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Disease of bones,stones,abdominal groans and psychiatric moans

Primary hyperparathyroidism is described as "a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands"

The signs and symptoms of primary hyperparathyroidism are those of hypercalcemia. They are classically summarized by the mnemonic "stones, bones, abdominal groans and psychiatric moans".

* "Stones" refers to kidney stones, nephrocalcinosis, and diabetes insipidus (polyuria and polydipsia). These can ultimately lead to renal failure.
* "Bones" refers to bone-related complications. The classic bone disease in hyperparathyroidism is osteitis fibrosa cystica, which results in pain and sometimes pathological fractures. Other bone diseases associated with hyperparathyroidism are osteoporosis, osteomalacia, and arthritis.
* "Abdominal groans" refers to gastrointestinal symptoms of constipation, indigestion, nausea and vomiting. Hypercalcemia can lead to peptic ulcers and acute pancreatitis.
* "Psychiatric moans" refers to effects on the central nervous system. Symptoms include lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma.

The German description of the same symptoms is "Stein-, Bein- und Magenpein", literally "stone, leg, and stomach-pain".

In 1990, A National Institutes of Health (NIH) consensus panel defined renal stones in patients with primary hyperparathyroidism as an absolute indication for parathyroidectomy.
2-year-old woman  underwent parathyroidectomy for primary hyperparathyroidism. Sonogram of left kidney shows multiple calculi (arrows).

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