Primary hyperparathyroidism: pathophysiology and impact on bone.

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Abstract

[Indexed for MEDLINE] 11. Wien Klin Wochenschr. 2026 Apr;138(7-8):217-224. doi: 10.1007/s00508-025-02670-z. Epub 2025 Dec 2. Bone metabolism in primary hyperparathyroidism. Kerschan-Schindl K(1)(2), Gelles K(3), Butylina M(3), Crevenna R(4)(5), Pietschmann P(3). Author information: (1)Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria. Katharina.Kerschan-Schindl@meduniwien.ac.at. (2)Comprehensive Center of Musculoskeletal Disorders (CCMSD), Medical University of Vienna, Vienna, Austria. Katharina.Kerschan-Schindl@meduniwien.ac.at. (3)Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria. (4)Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria. (5)Comprehensive Center of Musculoskeletal Disorders (CCMSD), Medical University of Vienna, Vienna, Austria. Primary hyperparathyroidism is a frequent endocrine disorder that affects various organ systems. In this review we present and discuss alterations of bone metabolism in primary hyperparathyroidism. Excessive secretion of parathyroid hormone results in increased bone remodelling with an excess of bone resorption. Consequently, bone mineral density declines, bone quality is compromised and fracture risk increases.Successful surgery for hyperparathyroidism results in a normalization of bone turnover and a decrease of fracture risk. Osteitis fibrosa cystica, a severe bone manifestation of hyperparathyroidism, is observed rarely today. © 2025. The Author(s). DOI: 10.1007/s00508-025-02670-z PMCID: PMC13099684