Endocrine Abstracts

Key words: Primary hyperparathyroidsm-Bone complications-Renal complications and digestive complications.

Introduction

Primary hyperparathyroidism is a frequent endocrinopathy whose diagnosis is biological and linked to an inappropriate secretion of parathyroid hormone (PTH), wich leads to an altered phosphocalcic metabolism that can be responsible for numerous complications. The aim of this work is to evaluate the classical complications of primary hyperparathyroidism in our series: bone, digestive and renal.

Material and methods: Retrospective descriptive and analytical study including 44 patients followed for primary hyperparathyroidism between 2015 and 2021. Only classical complications (bone, kidney and digestive) were noticed in this work. Data were collected from medical records and analyzed by SPSS-V21 software.

Results: The mean age was 55±11 years, with a clear predominance of women in 77.3% of whom 80% were postmenopausal. 81% of the cases had hypercalcemia, including 36% with malignant hypercalcemia (n=13). The diagnosis of primary hyperparathyroidism was revealed by complications in 25% of cases (n=11).The impact assessementof hyperparathyroidism showed a remarkable effect on the skeletal system with osteoporosis in 60.7% of the cases, osteolytic bone lesions in 18% (n=8), the majority of which were of diffuse localization, and brown tumors in 13.6% of the cases (n=6), Fibrocystic osteitis was observed in 2 cases (4.5% of our series) and a pathological fracture in one patient. On the renal level, renal lithiasis complicating primary hyperparathyroidism in 31.8% (n=14) which 78.5% of the cases were bilateral (n=11) and complicated by nephrocalcinosis in 2 cases or 5.7%. Alteration of renal function was noted in 11.6% (n=5 and GFR: 30–60 ml/min). The digestive complications were mainly represented by acute pancreatitis in 3 patients (6.8%) and chronic calcifying pancreatitis in one case. On postoperative, Hungry bone syndrome complicated 6.81% of the cases or 3 cases in our series. On postoperative, Hungry bone syndrome complicated 6.81% of the cases or 3 cases in our series. The relationship between the bio-intact PTH 1–84 level and the occurrence of complications finds: a statically significant association with the occurrence of brown tumor as well as a statically significant correlation with osteolytic bone lesions, while no significant correlation with the occurrence of renal lithiasis, osteoporosis and pancreatitis and PTH level.

Discussion–Conclusion: Primary hyperparathyroidism is an endocrinopathy that is usually benign but remains a serious condition because of its bone, kidney and digestive complications.