[Parathyroid and bone. Skeletal derangement in patients with primary hyperparathyroidism]

One of the principle purposes in treatment of patients with primary hyperparathyroidism in Japan is to improve bone fragility by increasing bone mineral density. Persistent excess actions of parathyroid hormone could cause decrease in bone mineral density and bone fragility. Parathyroid surgery should be considered when bone mineral density in patients with the disease is in a range of osteoporosis. After surgery, bone mineral density is increased with time during several years. It is suggested relative risk of fracture decreases with parathyroid surgery. Recently, accumulating evidence indicates that treatment with oral bisphosphonates increases bone mineral density in patients with mild primary hyperparathyroidism, although it is yet uncertain whether it also prevents fracture.