Primary hyperparathyroidism and anemia.

The frequency of anemia associated with primary hyperparathyroidism is uncertain. When anemia does occur, its mechanisms are obscure. Two patients with primary hyperparathyroidism and moderate normochromic, normocytic, reticulocytopenic anemia were studied in detail. Both had results of ferrokinetic studies that were consistent with the anemia of chronic disease; one had low serum iron concentrations and reduced normoblastic iron incorporation. Anemia in both patients resolved after parathyroidectomy. Clinical records of 100 nonuremic patients with primary hyperparathyroidism were reviewed and three other anemic patients were found. The cause of anemia in two of these individuals was bleeding in the upper gastrointestinal system, and the third had folate deficiency attributable to chronic alchoholism.