SFEBES2023 Poster Presentations Bone and Calcium (41 abstracts)
1University of Sheffield, Sheffield, United Kingdom. 2Metabolic Bone Centre, Sheffield, United Kingdom. 3Mellanby Centre for Musculoskeletal Research, Sheffield, United Kingdom
Background: At the Metabolic Bone Centre in Sheffield, UK, patients with asymptomatic primary hyperparathyroidism (PHPT) are followed up annually through a register, with annual blood tests, questionnaires inquiring about symptoms or renal stones within the past year, and biennial DXA scans, which doctors then evaluate. Patients are recalled to the clinic if their reported symptoms and/or biochemical results suggest abnormalities associated with PHPT requiring further assessment and intervention.
Objectives: This evaluation aims to describe the characteristics of the patients in the register and determine the effectiveness of the register in appropriately recalling its patients.
Methodology: A retrospective evaluation of all patients in the PHPT register since 2015 was conducted. The effectiveness was determined by identifying how many patients with indications for parathyroidectomy (according to international guidelines from 2015) were recalled to clinic.
Results: Ninety-two patients (mean age 73 ± 11 years, 87% female) were included in the evaluation. Their average duration in the register was 45 ± 20 months. Seventeen (18.7%) were recalled to clinic.
Indication assessed | Total No. of patients | No. of patients recalled |
Serum calcium >2.86 mmol/l | 2 | 1 |
New onset eGFR<60 ml/min1.73 m2 | 6 | 1 |
Sustained decrease in eGFR >25% | 2 | 0 |
New renal stone | 1 | 1 |
Indication assessed | Total no. of patients | No. of patients recalled |
New onset osteoporosis | 4 | 4 |
BMD decrease >4.5% | 22 | 21 |
New fragility fracture | 2 | 2 |
Conclusion: Patients with skeletal indications were identified well. The lack of patient recalls for biochemical indications may be attributed to a selective review of blood tests only done as part of the register rather than all prior investigations. However, if the doctors are trained to review all past investigations, a PHPT register offers an efficient and resource-conserving approach to managing patients with stable PHPT.