Primary hyper parathyroidism [PHPT] is a common endocrine disorder associated with increased serum calcium due to over secretion of Parathormone [PTH]. The early presentations of   patients with PHPT were dominated by those with Osteitis fibrosa csystica [OFC], Brown tumors of the long bones and associated subperiostal bone resorption, distal tapering of the clavicles and the classical ‘salt and pepper ‘erosions of the skull were typical findings .Over 80% of patients had associated renal stones, significant neuromuscular dysfunction and muscle weakness. This led to the traditional mnemonic of ‘bones, stones, abdominal groans, and psychiatric overtones’. Symptoms usually include neuromuscular weakness, fatigue, decreased concentration, and memory loss. Patients can also be presented with muscle and joint pains, peptic ulcers. The current pattern of clinical presentation of PHPT shifts from the classical symptomatic form to the asymptomatic form that the majority of the patients are now identified incidentally on routine biochemical investigations. In our institute there were 3 cases presented atypically with symptoms not related to PHPT although not suspected initially complete investigative workup revealed a solitary parathyroid adenomas with co existing PHPT.

Keywords: Primary Hyperparathyroidism, Parathormone, Osteitis Fibrosa Cystica, Hyperparathyroidism jaw tumor syndrome, Parathyroid adenoma.

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P.M. Prasanna Kumar

General Surgery Department, NRI General Hospital, Mangalagiri, Guntur District Andhra Pradesh, 522503, India

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