ASSOCIATION BETWEEN PAGETS-DISEASE AND PR IMARY HYPERPARATHYROIDISM

Association between primary hyperparathyroidism and Paget's disease of bone is extremely uncommon, despite the relatively high incidence of both entities. The mechanism of this association remains unknown. Dram atic changes in parathyroid function are found in patients with Paget' s disease and, on the other hand, the evolution of Paget's disease is influenced by parathyroid functional disorders. We reviewed 175 patien ts with Paget's disease and 60 with primary hyperparathyroidism, follo wed during 10 years. We only found 5 cases with the association of the two diseases. Approximately equal number were male and female (ratio: 1.5/1) patients and the average age was 63.60 +/- 2.65 years. Hyperca lcemia in Paget's patients, and an increase in alkaline phosphatase in post parathyroid adenoma surgery patients were the clues that suggest ed the presence of the second disease. Surgical treatment was indicate d in 3 patients, and the others were treated with antiresorptive drugs . We also reviewed the cases published since 1934, comparing their dia gnostic, clinical, treatment and evolution features with our own cases .