Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHP), is generalized with calcium, phosphate, and bone metabolism disorder due to increased PTH secretion. It’s common in fifth and sixth decades. Nowadays, it’s widely detected by measurement of blood calcium and may be presented with minimal or no symptoms.

Design: 102 patients with PHP admitted to Department of Endocrinology, between years of 2008–2013 were analyzed.

Results: The sample included 80 females and 22 males. Mean age was 54.6±10.9. Mean level of serum calcium was 12.03 (9.4–18.4) mg/dl (normal range 8.9–10.3), phosphorus was 2.7 mg/dl (normal range 2.4–4.7), PTH was 364.5 pg/ml (12–88), and 24 h urine calcium was 470 mg/24 h (100–300). In ultrasonography, adenoma was detected in 66 of patients. Average adenoma size was 15.76 mm (min size 6 mm and max size 60 mm). Parathyroid MIBI scintigraphy was performed in 90 patients and in 70 of them adenomas were detected. Adenomas were most frequently in right inferior localization (52.7%). Bone densitometry was performed in 60 patients and 33 osteoporosis and 20 osteopenia were detected. 22 patients had history of nephrolithiasis. Preoperatively, fine-needle biopsy was performed for thyroid nodule/adenoma differentiation and PTH washing was analysed in ten patients. The average value was 2235±1488 pg/ml. Minimally invasive surgery (MIS) was performed in 33 patients, open surgery (OS) was performed in 56 patients. In pathological evaluation, 71 of 89 patients had parathyroid adenoma, 14 of them had parathyroid hyperplasia, and three of them had parathyroid carcinoma.

Conclusion: The majority of our patients (63%) were treated with OS. MIS has lower morbidity than OS in literature. If we cannot define the adenomas with radiologic and scintigraphic methods, fine-needle biopsy and PTH wash can be used. In this way, more patients may have the chance of MIS.