Marini Francesca, Giusti Francesca, Brandi Maria Luisa
Fondazione F.I.R.M.O. Onlus (Italian Foundation for the Research on Bone Diseases), Firenze, Italy.
Department of Clinical and Experimental Biomedical Sciences, University of Florence, Firenze, Italy.
Best Pract Res Clin Endocrinol Metab. 2025 Mar;39(2):101982. doi: 10.1016/j.beem.2025.101982. Epub 2025 Jan 31.
Primary hyperparathyroidism is a constitutive excess of parathyroid hormone (PTH) in the blood, caused by an idiopathic defect of growth and/or function of the parathyroid glands. PHPT is usually an acquired disease, due to the sporadic development of parathyroid hyperplasia, adenoma, and, in extremely rare cases, malignant carcinoma, mainly occurring by the sixth decade of life. In about 5-10 % of cases PHPT manifests in the context of congenital disorders, having a genetic base and occurring much earlier in life, compared to the sporadic counterpart. Congenital PHPT can manifest as isolated PHPT or as syndromic PHPT in the context of complex multiorgan disorders. Non-syndromic inherited PHPT includes Familial Hypocalciuric Hypercalcemia types 1, 2 and 3, Neonatal Severe Primary Hyperparathyroidism, and three different genetic forms of Familial Isolated Hyperparathyroidism, while syndromic inherited PHPT includes Hyperparathyroidism-Jaw Tumor Syndrome and Multiple Endocrine Neoplasias types 1, 2 A and 4.
原发性甲状旁腺功能亢进症是指血液中甲状旁腺激素(PTH)持续过量,由甲状旁腺生长和/或功能的特发性缺陷引起。原发性甲状旁腺功能亢进症通常是一种后天性疾病,由于甲状旁腺增生、腺瘤的散发性发展,在极少数情况下,还由于恶性癌,主要发生在60岁左右。在大约5%-10%的病例中,原发性甲状旁腺功能亢进症在先天性疾病的背景下表现出来,具有遗传基础,与散发性病例相比,发病年龄要早得多。先天性原发性甲状旁腺功能亢进症可表现为孤立性原发性甲状旁腺功能亢进症,或在复杂多器官疾病的背景下表现为综合征性原发性甲状旁腺功能亢进症。非综合征性遗传性原发性甲状旁腺功能亢进症包括1型、2型和3型家族性低钙血症性高钙血症、新生儿重症原发性甲状旁腺功能亢进症以及三种不同基因形式的家族性孤立性甲状旁腺功能亢进症,而综合征性遗传性原发性甲状旁腺功能亢进症包括甲状旁腺功能亢进-颌骨肿瘤综合征以及1型、2A型和4型多发性内分泌肿瘤。