{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T10:53:29Z","timestamp":1792752809933,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T00:00:00Z","timestamp":1577664000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2019,12,30]]},"abstract":"<jats:p>Current primary hyperparathyroidism (PHPT) clinical presentation is asymptomatic in more than 90% of patients, while symptoms concern osteoporosis and rarely kidney stones. Here, we retrospectively investigated the prevalence of PHPT patients presenting with hypercalcemic-related symptoms (HS-PHPT) as cognitive impairment, changes in sensorium, proximal muscle weakness, nausea and vomiting, constipation, and severe dehydration, in a single center equipped with an emergency department and described their clinical features and outcome in comparison with a series of asymptomatic PHPT out-patients (A-PHPT). From 2006 to 2016, 112 PHPT patients were consecutively diagnosed: 16% (<jats:italic>n<\/jats:italic>\u2009=\u200918, 3M\/15F) presented with hypercalcemic-related symptoms. Gastrointestinal symptoms occurred in 66% of HS-PHPT patients and cognitive impairment in 44%; one woman experienced hypertensive heart failure. Two-thirds of HS-PHPT patients were hospitalized due to the severity of symptoms. Comparing the clinical features of HS-PHPT patients with A-PHPT patients, no gender differences were detected in the two groups, while HS-PHPT patients were older at diagnosis (71 (61\u201381) vs. 64 (56\u201374) years, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:mrow><\/mml:math>; median (IQR)). HS-PHPT patients presented higher albumin-corrected calcium levels (12.3 (11.3\u201313.7) vs. 10.6 (10.3\u201311.3) mg\/dl, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>); 4 HS-PHPT presented corrected calcium levels &gt;14\u2009mg\/dl. Serum PTH levels and total alkaline phosphatase activity were higher in HS-PHPT. Reduced kidney function (eGFR\u2009&lt;\u200945\u2009ml\/min) was prevalent in HS-PHPT patients (42% vs. 5%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:mrow><\/mml:math>). No differences in kidney stones and osteoporosis were detected, as well as in the rates of cardiovascular comorbidities and main cardiovascular risk factors. HS-PHPT patients had an age-adjusted Charlson Comorbidity Index higher than that of the A-PHPT patients and were on chronic therapy with a greater number of medications than A-PHPT patients. In conclusion, hypercalcemic-related symptoms occurred in 16% of PHPT patients. Risk factors were severity of the parathyroid tumor function, multimorbidity, and polypharmacy.<\/jats:p>","DOI":"10.1155\/2019\/7617254","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T18:32:19Z","timestamp":1577730739000},"page":"1-7","source":"Crossref","is-referenced-by-count":21,"title":["Symptomatic Hypercalcemia in Patients with Primary Hyperparathyroidism Is Associated with Severity of Disease, Polypharmacy, and Comorbidity"],"prefix":"10.1155","volume":"2019","author":[{"given":"C.","family":"Aresta","sequence":"first","affiliation":[{"name":"Endocrine Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Passeri","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8140-3175","authenticated-orcid":true,"given":"S.","family":"Corbetta","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.33"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1106636"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2012.12.001"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90129-5"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.21921"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1007\/bf00280883"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090802"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-19-0316"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.04.088"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.09.010"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(97)12331-5"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-018-1676-3"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14718"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2017.07.008"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12487"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12840"}],"container-title":["International Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2019\/7617254.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2019\/7617254.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2019\/7617254.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T18:32:20Z","timestamp":1577730740000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/ije\/2019\/7617254\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,30]]},"references-count":17,"alternative-id":["7617254","7617254"],"URL":"https:\/\/doi.org\/10.1155\/2019\/7617254","relation":{},"ISSN":["1687-8337","1687-8345"],"issn-type":[{"value":"1687-8337","type":"print"},{"value":"1687-8345","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,30]]}}}