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Related Experiment Video

Updated: Jan 30, 2026

Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
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Classical complications of primary hyperparathyroidism.

Salvatore Minisola1, Laura Gianotti2, Sanjay Bhadada3

  • 1Department of Internal Medicine and Medical Disciplines, "Sapienza", Rome University, Italy.

Best Practice & Research. Clinical Endocrinology & Metabolism
|January 23, 2019
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Summary

Primary hyperparathyroidism complications, including skeletal and kidney issues, are increasingly detected with advanced imaging. Early identification of these conditions in asymptomatic patients is crucial for timely intervention.

Keywords:
fractureskidney stonesnephrocalcinosisosteitis fibrosa cysticapancreatitis

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Area of Science:

  • Endocrinology
  • Nephrology
  • Orthopedics

Background:

  • Classical complications of primary hyperparathyroidism (PHPT) involve skeletal, kidney, and gastrointestinal systems.
  • Osteitis fibrosa cystica is now rare, but advanced imaging reveals subclinical skeletal deterioration in PHPT.
  • Hyperparathyroidism leads to hypercalciuria and kidney stones, though pathogenesis remains unclear.

Purpose of the Study:

  • To highlight the evolving understanding of primary hyperparathyroidism complications.
  • To emphasize the role of advanced imaging in detecting skeletal and renal issues in asymptomatic PHPT patients.
  • To review gastrointestinal manifestations and identify areas for further research.

Main Methods:

  • Review of traditional and modern imaging techniques for skeletal and renal complications.
  • Analysis of literature concerning gastrointestinal manifestations of PHPT.
  • Discussion of findings from the 2013 International Congress on Asymptomatic Primary Hyperparathyroidism.

Main Results:

  • New imaging modalities detect skeletal deterioration not evident on DXA scans.
  • Hyperparathyroidism is linked to hypercalciuria and nephrolithiasis, with unknown precise mechanisms.
  • Gastrointestinal issues include acid-peptic disease, constipation, pancreatitis, and gallstones.

Conclusions:

  • Advanced imaging is vital for early detection of skeletal and renal complications in PHPT.
  • Further research is needed to elucidate the pathophysiology of gastrointestinal manifestations and the impact of parathyroid surgery.