Introduction. Normocalcemic primary hyperparathyroidism (NPHPT) is considered a variant of the more frequent form of the disease characterized by normal serum calcium levels with high PTH. The higher prevalence of renal stones in patients with HPTP and the well established association with bone disorders show the importance of studies on how to manage asymptomatic patients. Objective. To compare the clinical and laboratory data between the normocalcemic and mild hypercalcemic forms of PHPT. Methods. We retrospectively evaluated 70 patients with PHPT, 33 normocalcemic and 37 mild hypercalcemic. Results. The frequency of nephrolithiasis was 18.2% in normocalcemic patients and 18.9% in the hypercalcemic ones (P = 0.937). Fifteen percent of normocalcemic patients had a previous history of fractures compared to 10.8% of hypercalcemic patients, although there was no statistically significant difference (P = 0.726). Conclusion. Our data confirms a high prevalence of urolithiasis in normocalcemic primary hyperparathyroidism, but with the preservation of cortical bone. This finding supports the hypothesis that this disease is not an idle condition and needs treatment.

Objective To describe the characteristics of normocalcemic primary hyperparathyroidism (NPHPT) in patients seen for osteoporosis evaluation. Patients and methods We examined the records of 156 women who came to the hospital to be screened for osteoporosis. Measurements of total calcium, PTH, 25-hydroxy vitamin D, and β-C-telopeptide were recorded. Bone mineral density and T-scores were evaluated by densitometry of the lumbar spine, femoral neck and distal one-third of the radius. The latter was only measured in patients with primary hyperparathyroidism. Nephrolithiasis and bone fractures were documented by a review of the medical records. Results We identified 14 patients with NPHPT, accounting for 8.9% of the population studied. In the medical records, the occurrence of kidney stones was reported in 28.6% of the patients with NPHPT, in contrast with only 0.7% of the noncarriers. Regarding the presence of general fractures, 21.4% of the patients with NPHPT were affected versus 16.2% of noncarriers. Conclusion Data from our study suggest that NPHPT has a diverse phenotypic presentation, implying that this may not be an “indolent” disease.

Objective: To determine vitamin D (25OHD) status and its relationship with bone mineral density (BMD) in 93 postmenopausal women. Subjects and methods: Patients were distributed in two groups: Group 1 -51 to 65 years (n = 45) and Group 2 -66 to 84 years (n = 48); 25OHD and PTH serum were analyzed and a DXA scan of the lumbar spine (LS) and femoral neck (FN) were taken. Results: Mean ± SD of serum 25OHD levels were 80.6 ± 43.3 nmol/L (Group 1) and 63.7 ± 27.6 nmol/L (Group 2); 24% had 25OHD levels < 25 nmol/L and 43.

OBJECTIVE: To evaluate bone metabolism, bone density (BMD) and vertebral fractures in morbidly obese individuals. SUBJECTS AND METHODS: Case series of 29 premenopausal obese patients, 15 of whom had been submitted to bariatric surgery. Serum calcium, albumin, PTH and 25-hydroxy vitamin D (25OHD) were measured as well as bone densitometry of the lumbar spine and proximal femur, and lateral spine x-rays. RESULTS: High parathyroid hormone (PTH) levels were recorded in 46.6% of the surgical patients and in 21.4% of the non-surgical patients (p = 0.245); 26.7% of the former and 28.6% of the latter revealed levels 25OHD < 30 ng/mL (p = 1.000). Calcium intake was higher in the surgical group (p = 0.004) along with lower serum calcium concentrations (p = 0.019). There were no significant differences in bone mineral density (BMD) or in the prevalence of vertebral fractures between groups. CONCLUSION: In premenopausal women undergoing Roux-en-Y gastric bypass there is important intestinal calcium mal absorption which seems to be the main factor causing secondary hyperparathyroidism.