Endocrine Abstracts

There is limited data on primary hyperparathyroidism in Nepal. We did a retrospective study, where we analyzed data of sixteen patients who presented in our endocrine clinic from January 2016 to December 2022. Among them 10 patients (62.5%) were female and 6 (37.5%) were male. The mean age of the patients was 53.88 +/- 17.72 years ranging from 24 to 82 years. The mean BMI of the patients was 28.38 +/- 5.22 kg/m². The most common presenting features were bone and joint pain (38.89%) followed by fatigue and muscle weakness (33.33% each). Renal calculi were present in seven cases (38.89%). Two patients (12.5%) had acute pancreatitis. Hypertension was present in 50% of the cases and diabetes was present in 2 cases only (12.5%). DEXA san was done in 4 patients (25%); one patient had osteoporosis and two had osteopenia. No patient had fragility fracture. Mean eGFR was 73 +/- 21.10 ml/min/1.73 m2. The mean corrected serum calcium concentration was 12.12 +/- 2.65 mg/dl. The mean serum 25(OH) Vitamin D concentration was 24.05 +/- 13.55 ng/ml. The mean parathyroid hormone was 342.56 +/- 231.35 pg/ml ranging from 81.80 pg/ml to 926.90 pg/ml. Serum phosphorus level was investigated in fourteen patients and the mean phosphorus level was 2.80 +/ 0.76 mg/dl. 24hr urinary calcium was evaluated among 10 patients and the mean was 295.07+/-133.67 mg. Ultrasonography of neck was done in thirteen patients; among them parathyroid adenoma was seen in 10 patients (76.92%). Sestamibi scan was done in all patients which showed parathyroid adenoma in thirteen patients (81.25%) and in three patients (18.75 %) there was no evidence of parathyroid adenoma. Seven of them (53.84%) had left inferior parathyroid adenoma whereas five (38.46%) had right inferior parathyroid adenoma and one (7.69%) patient had left superior parathyroid adenoma. Ten patients (62.5%) underwent surgery to remove parathyroid adenoma. Six patients (37.5%) refused surgery. Patients who refused surgery received Cinacalcet. Before surgery, two patients received IV Zolendronic acid. Postoperatively the mean PTH was 39.32 +/- 27.29 pg/ml ranging from 2 to 126 pg/ml. The mean corrected serum calcium was 9.13 +/- 0.82 mg/dl and the mean serum phosphorus of seven patients was 2.9 +/- 0.38 mg/dl.