Anemia in Hypercalcemic Hyperparathyroidism

Abstract

Clinicians have long been amazed by the myriad of symptoms and complications that can be produced by hypercalcemic (primary) hyperparathyroidism. Osteitis fibrosa cystica, renal stone, nephrocalcinosis, pancreatitis, and peptic ulcer disease are the most widely recognized. Other complications or associations have received emphasis more recently, including spinal osteoporosis with pain and compression fractures, 1 gout, 2 pseudogout, 3 hypertension, 4 neuromuscular disease, 5 and mental changes such as depression and psychosis. 6,7 Also proposed as associations, but less well established, are cholelithiasis, 8 ankylosing spondylitis, 9 and an increased incidence of concomitant papillary thyroid carcinoma 10 or other malignancy. 11 The article by Boxer et al in this issue (see p 588) supplements other recent reports indicating that we must now add anemia to the list of complications of hyperparathyroidism. 12,13 Anemia is actually not a newly recognized complication of primary hyperparathyroidism, since it was mentioned in earlier reviews by Albright