ECE2023 Poster Presentations Calcium and Bone (83 abstracts)
Clinical Features of Patients with Primary Hyperparathyroidism in Mugla: A Single-Center Experience
Kenan Sakar 1 , Anil Ugurlu 2 , Irmak Taskiran Uyar 2 , Gulhan Akbaba 1 , Ismail Kirli 2 , Nesat Cullu 3 , Onder Ozcan 4 , Ozcan Dere 4 , Ozan Kandemir 5 , Yelda Dere 6 & Nese Cinar 1
1Mugla Sitki Kocman University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Mugla, Turkey; 2Mugla Sitki Kocman University Faculty of Medicine, Department of Internal Medicine, Mugla, Turkey; 3Mugla Sitki Kocman University Faculty of Medicine, Department of Radiology, Mugla, Turkey; 4Mugla Sitki Kocman University Faculty of Medicine, Department of General Surgery, Mugla, Turkey; 5Mugla Sitki Kocman University Faculty of Medicine, Department of Nuclear Medicine, Mugla, Turkey; 6Mugla Sitki Kocman University Faculty of Medicine, Department of Pathology, Mugla, Turkey
Introduction: Primary hyperparathyroidism (pHPT) is the third most frequently seen endocrine disease with autonomous overproduction of parathyroid hormone (PTH) in one or more parathyroid glands. It’s associated with osteoporosis, bone fractures, nephrolithiasis, renal failure and increased cardiovascular risk. We aimed to investigate the distribution of the clinical manifestations and biochemical features in patients with pHPT.
Methods: A retrospective study was performed in 156 patients [19M (12.2%)/137F (87.8%)] with pHPT. The patients’ comorbidities, complications, laboratory results, preoperative imaging findings and postoperative pathology results were recorded.
Results: The mean age of the patients was 59.49±12.38 years. The mean calcium level was 11.12±1.05 mg/dl, the mean phosphorus level was 2.63±0.54 mg/dl, the mean parathormone level was 176.12±237.34 pg/ml, the mean 25(OH)D level was 22.19±11.49 ng/ml. Among patients, 70 (45%) had hypertension, 81 (51.9%) had osteoporosis, 46 (29.9%) had nephrolithiasis, 20 (12.9%) had a history of bone fracture. 19 of the patients (12.1%) had normocalcemic primary hyperparathyroidism with normal serum calcium and elevated PTH levels (NHPT). Of the patients with NHPT, 14 (73.7%) had hypertension, 11 (57.9%) patients had osteoporosis, 3 (15.8%) had nephrolithiasis and 4 (21.0%) had a history of bone fracture. The location of abnormal parathyroid gland was found in the ultrasound of 85 patients (62.5%) and in the parathyroid scintigraphy of 81 patients (63.3%). 73 patients (46.7%) were operated and among them, 68 patients had adenoma and 5 had hyperplasia in pathology reports. Among patients undergone surgery, 7 parathyroid adenomas were located in the right superior, 26 in the right inferior, 6 in left superior, 27 in left inferior part of the thyroid gland.
Discussion: The profile of pHPT is changing with older age at presentation. The most common complications of pHPT patients were osteoporosis and nephrolithiasis consistent with the literature. The emergence of nephrolithiasis and bone fracture is decreasing. The prevalence of NHPT was higher than other studies reporting prevalance between 0.5% and 0.7%. Complications such as osteoporosis and bone fracture were also commonly observed in patients with NHPT.
Conclusion: Most patients with PHPT in Mugla still exhibit classic clinical and biochemical features. Due to increased risk of complications in NPHPT patients, their complications should be well screened.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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