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Primary hyperparathyroidism causes hypercalcemia (elevated blood calcium levels) through the excessive secretion of parathyroid hormone (PTH), usually by an adenoma (benign tumors) of the parathyroid glands. Its incidence is approximately 42 per 100,000 people. It is almost exactly three times as common in women as men.
The signs and symptoms of primary hyperparathyroidism are those of hypercalcemia. They are classically summarized by the mnemonic “stones, bones, abdominal groans and psychic moans”.
The German description of the same symptoms is “Stein-, Bein- und Magenpein”, literally “stone, leg, and stomach-pain”.
Other signs include proximal muscle weakness, itching, and band keratopathy of the eyes.
The diagnosis of primary hyperparathyroidism is made by blood tests. Serum calcium levels are elevated.
The serum chloride phosphate ratio is 33 or more in most patients with primary hyperparathyroidism.[3][4][5] However, thiazide medications have been reported to causes ratios above 33.[6]
Urinary cAMP is occasionally measured; this is generally elevated.
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