Osteoporosis secundaria a hiperparatiroidismo primario: cambios clínicos y evaluación densitométrica tras paratiroidectomía, reporte de caso.

Abstract

Primary hyperparathyroidism (PHPT) is an endocrine disease caused by the synthesis
and autonomous secretion of parathyroid hormone (PTH). The uncontrolled amount of
endogenous PTH enhances osteoclastic activity, leading to an imbalance in bone
remodeling and a consequent decrease in bone mineral density (BMD). The first-line
treatment is surgical intervention, which has demonstrated to have a cure rate exceeding
90%, and may promote regression of skeletal changes in up to 95% of all cases.
We describe the case of a 70-year-old female patient with a history secondary
osteoporosis and primary hyperparathyroidism. Since 2023, she had been receiving
pharmacological treatment with bisphosphonates and vitamin D supplementation. In
2024, she underwent parathyroid adenoma resection without any complications. She is
currently under follow-up in the osteoporosis rehabilitation service, continuing
management with oral bisphosphonates. To date, she has not experienced fractures,
nephrolithiasis, or other complications. Notable improvements include a significant
reduction in bone turnover markers and an increase in BMD.