All of the following are true regarding primary hyperparathyroidism except: September 200

Ans. A: Hypocalcemia Solitary parathyroid adenoma is the cause in nearly 80% of the patients.More than half of the patients are asymptomatic. The investigations in primary hyperparathyroidism include: Raised serum Calcium with high serum PTH Serum alkaline phosphatase - often normal but may be markedly increased in bone disease Serum phosphate: - Decreased in about half of cases - a Eaised serum phosphate suggests nonparathyroid hypercalcaemia - a Normal serum phosphate is not diagnostically useful/in case of renal failure Urine Ca - increased in most patients Metabolic acidosis is reflected by reduced plasma bicarbonate and high plasma chloride Bone radiographs - pathognomonic subperiosteal bone resorption of the phalanges; there may be loss of the lamina Jura of the teeth; in severe cases osteitis fibrosa cystica is present.