Biochemical Predictors and Clinical Characteristics for the Development of Cytopenia and Bone Marrow Involvement Among Patients With Primary Hyperparathyroidism
Abstract
Background: The clinical features associated with primary hyperparathyroidism (PHPT) giving rise to bone marrow fibrosis are poorly documented. We hypothesised that the severity of PHPT may contribute to the development of this complication.
Methods: We identified two clinical cases managed within our clinical service and reviewed case reports and cohort studies using search terms, inter alia, 'primary hyperparathyroidism,' 'pancytopenia,' 'myelofibrosis' and 'bone marrow fibrosis,' utilising PubMed, Google Scholar, Microsoft Academic Search and Web of Science. We excluded patients with chronic renal failure and/or secondary hyperparathyroidism. Studies lacking a histological assessment of bone marrow were also excluded.
Results: We identified a total of 41 reports that satisfied our search criteria, comprising individual cases and three previously reported cohorts. Of these, 27 cases were excluded as they had secondary hyperparathyroidism from renal failure, or because an alternative aetiology for bone marrow fibrosis, such as toxin exposure, was identified. In addition, one large cohort of patients with PHPT and cytopenia was excluded due to the absence of a bone marrow biopsy and missing key biochemical and skeletal data. The included reports consisted of 11 individual cases of bone marrow fibrosis associated with PHPT, along with 2 small cohorts of 17 and 8 patients, respectively. Common clinical features across the 11 case reports included markedly elevated parathyroid…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 17 participants or records.
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.