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From the Editor-in-Chief

he theme of this issue of Clinical Cases in Mineral and Bone Metabolism is Primary Hypoparathyroidism. Primary Hypoparathyroidism is a disorder of mineral metabolism in which hypocalcemia and hyperphosphatemia are the result of an inappropriately low parathyroid hormone action. The Primary Hypoparathyroidism syndromes are diverse and their diversity is a characteristic both clinically important and instructive when basic pathogenetic mechanisms are considered.

In many respects, what is happening in Primary Hypoparathyroidism mirrors the situation in other disorders of mineral metabolism. The last decade has witnessed major advances in the under-standing of the molecular basis of Primary Hypoparathyroidism syndromes. The progress in the genetic studies has made possible the identification of abnormalities of specific genes or of the chromosomal location of the mutant gene. Currently, for the clinician and family, recognition and early detection of the syndromes can contribute to the prevention of illness and, in some cases, death. It is understandable that scientists and clinicians are now confronting new questions. Some are basic issues, involving the identification of new genes and their mutations. Other are challenges for diagnosis and treatment: Have we adopted genetic diagnosis when needed, and have we offered all the available therapeutic approaches to our patients?

Although the problem has surfaced most widely in groups of experts, the reality is that the grand medical challenge of our generation is to educate the clinicians involved in the management of mineral metabolic disorders. We are learning an important lesson: that not field stands alone in the mineral and bone metabolism. Progress in anyone area is absolutely dependent on progress in many other domains. Under-standing of mechanisms in Primary Hypoparathyroidism syndromes could rapidly ensure an appropriate differential diagnosis.

And of course, this is an opportune moment for review. In this issue of Clinical Cases of Mineral and Bone Metabolism, we have brought together a unique collection of special features written by author-ities in the field. You will find Mini-reviews and Articles on mechanisms, molecules, genes, and ther-apeutic approaches to Primary Hypoparathyroidism. Management of Hypoparathyroidism is the focus of a Consensus Statement by Karen K. Winer, John T. Potts, Laura Masi and Maria Luisa Brandi. We are particularly pleased to have been able to include original Case Reports on Primary Hypoparathyroidism.

I hope that the readers of Clinical Cases in Mineral and Bone Metabolism will particularly enjoy the contributions of this issue, all of which focus on this important and scientifically exciting area of cutting-edge mineral metabolic research.

Maria Luisa Brandi, M.D., Ph.D.

T

FOR REVIEW ONLY

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