ECE2017 Guided Posters Bone & Calcium Homeostasis 1 (10 abstracts)
“Hyperparanet”: a multicenter Italian study on Primary Hyperparathyroidism
Federica Saponaro 1 , Filomena Cetani 1 , Valentina Camozzi 2 , Antonella D’Angelo 3 , Salvatore Minisola 3 , Alfredo Scillitani 4 , Claudia Cipri 5 , Serena Palmieri 6 , Iacopo Chiodini 6 , Francesco Romanelli 7 , Bruno Madeo 8 , Elena Castellano 9 , Laura Gianotti 9 , Antongiulio Faggiano 10 , Luisella Cianferotti 11 , Maria Luisa Brandi 11 , Sabrina Corbetta 12 , Maria Laura De Feo 13 , Andrea Palermo 14 & Claudio Marcocci 1
1Endocrine Unit 2, University of Pisa, Pisa, Italy; 2Endocrine Unit, University of Padova, Padova, Italy; 3Department of Internal Medicine and Medical Disciplines’Sapienza’ University, Rome, Italy; 4Casa Sollievo della Sofferenza,’’ IRCCS, San Giovanni Rotondo, Italy; 5Endocrinology and Metabolism Unit University-Hospital of Udine, Udine, Italy; 6Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy; 7Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; 8Unit of Endocrinology, Modena, Italy; 9Division of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy; 10Endocrinology, Federico II University of Naples, Naples, Italy; 11Department of Internal Medicine, University of Florence, Florence, Italy; 12Area di Endocrinologia e Malattie Metaboliche, IRCCS Policlinico San Donato, Milano, Italy; 13Endocrinology Unit, Careggi Hospital and University of Florence, Florence, Italy; 14Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.
The aim of the present study was to evaluate the phenotype of PHPT, the adherence to International Guidelines and the rate of surgical cure of PHPT in Italy. From January 2014–January 2016, we conducted a prospective, multicenter (n=29 endocrine tertiary referral centers) study on patients with PHPT, recording clinical and biochemical data, parathyroid imaging and therapy choice at baseline and at last follow-up. The study group included 604 patients with PHPT, with a mean age of 61±14 yrs (F:M=5:1). Most patients had sporadic PHPT (n=566 (93.7%), mean age 63±13 yrs); the remaining 38 (6.3%, mean age 41±17 yrs) were familial forms. Follow up data were available in 345 patients: 158 (45.8%) with symptomatic and 187 (54.2%) with asymptomatic PHPT. Eighty-six patients (54.4%) of the former group underwent PTx, mainly for symptomatic nephrolithiasis (n=71, 82.6%). One hundred twenty-one asymptomatic patients (64.7%) met at least one criterion for PTx according to the 2008 International guidelines for parathyroidectomy and 65 patients (53.7%) underwent surgery. Criteria for PTX were: serum calcium levels 1 mg above the upper normal limit (n=37, 56.9%), osteoporosis (n=35, 53.8%) and age <50 yrs (n=14, 21.5%). Surgery was not performed in the remaining patients (n=56, 46.3%) despite the presence of serum calcium levels 1 mg above the upper normal limit (n=12, 21.4%), osteoporosis (n=44, 78.6%) and age <50 yrs (n=11, 19.6%). Surgery was also performed in 16 of the 66 (25.7%) patients who did not meet the criteria for surgery. A total of 168 patients underwent PTX. The histological diagnosis was single adenoma in 89% of cases, hyperplasia in 9%, atypical adenoma in 1%, and carcinoma in 1%. The large majority (n=158, 94%) of patients were cured. Persistence of PHPT was observed in the remaining 10 patients, who were apparently sporadic. Patients followed without surgery showed a stable clinical and biochemical disease, after one year of follow-up. This is the first multicenter Italian study with the specific aim of evaluating PHPT phenotype and therapeutic approach. International guidelines recommendations for surgery were observed in half of cases, either for symptomatic or asymptomatic patients.
Volume 49
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Endocrine Abstracts
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