Endocrine Abstracts

Objective: Primary hyperparathyroidism (PHPT) is one of the most frequently diagnosed endocrine disorders. The Russian Registry of PHPT is an on-line web-based database created in 2016 with the aim to estimate the disease prevalence and improve the quality of health care for such patients in Russian Federation. The Endocrinology Research Centre, Moscow represents The Head organization.

Material and methods: We retrieved retrospective data submitted to the Russian PHPT registry (http://pgpt.clin-reg.ru/) between 2007 and 2017 from 10 geographical regions connected at the moment. The clinical, biochemical, radiological and histopathological characteristics of PHPT patients were analyzed for similarity and variability across the centers. There were registered 1914 patients with different forms of PHPT (hypercalcemic, normocalcemic, sporadic and hereditary cases).

Results: The median age of the all patients at the time of diagnosis (1744 women and 170 men) was 55,6±10 years. The median duration from disease onset till diagnosis was 2 years in Moscow and 5 years in other regions. According to the Registry the sporadic PHPT was the most frequent form and caused by solitary adenoma. The estimated incidence of parathyroid cancer was 2% comparable with other epidemiological studies. PHPT as a MEN syndrome component occurred in 9% of cases. We included cases confirmed by genetic testing for mutations in the MEN-1 gene (9%) as well as cases with clinical features of MEN 1 syndrome. The most frequent components were pituitary adenoma (30%), adrenal adenoma (27%), pancreatic neoplasm (13,9%). The normocalcemic PHPT with median calcium level 2.45±0.1 mmol/l was observed in 11.7%. The majority of patients were symptomatic (74%). Common clinical manifestations among all PHPT subjects were law trauma fracture and osteoporosis (20% and 8% respectively) nephrolithiasis and/or decrease in glomerular filtration rate (25%), cardiovascular complications (59%), upper gastrointestinal complications (12%). Mean serum calcium, and parathyroid hormone levels in hypercalcemic forms were 2.75 mmol/l±0.2 and 250±300 pg/mL respectively. Surgical treatment was performed in 65% cases with recurrence rate 5.1%.

Conclusion: PHPT considerably influences the Russian healthcare system. We observed a tendency to progressive increase in disease detectability. It should be noted that compared to European countries, the symptomatic PHPT is more likely to be diagnosed, which indicates delayed diagnosis because of no routine screening of serum calcium level.