Chapter 3: Impact of primary hyperparathyroidism - 26/02/25

Doi : 10.1016/j.ando.2025.101692

Nicolas Scheyer ^a, Samuel Frey ^b, Eugénie Koumakis ^c, Carole Guérin ^d, Rachel Desailloud ^e, Lionel Groussin ^f,^{^{1
Section coordinated by Lionel Groussin and Eric Mirallié.},}⁎ , Bertrand Cariou ^g,^h, Bruno Vergès ⁱ, Laurent Brunaud ^j, Eric Mirallié ^b,^{^{1
Section coordinated by Lionel Groussin and Eric Mirallié.}}, Lucile Figueres ^k,^l, Hélène Lasolle ^m
^a University of Lorraine, Endocrinology, Diabetology and Nutrition Department, Nancy University Hospital, Nancy, France
^b Nantes University, CHU de Nantes, Oncological, Digestive and Endocrine Surgery, Institut des Maladies de l’Appareil Digestif, 44093 Nantes, France
^c Centre de Référence des Maladies Osseuses Rares, Institut de Rhumatologie, Hôpital Cochin, Inserm UMR 1163, Paris, France
^d Department of General, Endocrine and Metabolic Surgery, La Conception Hospital, Aix-Marseille University, Marseille, France
^e Endocrinology-Diabetology and Nutrition Department, Hôpital Sud Nord, CHU, 80054 Amiens, France
^f Endocrinology Department, Hôpital Cochin, Inserm U1016, CNRS UMR 8104, Université Paris Cité, Paris, France
^g Endocrinology, Metabolism and Nutrition Department, Nantes Université, CHU de Nantes, CNRS, Inserm, l’Institut du Thorax, 44000 Nantes, France
^h CHU de Nantes, Inserm, CIC 1413, l’Institut du Thorax, 44000 Nantes, France
ⁱ Endocrinology and Diabetology Department, CHU de Dijon, Inserm UMR 1231, University of Burgundy and Franche-Comté, Dijon, France
^j University of Lorraine. Visceral, Metabolic and Cancer Surgery, CHU de Nancy, Nancy, France
^k Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
^l Centre de Recherche en Transplantation et Immunologie UMR 1064, Inserm, Université de Nantes, 44093 Nantes, France
^m Hospices Civils de Lyon, Groupement Hospitalier Est, Endocrinology Federation, Lyon, France

^*Corresponding author. Hôpital Cochin, Service d’endocrinologie et maladies métaboliques, 123, boulevard de Port-Royal, 75014 Paris, France.Hôpital Cochin, Service d’endocrinologie et maladies métaboliques123, boulevard de Port-RoyalParis75014France

Abstract

At present, primary hyperparathyroidism is most often discovered in an asymptomatic patient, but can sometimes be revealed by a renal or bone complications. In all cases, a full work-up is recommended, with assessment of renal function (glomerular filtration rate), 24-hour calciuria, screening for risk factors for lithiasis, and renal and urinary tract imaging (ultrasound or CT scan) to look for stones or nephrocalcinosis. Bone densitometry, with measurements of the spine, femur and radius, is the recommended reference test for demineralization. Standard X-rays of the spine or other imaging techniques are recommended for the detection of asymptomatic vertebral fracture. Neurocognitive manifestations, reduced quality of life or cardiovascular manifestations should not be routinely screened for, as they are not currently consensual criteria for surgical indications.

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Keywords : Primary hyperparathyroidism, Renal lithiasis, Renal failure, Nephrocalcinosis, Osteoporosis, Vertebral fracture, Quality of life, Bone densitometry, Hypercalciuria