Primary Hyperparathyroidism: A Tale of Two Cities Revisited — New York and Shanghai

摘要: In the 1970s, with advent of biochemical multichannel screening in United States and other western countries, clinical presentation primary hyperparathyroidism (PHPT) changed from a symptomatic to an asymptomatic disorder. However, Asian like China, PHPT did not show this evolution, but rather continued be disease target organ involvement. paper, we revisit features New York Shanghai, representative Chinese cites, over past decade. The questions address are whether evolved China more one and, further changes evident. results indicate that while continues present primarily as States, new phenotype characterized by normal serum calcium high parathyroid hormone levels, normocalcemic PHPT, has emerged. Data Shanghai demonstrates trend for commonly disorder China. most patients still manifest classical symptoms, i.e. nephrolithiasis fractures. A comparison two cohorts shows younger, higher PTH lower 25-hydroxyvitamin D levels than York. Normocalcemic yet been recognized Shanghai. summary, although phenotypes both cities evolving towards less evident disease, sharp differences apparent expressed States.