Primary Hyperparathyroidism in Celiac Disease: Diagnostic Challenges and Therapeutic Strategies
Abstract
Celiac disease (CD) is a primary immune-mediated enteropathy triggered by gluten ingestion in genetically predisposed individuals. Gluten ingestion results in villous atrophy of the small intestine and can lead to impaired absorption of multiple vitamins and nutrients, including vitamin D and calcium. This may result in vitamin D deficiency, a physiologic stimulus for parathyroid hormone (PTH) secretion, subsequently causing secondary hyperparathyroidism. Malabsorption and hyperparathyroidism in CD can contribute to metabolic bone disease (MBD), including osteopenia or osteoporosis. Correction of CD with a gluten-free diet (GFD) does not always reverse MBD. Although malabsorption in CD is a well-recognized cause of secondary hyperparathyroidism, some case reports have also suggested a potential association between CD and primary hyperparathyroidism (PHPT). In this literature review, we present evidence from observational studies, case series, and case reports that suggest a potential association or coexistence of CD and PHPT. Although the exact relationship between CD and PHPT remains unclear, limited evidence suggests that the two conditions may be related or may coexist independently of one another, with GFD treatment potentially unmasking underlying PHPT in patients with CD. One proposed mechanism is that vitamin D deficiency in CD reduces the vitamin D-mediated suppression of parathyroid cell proliferation, potentially contributing to the development of PHPT; however,…
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.