Endocrine Abstracts

Background The combination of primary hyperparathyroidism (PHPT) with anemia was first described in 1931. It remains unclear whether PHPT is the direct cause of anemia, or it develops as a PHPT’s complication. The etiology of anemia in PHPT could be multifactorial, including iron deficiency, renal failure as well as bone marrow fibrosis.

Aim To assess the prevalence of anemia in patients with PHPT admitted to the Department of Parathyroid Glands Pathology of the Endocrinology Research Centre from January 2017 to August 2020.

Materials and Methods The study included patients with PHPT over 18 years old. A single-center observational one-stage one-sample uncontrolled study was carried out. We analyzed laboratory and instrumental data obtained during inpatient examination in accordance with the standards of medical care. Statistical analysis was performed using Statistica 13 (StatSoft, USA) and SPSS (IBM, USA) software.

Results The study included 327 patients with PHPT, 28(9%) men and 299(91%) women. The median age was 59 years [51;66]. 26 patients (8%) with anemia were identified. Significant differences between patients with and without anemia were found only in the GFR. Comparison of patients with and without anemia didn’t reveal any significant differences in the incidence of PHPT’s complications. Significant differences in serum hemoglobin concentration and average hemoglobin concentration in erythrocytes were revealed between patients with and without vertebrae fractures. In the group of patients without compression fractures these parameters were higher (p<0.001 for both). In the subgroup of patients with total calcium >3 mmol/l and iPTH >3 normal values, the incidence of anemia reached 21% (95% CI: 10%;35%). Within this subgroup we revealed tendencies to higher levels of iPTH, ionized calcium and osteocalcin in patients with anemia.

Conclusion We did not find any correlations between hypercalcemia, iPTH levels and the presence of anemia in the general group. However, in the subgroup of patients with severe hypercalcemia, there was a relationship between the iPTH, ionized calcium and the incidence of anemia. In patients with PHPT and vertebral fractures, significantly lower concentrations of blood hemoglobin and hemoglobin in erythrocytes were observed.