Coincidence of Paget disease of bone and primary hyperparathyroidism

The coincidence or association of some metabolic bone diseases is known although it occurs rarely. The authors present a very rare association of Paget's bone disease with primary hyperparathyroidism in a 65 year old male with overt Paget's disease of bone since 1985. For during five years the patient was treated symptomatically only. Later he developed a biochemical syndrome suspect from primary hyperparathyroidism with signs of preexisting Paget's disease of bone. The diagnostic and therapeutic approach is presented. After the removal of parathyroid adenoma, laboratory findings depicted recent status of Paget's disease of bone with high activity. Treatment of this disorder was advised and begun. The overproduction of parathyroid hormone in Paget's disease of bone is not usual and the mechanism of overproduction remains often unclear. Some views from literature are presented and discussed. If the parameters of bone metabolism cause doubt about the origin of the bone disease and a possibility of some combination occurs, it must be born in mind that such combinations may exist.