porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo9783porozendo-9783Research ArticleНаучный обзорReviewПатологические изменения в суставах и мышцах при первичном гиперпаратиреозеJoint and muscle involvement in primary hyperparathyroidismhttps://orcid.org/0000-0002-9717-9742МокрышеваНаталья ГеоргиевнаMokryshevaNatalia G.

д.м.н. заведующая отделением патологии околощитовидных желез, заместитель директора Центра - исполнительный директор

MD, PhD

nm70@mail.ruhttps://orcid.org/0000-0001-6667-062XЕремкинаАнна КонстантиновнаEremkinaAnna K.

к.м.н., и.о. зав. отделением патологии околощитовидных желез

PhD

a.lipatenkova@gmail.comhttps://orcid.org/0000-0002-1341-0397МирнаяСветлана СергеевнаMirnayaSvetlana S.

к.м.н. научный сотрудник отделения патологии околощитовидных желез

MD, PhD

svetlanamirnaya@yahoo.comhttps://orcid.org/0000-0003-3355-2744ВолодичеваВиктория ЛеонидовнаVolodichevaVictoria L.

научный сотрудник отделения патологии околощитовидных желез

MD

volodicheva.v.l@gmail.comhttps://orcid.org/0000-0002-5290-156XПаневинТарас СергеевичPanevinTaras S.

врач-ревматолог консультативно-диагностического отдела

MD

tarasel@list.ruhttps://orcid.org/0000-0002-5634-7877МельниченкоГалина АфанасьевнаMelnichenkoGalina A.

д.м.н., профессор, академик РАН, директор Института клинической эндокринологии

MD, PhD

teofrast2000@mail.ru<p>ФГБУ &laquo;Научный медицинский исследовательский центр эндокринологии&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation2018040920192141018Copyright &#x00A9; Мокрышева Н.Г., Еремкина А.К., Мирная С.С., Володичева В.Л., Паневин Т.С., Мельниченко Г.А., 20182018Мокрышева Н.Г., Еремкина А.К., Мирная С.С., Володичева В.Л., Паневин Т.С., Мельниченко Г.А.Mokrysheva N.G., Eremkina A.K., Mirnaya S.S., Volodicheva V.L., Panevin T.S., Melnichenko G.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/9783

По результатам многочисленных исследований первичный гиперпаратиреоз ассоциирован не только с классическими осложнениями заболевания со стороны костной, почечной систем и желудочно-кишечного тракта, но и сопровождается другими «неклассическими» проявлениями, в том числе развитием мышечной и суставной патологии. В ряде случаев повреждения суставов и мышц могут выступать в качестве единственных и доминирующих симптомов заболевания. Несмотря на сравнительно длительный период наблюдения пациентов с первичным гиперпаратиреозом, истинная распространенность мышечно-суставной патологии у данной категории больных остается неизвестной. Расхождения в результатах исследований могут быть обусловлены разнообразием неспецифических симптомов, предъявляемых пациентами, неоднородностью выборки, отсутствием поправки на коморбидные состояния и формы заболевания, вариабельностью в объективных методах оценки. Тем не менее, поражение суставов и мышц зачастую не привлекает должного внимания специалистов при первичной оценке статуса больного, что может повлечь за собой снижение качества жизни и повышение риска инвалидизации, в первую очередь, в результате возникновения переломов. Большинство работ продемонстрировало значимое улучшение функционального мышечного статуса после успешной паратиреоидэктомии. Данные по суставным нарушениям остаются неоднозначными. Фундаментальные исследования, посвященные патогенетическим аспектам и динамике развития мышечно-суставной патологии при первичном гиперпаратиреозе, ограничены. Большинство исследований по гиперпаратиреозу посвящено оценке поражения костной ткани, что послужило поводом для создания аналитического обзора по данной проблеме.

In addition to the classical symptoms such as osteoporosis, renal stones and gastric ulcers primary hyperparathyroidism (PHPT) could be presented with “non-classical” manifestations, including muscle and joint pathology. Moreover, in some cases the articular and neuromuscular impairment might be the main signs of the disease. Despite the long research history the true prevalence of these PHPT complications remains unknown. Discrepancies in studies results may be due the non-specific and different symptoms that patients complain about, various study design, uncorrected comorbid conditions, the different PHPT populations, a wide methods variety in the assessment of neuromuscular and articular involvement. However, the underestimated muscle dysfunction and joint damage can lead to decreased quality of life and disability, primarily from fragility fractures. In the majority of the studies parathyroidectomy improved muscle strength, but there is no clear results for articular manifestations. Basic research and large randomized control trials are limited. The main goal of this review is to summarize currently available data on muscle and joint involvement in patients with PHPT.

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The authors declare that there are no conflicts of interest present.