Primary hyperparathyroidism is associated with subclinical peripheral neural alterations

Endocr Pract. 2013 Mar-Apr;19(2):219-25. doi: 10.4158/EP12207.OR.

Abstract

Objective: Some case reports have suggested primary hyperparathyroidism (PHPT) and peripheral polyneuropathy (PPN) are associated; however, there are no reports of studies examining this possible relationship. The aim of this study was to evaluate peripheral nerve conduction in subjects with PHPT.

Methods: The study involved 17 patients with PHPT. Mean patient age was 60.5 ± 12.9 years, serum calcium concentration was 11.5 ± 1.0 mg/dL, and the serum parathyroid hormone (PTH) level was 315 ± 569 pg/dL. The control group comprised 17 individuals without PHPT. The mean age of controls was 60.8 ± 12.5 years and the serum calcium concentration was 9.8 ± 0.3 mg/dL. Motor and sensory nerve conduction was assessed by electroneurography (ENG).

Results: The following ENG parameters differed significantly between the PHPT and control groups: right (R) sural sensory nerve action potential conduction velocity (52.7 ± 6.3 m/s versus 58.0 ± 8.0 m/s; P = .041); R median compound muscle action potential (CMAP) amplitude (7.4 ± 1.6 mV versus 8.9 ± 1.7 mV; P = .002); R median CMAP latency (4.3 ± 1.2 ms versus 3.6 ± 0.6 ms; P = .032); R tibial CMAP latency (4.2 ± 1.1 ms versus 3.3 ± 0.4 ms; P = .001). The neurological examination was normal in all patients.

Conclusion: Our data demonstrate an association between PHPT and peripheral neurological alterations, consistent with subclinical sensory-motor PPN.

MeSH terms

  • Action Potentials
  • Aged
  • Calcium / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypercalcemia / etiology
  • Hyperparathyroidism, Primary / blood
  • Hyperparathyroidism, Primary / metabolism
  • Hyperparathyroidism, Primary / physiopathology*
  • Male
  • Median Nerve / metabolism
  • Median Nerve / physiopathology
  • Middle Aged
  • Motor Neurons / metabolism
  • Neural Conduction
  • Parathyroid Hormone / blood
  • Peripheral Nervous System / metabolism
  • Peripheral Nervous System / physiopathology*
  • Polyneuropathies / etiology*
  • Polyneuropathies / physiopathology
  • Sensory Receptor Cells / metabolism
  • Severity of Illness Index
  • Sural Nerve / metabolism
  • Sural Nerve / physiopathology
  • Tibial Nerve / metabolism
  • Tibial Nerve / physiopathology

Substances

  • PTH protein, human
  • Parathyroid Hormone
  • Calcium