Endocrine Abstracts

Key words: Primary hyperparathyroidism-PTH level –osteoporosis-osteolytic bone lesions-brown tumor

Introduction: Primary hyperparathyroidism is a frequent pathology responsible for an alteration of the phosphocalcic metabolism at the origin of numerous complications, in particular osseous. The objective of this work is to evaluate the bone impact of primary hyperparathyroidism in our series.

Matériel et méthodes: Retrospective descriptive and analytical study, including 44 patients followed for primary hyperparathyroidism over a period spanning 6 years from 2015 to 2021. Data were collected from medical records and analyzed by SPSS-V21 software.

Material and methods: The mean age was 55±11 years, with a clear female predominance with a sex ratio M/F=0.29 which 80% of the women were menopausal. Eighty-one percent of the cases had hypercalcemia with 36% of the cases presenting with malignant hypercalcemia.The assessment of the bone consequences of primary hyperparathyroidism showed osteoporosis in 58.6% of the cases with osteopenia in 24%. A pathological fracture revealed primary hyperparathyroidism in one case or in 2.3% of cases. The bone CT scan showed osteolytic bone lesions in 51.5% of the cases, the most of them were diffuse, brown tumors in 18.2% of the cases, most often of multiple locations, affecting the maxillomandibular region, pelvis (iliac bone and ischium), scapula and femoral neck respectively. Primary hyperpathyroidism was complicated by fibrocystic osteitis in one case, i.e. 2.3% of our series. Vitamin D deficiency was noted in all patients, with a deficiency in 61.4% of cases. six point eight percent of cases in our series (n=3) were complicated by Hungry bone syndrome and 3 cases (6.8%) by defenitive hypoparathyroidism. The relationship between the level of bio-intact PTH 1–84 and the occurrence of bone complications found: a statically significant association with the occurrence of brown tumor and osteolytic bone lesions and with Hungry bone syndrome, while no statically significant correlation with osteoporosis and bio-intact PTH 1–84 level.

Discussion–conclusion: Although primary hyperparathyroidism is a benign endocrinopathy, it remains a serious condition because of its complications, particularly bone complications, as shown by the results of our work in our series, which is in agreement with the literature. Early and adequate management can improve the prognosis of its complications.