Chapter 28 – Bone Turnover Markers in Primary Hyperparathyroidism

In primary hyperparathyroidism (PHPT) there is an overproduction of parathyroid hormone (PTH) resulting in elevated or inappropriate normal PTH levels in the setting of hypercalcemia. Since calcium has been included in the basic metabolic bone panel, PHPT has been diagnosed even in mild stages and in the absence of symptoms. Nevertheless, even when this disorder is still asymptomatic, the skeleton can already be a target of the excess PTH activity. The skeletal involvement can be monitored by assessing the levels of bone turnover markers.