ABSTRACT
Primary hyperparathyroidism (PHPT) in South Asian countries continues to manifest as an overtly symptomatic disorder of “bones, stones, abdominal groans and psychic moans,” unlike the West, where it is managed mostly as an asymptomatic or minimally symptomatic clinical entity. Patients with extremely high serum parathormone and serum calcium levels over long duration are likely to have more extensive target organ damage and can have varied systemic manifestations. Musculoskeletal symptoms of PHPT remain the most common mode of presentation in developing countries, though renal manifestations too are commonly encountered. A direct correlation exits between vitamin D levels and bone mineral density and an inverse relationship with weight of parathyroid tumors. PHPT patients with coexisting vitamin D deficiency manifests with severe symptomatic bone disease. If PHPT is left untreated, the disease will progress to cause a detrimental impact on musculoskeletal, cardiovascular, renal and metabolic functions with worsening quality of life. A successful parathyroidectomy results in the resolution of most symptoms and improves the quality of life.
