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Primary hyperparathyroidism presenting with pathological fracture

R G Deshmukh1, S A Alsagoff, S Krishnan

  • 1Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Journal of the Royal College of Surgeons of Edinburgh
|February 17, 1999
PubMed
Summary

Primary hyperparathyroidism (PHPT) is often asymptomatic and diagnosed early in developed nations. However, advanced PHPT with bone fractures is common in developing countries, posing diagnostic challenges.

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Area of Science:

  • Endocrinology
  • Metabolic Bone Disease

Background:

  • Primary hyperparathyroidism (PHPT) diagnosis is common in developed countries due to routine screening, often detecting asymptomatic cases.
  • In developing regions, PHPT frequently presents at advanced stages, characterized by significant bone involvement.
  • Dietary deficiencies in certain populations can complicate the biochemical presentation of PHPT, leading to diagnostic difficulties.

Observation:

  • This report details three cases of primary hyperparathyroidism presenting with pathological fractures.
  • The cases highlight the importance of considering PHPT in the differential diagnosis of fractures, especially in at-risk populations.
  • Diagnostic challenges arise from altered biochemical profiles potentially caused by coexisting nutritional deficiencies.

Findings:

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  • PHPT can manifest with severe skeletal complications, including pathological fractures.
  • Early diagnosis through biochemical screening is crucial for preventing advanced disease manifestations.
  • Management requires a comprehensive approach addressing both the hyperparathyroidism and its skeletal consequences.

    • Implications:

    • Increased awareness of PHPT as a cause of pathological fractures is necessary, particularly in immigrant populations from developing countries.
    • Further research into the interplay between dietary factors and PHPT presentation is warranted.
    • Timely diagnosis and management of PHPT can prevent debilitating bone disease and improve patient outcomes.