Primary hyperparathyroidism (PHT) is the third most common endocrine disorder in men and women after diabetes mellitus and thyroid disease and one of the most frequent causes of osteoporosis and fractures among the secondary osteopathy. PHT refers to socially significant problems in connection with involvement in the pathological process of the majority of organs and system In recent years, the conception of epidemiology, clinic and tactics of management of patients with PHT has changed due to significant increase of morbidity at the expense of identification of mild forms of disease. The modern management concept tactics depends on clinical manifestations. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of PHT based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on PHT.

Sarcopenia is one of the syndromes that significantly affects the health and life of the patient. Sarcopenia is a polyetiological syndrome with a complex, insufficiently studied pathogenesis, in which endocrine factors play a leading role. Comorbidity of elderly patients creates difficulties in differential diagnosis of existing pathology. The combination of sarcopenia with various endocrine pathologies, such as obesity, osteoporosis, hypothyroidism, hypoparathyroidism, vitamin D deficiency leads to a more severe course of disease and a worse prognosis for the quality and life expectancy of the patient. In this case, in some situations, the patient's condition can be improved by assessing pathogenetic causes and their elimination. Thus, the endocrinologist should pay more attention to the sarcopenia syndrome and its correction, as well as for its prevention at the earliest stages.

In addition to the classical symptoms such as osteoporosis, renal stones and gastric ulcers primary hyperparathyroidism (PHPT) could be presented with “non-classical” manifestations, including muscle and joint pathology. Moreover, in some cases the articular and neuromuscular impairment might be the main signs of the disease. Despite the long research history the true prevalence of these PHPT complications remains unknown. Discrepancies in studies results may be due the non-specific and different symptoms that patients complain about, various study design, uncorrected comorbid conditions, the different PHPT populations, a wide methods variety in the assessment of neuromuscular and articular involvement. However, the underestimated muscle dysfunction and joint damage can lead to decreased quality of life and disability, primarily from fragility fractures. In the majority of the studies parathyroidectomy improved muscle strength, but there is no clear results for articular manifestations. Basic research and large randomized control trials are limited. The main goal of this review is to summarize currently available data on muscle and joint involvement in patients with PHPT.

Primary hyperparathyroidism (PHPT) is well studied in elderly patients. Studies of PHPT characteristics in children, adolescents, and young adults are rare. In some of these studies, investigators have compared clinical and laboratory characteristics of PHPT between young and elderly patients and revealed several differences. An early onset of PHPT may indicate familial syndromes associated with PHPT. These include: multiple endocrine neoplasia syndrome type 1, type 2A, and type 4, hyperparathyroidism-jaw tumor syndrome, familial hypocalciuric hypercalcemia, and familial isolated hyperparathyroidism. However, the need for routine genetic tests to exclude these syndromes in all patients with PHPT manifested at a young age is not obvious. To date, there are a few foreign studies on the need for genetic testing in all young patients with PHPT, but their results are controversial. Our review summarizes the data of foreign and Russian studies on characteristics of PHPT in patients with disease onset at a young age.

Currently, the parathyroid glands (PG) are admited as vital organs in humans. At the same time, the way to this acknowledgment was long and difficult, and the establishment of a link between the pathological conditions of the PG and their complications passed through many mistakes and errors. Understanding the regulation of calcium-phosphorus metabolism in the body and recognition of the main role of parathyroid hormone (PTH) in it was slow, throughout the XIX − early XX centuries. Despite the increasing number of observations confirming the development of complications because of hyperfunction of the PG or development of tetany due to their removal, the main link of this relationship remained unidentified for a long time. In view of the unique anatomical features of the PG, they were the last of the endocrine glands found, which the main obstacle was in the rapid study of their functional characteristics. Today, the structure and functions of the PG are described in detail, the manifestations of their various pathological conditions are well studied, and the capabilities of modern medicine allow timely diagnosis and treatment of diseases. The review describes the history of the discovery of the PG, highlights the main stages in the study of their role in calcium-phosphorus metabolism in particular and in the body as a whole, and discusses the prospects for further development in this direction. We analyzed the work devoted to the evolution in the notions of anatomical, physiological, pathological features of the PG.