Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHPT) is associated with adverse effects especially on the bones and kidney. While nowadays it is mostly diagnosed at an asymptomatic stage, patients with overt involvement of the target organs at the time of diagnosis are still encountered.

Aim: To explore the frequency of disease complications already present at the time of diagnosis in a cohort of patients with sporadic PHPT who meet the current surgical guidelines criteria.

Material and methods: We retrospectively selected a cohort of patients consecutively diagnosed with PHPT in whom surgical intervention was recommended. We collected from patients’ files biochemical and medical history data.

Results: 54 patients (50 women-92.6%, 4 men) with a median age of 64 years (28–75) with sporadic PHPT were included. The serum calcium level ranged between 9.7–19.2 mg/dl (median 11.5) with a corresponding PTH level between 72.4–10 370 pg/ml (median 185.3). Serum 25OHD level was 4–26 ng/ml (median 14 ng/ml). The most frequent complications at diagnosis were osteoporosis, kidney stones, decreased estimated glomerular filtration rate (eGFR). 48.38% of cases had a lumbar-spine T-score <−2.5 S.D. ([−4.2;0.2], median −2.5) and the percentage was 52.35 for distal third radius ([−5.1;0.47], median −2.6). 5.6 % of patients had prevalent fragility fractures. eGFR was also affected in many cases: only 25% of patients had a GFR>90 ml/min and 41.67% between 60 and 90 ml/min; 57.4% had kidney stones.

Conclusions: Despite the increased use of screening methods aimed to diagnose early-stage PHPT, the rate of complications at the time of diagnosis in patients with surgical indications is still elevated.