Suat ŞEN, Fettah ACIBUCU, Asım TEKIN, Neşe BÜLBÜL, Ekin Yiğit KÖROĞLU

Review of Clinical and Laboratory Findings of Patients with Primary Hyperparathyroidism by the Literature

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by hypercalcemia and a high or normal parathyroid hormone (PTH) level inconsistent with calcium. Complications caused by hypercalcemia or excess PTH in patients affect many systems. Therefore, early diagnosis of PHPT can help prevent complications and determine the treatment. Method: In our study, a total of 154 patients, 122 women and 32 men, who were diagnosed with PHPT in the Endocrinology outpatient clinic were retrospectively reviewed and evaluated in the light of the literature. Results: The mean age of the patients was 53.83±13.80 years. Detected mean values for calcium were 11.83±1.28 mg/dl, for phosphorus 2.47±0.57 mg/dl, for PTH 357.32±424.08 pg/ml, for vitamin 25OH D₃ 16.58±9.57 ng/ml, for estimated glomerular filtration rate (eGFR) was 99.03±23.84 ml/min/1.7 and for urinary calcium amount was 381.80±204.11 mg/24h. Bone mineral density (BMD) measurements were made in 64.3% (n: 99) of the patients, 38.4 % (n: 38) had osteopenia, and 42.4 % (n: 42) had osteoporosis. A history of urinary stones was found in 35.7% (n: 55) of the patients, and stone findings were found on ultrasonography in 36.1 % (n: 35). In total, 37% (n: 57) of the cases developed nephrolithiasis as a complication. In the localization study, adenoma was detected in 76.8% (n: 116) of the patients by ultrasonography, while 70.7% (n: 106) were found positive by Tc99 sestamibi scan. The lower right part was the most commonly detected adenoma localization in both imaging. In the pathology results of the operated patients, 91.5% (n: 118) were reported as adenomas. In the follow-up of the operated patients, recurrence was detected in 4.6% (n: 6). Conclusion: Early diagnosis and treatment of PHPT are important to prevent serious complications. The absence of serious complications in the cases in our study shows the importance of early diagnosis.

Keywords:

primary hyperparathyroidism, hypercalcemia, nephrolithiasis, osteoporosis,

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