Endocrine Abstracts

Introduction

The association between vitamin D deficiency and primary hyperparathyroidism( PHP) has clear implications. Co-existing vitamin D deficiency may cause the serum calcium level to fall into the normal range, which can lead to diagnostic uncertainty. The objective of this study is to assess the vitamin D status of patients followed for primary hyperparathyroidism.

Materials and methods

This is a retrospective study conducted at the endocrinology department of EPH Bologhine in Algiers between 2013 and 2017, involving 21 patients followed for primary hyperparathyroidism. The diagnosis of PHP was made in the presence of normal or elevated serum calcium in relation to inappropriate PTH with elimination of secondary hyperparathyroidism. The 25OHD assay was performed in 16 patients.

Results

The mean age of the patients was 56.5 years. These were 20 women and only one man diagnosed with a familial form. HPP was asymptomatic in 47.6%. The mean serum calcium was 2.98 mmol/l. The mean PTH was 475 ng/l. The mean 25OHD level was 14.42 ng/ml. 87.5% of patients had 25OHD <30 ng/ml, 81.2% had 25OHD <20 ng/ml) and 25OHD <10 ng/ml was found in 43% of patients. Osteodensitometry was performed in 13 patients, it was normal in 2 patients, osteoporosis was found in 69.2% (9 cases) and osteopenia in 15.4 cases.

Discussion

Vitamin D deficiency and insufficiency seem to be more prevalent in patients with primary hyperparathyroidism than in geographically matched populations. Regardless of the clinical severity of primary hyperparathyroidism, the disease seems to be more severe in those with concomitant vitamin D deficiency.

Conclusion

Vitamin D insufficiency is very common in patients with primary hyperparathyroidism. Vitamin D deficiency is associated with high blood calcium and high PTH levels. Recent recommendations from learned societies propose a systematic dosage of 25OHD in all patients with primary hyperparathyroidism.