Bilezikian John P, Silverberg Shonni J
Departamento de Medicina, Columbia University, NY, NY, USA.
Arq Bras Endocrinol Metabol. 2010 Mar;54(2):106-9. doi: 10.1590/s0004-27302010000200004.
Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease.
原发性甲状旁腺功能亢进症是一种常见的矿物质代谢紊乱疾病，其特征是一个或多个甲状旁腺分泌甲状旁腺激素不受完全调节且分泌过多。关于这种疾病的历史观点描述了由两个时代标志的两种不同实体。大约80年前首次发现原发性甲状旁腺功能亢进症时，它总是伴有肾结石、骨病和明显的高钙血症等症状。大约40年前随着多通道自动分析仪的出现，临床表型转变为以轻度高钙血症且无该疾病的典型其他特征为特点的一种紊乱。我们现在可能正进入这种疾病历史上的第三个时代，在这个时代中发现的患者血清总钙和离子钙浓度正常，但甲状旁腺激素水平持续升高。在本文中，我们描述了这种新的实体，即血钙正常的原发性甲状旁腺功能亢进症，它是该疾病的一种顿挫型。
