Endocrine Abstracts

Introduction: Primary hyperparathyroidism is one of the most common endocrinopathies with an estimated prevalence in the general population of 1 to 6/1000.

Objective: To describe the epidemiological, clinical and biological characteristics of patients with primary hyperparathyroidism.

Patients and methods: Retrospective descriptive study, including patients hospitalized in the Endocrinology Department of the Ibn Rochd University Hospital of Casablanca from January 1988 to December 2022. The data collection was carried out with the help of the patients’ files, the data collected are the following: age, sex, pathological history, history of the disease, clinical examination, paraclinical examination, management, histological study of the operative part as well as the postoperative evolution. The analysis of the files was done with SPSS software.

Results: The mean age was 52.7 years (10-78), the sex ratio M/F was 0.16. Symptomatology was dominated by bone pain (63%), pathological fractures (42%) and digestive disorders. The mean blood calcium level was 126.19 mg/l. The 24-hour calciuria was elevated in 27 patients. The mean phosphorus level was 21.16 mg/l. Mean PTH was 993.11 pg/ml. The data from our study showed vitamin D deficiency in 83 with a mean Vit D level of 14.09 ng/dl. The average duration of symptoms was around 24 months. Pathological fracture was found in 46 patients, digestive disorder in 17 patients, renal lithiasis in 17 patients and vesicular lithiasis in 4 patients. 96 patients underwent cervical ultrasound, which revealed a parathyroid nodule in 78 cases. Scintigraphy was performed in 31 cases showing pathological fixation in 24 cases. CT scans were performed in 65 patients and revealed a parathyroid adenoma in 51 cases. 89 patients underwent surgery, with associated thyroid surgery in 49 patients. Pathological examination showed parathyroid adenoma in 76 cases, parathyroid hyperplasia in 10 cases and parathyroid carcinoma in 2 cases.

Conclusion: Primary hyperparathyroidism is a frequent endocrinopathy with clinical polymorphism, the main etiology being parathyroid adenoma. The main complications were pathological fractures and renal lithiasis.