Natural history of primary hyperparathyroidism

Primary hyperparathyroidism has evolved into a disorder that is largely asymptomatic. Nevertheless, there is ample evidence of target organ effects even in asymptomatic patients. Recent data suggest that the disease is stable in most asymptomatic patients. Little change is observed in biochemical parameters or bone mineral density over time. A subgroup of asymptomatic patients shows biochemical evidence of disease progression, although, in the author's series, no overt clinical complications developed. Surgical cure is associated with biochemical normalization and increased bone density.