an isolated (non-syndromic) disorder, and both of these forms can occur as hereditary (i.e. familial) or non-familial (i.e. sporadic) diseases. Syndromic forms of PHPT include multiple endocrine neoplasia (MEN) types 1–4 (MEN1–MEN4), and the hyperparathyroidism–jaw tumour (HPT–JT) syndrome. MEN1 is characterised by the combined occurrence of parathyroid tumours, pancreatic neur...

The pathophysiology of secondary hyperparathyroidism (II HPT) in the absence of renal disease is mainly due to lack of vitamin D, calcium deficiency being extremely rare. In case of chronic kidney disease (CKD), phosphate retention and increase in secretion of FGF23 by bone are among the earliest factors associated with II HPT occurrence. Then, the deficit in calcitriol synthesis induces lack of calcium intestinal absorption which worsens II HPT. As renal function declines, th...