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Journal of Osteoporosis
Volume 2012 (2012), Article ID 128352, 4 pages
Clinical Study

Normocalcemic versus Hypercalcemic Primary Hyperparathyroidism: More Stone than Bone?

Division of Endocrinology and Diabetes, Agamenon MagalhΓ£es Hospital, Brazilian Ministry of Health (MS/SUS), University of Pernambuco Medical School, 52021-380 Recife, PE, Brazil

Received 1 November 2011; Revised 2 January 2012; Accepted 14 January 2012

Academic Editor: Carmelo E. Fiore

Copyright © 2012 L. M. Amaral et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Normocalcemic primary hyperparathyroidism (NPHPT) is considered a variant of the more frequent form of the disease characterized by normal serum calcium levels with high PTH. The higher prevalence of renal stones in patients with HPTP and the well established association with bone disorders show the importance of studies on how to manage asymptomatic patients. Objective. To compare the clinical and laboratory data between the normocalcemic and mild hypercalcemic forms of PHPT. Methods. We retrospectively evaluated 70 patients with PHPT, 33 normocalcemic and 37 mild hypercalcemic. Results. The frequency of nephrolithiasis was 18.2% in normocalcemic patients and 18.9% in the hypercalcemic ones ( 𝑃 = 0 . 9 3 7 ). Fifteen percent of normocalcemic patients had a previous history of fractures compared to 10.8% of hypercalcemic patients, although there was no statistically significant difference ( 𝑃 = 0 . 7 2 6 ). Conclusion. Our data confirms a high prevalence of urolithiasis in normocalcemic primary hyperparathyroidism, but with the preservation of cortical bone. This finding supports the hypothesis that this disease is not an idle condition and needs treatment.