Anaemia in primary hyperparathyroidism--fantasy or reality

Controversy exists as to whether primary hyperparathyroidism is associated with an anaemia. Records corresponding to 215 patients operated on at the Karolinska Hospital between 1972 and 1981 were reviewed. An incidence of 7.4% of anaemia was found, but in only 3% of these cases the anaemia could not be explained by any other known cause. The anaemic group was characteristic in presenting a normochromic and normocytic picture, with iron and serum transferrin values below the normal range. No renal or osseous pathology was observed. In these patients, the anaemia disappeared after the parathyroidectomy, and iron values remained below the normal range. In conclusion, a mild normochromic and normocytic anaemia that disappeared after parathyroid surgery was observed in six patients with PHPT (3%). Its mechanisms are obscure, but data available suggest that parathyroid disease could be of aetiological importance.