Endocrine Abstracts

Objective: To describe the clinical characteristics and post-surgical outcome of our primary hyperparathyroidism case series.

Methods: A retrospective cohort study of primary hyperparathyroidism patients who underwent surgery in the last 10 years in our centre. The medical records were reviewed to extract data. A statistical descriptive analysis was performed using mean and S.D. for continuous variables and percentages for qualitative variables.

Results: Sixty-three patients were included (83% women). Mean age: 58.2±15. 78% of patients were referred for altered blood tests, 20% for clinical symptoms, and 2% for imaging findings. Serum biochemistry tests results are showed in Table 1. 52.3% of patients had associated nephrocalcinosis, 47.6% high blood pressure, 31.7% osteoporosis, 20.6% renal insufficiency, and 17.6% altered hydrocarbon metabolism. One patient was diagnosed with multiple endocrine neoplasia. 99mTC was performed in 37 patients: 73% showed focal uptake. 54 patients underwent an ultrasonographic test of which 29.6% showed a parathyroid disorder. 44% of patients fulfilled the clinical criteria for surgery. Of these, 56% were asymptomatic at the time of the surgery. Anatomic pathology results were as follows: 74% adenoma, 23% hyperplasia, and 3% carcinoma. The recovery rate was 88.7% (87% of adenomas and 93% of hyperplasias). The post-surgical permanent complications were: 4.8% hypoparathyroidism and 4.8% vocal paralysis. Patients without a pre-surgery scintigraphy had more complications compared to those who had it (30.8 vs 8.3%).

Conclusions: Primary hyperparathyrodism is more common in women over the age of 50. Post-surgical complications and recovery rates in our cohort are similar to other published series. Recovery is not associated with pathology. 99mTc is the most useful diagnostic procedure and is associated with fewer post-surgical complications.