Hyperparathyroidism and anemia: an underestimated relationship?
Keywords:
Hyperparathyroidism, anemia, translational medicineAbstract
The relationship between hyperparathyroidism (HPT) and anemia, although supported by growing evidence, remains underestimated in clinical practice. HPT, both primary and secondary, has traditionally been associated with bone and kidney abnormalities, but recent studies suggest that parathyroid hormone (PTH) also affects erythropoiesis, contributing to the development of anemia. This connection is crucial for three main reasons: 1) Clinical prevalence: up to 40% of patients with primary HPT present with anemia, which improves after parathyroidectomy, indicating a frequently overlooked causal relationship. 2) Therapeutic implications: correcting HPT could be key in refractory anemia, where conventional treatments (iron, erythropoietin) fail. 3) Mechanisms to be elucidated: although suppressive effects of PTH on bone marrow, iron abnormalities and inflammation are proposed, the exact processes remain undefined, limiting specific approaches.
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