Endocrine Abstracts

Introduction: Hyperparathyroidism is defined by excessive secretion of parathyroid hormone (PTH) that is responsible for calcium regulation. Hyperparathyroidism can be primary in which the gland is affected and it produces PTH excessively or secondary or tertiary that cause hypersecretion of PTH as a regulatory response. The aim of our study was to describe patients with hyperparathyroidise diagnosed in internal medicine departement.

Methods: It was a retrospective descriptive study about patients hospitalized in the internal medicine ward between 2009 and 2019 and diagnosed with hyperparathyroidism.

Results: our study interested 12 patients with 3 men and 9 women. Mean age was 58 [35–80]. Three of them were hospitalized for malignant hypercalcemia. The other causes of hospitalisations were: flush Syndrom (n = 1), severe malabsorption (n = 1), profound anemia (n = 1), deterioration of the general status (n = 3) and a diagnosed systemic disease (n = 3). Medical history included kidney failure(n = 7) ,hypertension(n = 3), diabetes(n = 2),urinary lithiasis(n = 2), cardiac rhythm disorders (n = 3) and one of the patients had several episodes of pancreatitis.

– primary hyperparathyroidism was diagnosed in five patients.

– secondary hyperparathyroidism caused by kidney failure was diagnosed in 6 patients and the cause – was severe malabsorption due to coeliac disease in one case.

– general manifestations were the most to be found :weigh loss and asthenia (n = 10) Digestive signs such as epigastric pain and nausea (n = 8) with two cases of chronic gastritis.

Cervical echography showed the presence of thyroid nodule in five cases, with hypothyroidism for one of them. For one patient we found microprolactinoma and she is suspected to be a case of NEM1. Patients with primary hyperparathyroidism went through surgery with positive outcomes, when in secondary hyperparathyroidism calcium substitution was initiated.

Conclusion: Hyperparathyroidism is a common endocrine disease that can be asymptomatic or can be present with non-specific signs, but it can have severe manifestations and complications. It is frequent in adults and the elderly. This disease should be recognized at early stages to initiate optimal therapeutic strategy and have better outcomes such as reduced cardiovascular disease and improved survival.