Endocrine Abstracts

Introduction: Hyperparathyroidism is the clinical and biological manifestation of excessive and inappropriate parathyroid hormone (PTH) production. It is the third most common endocrinopathy. It is often secondary to a single adenoma (80%). Occasionally, it may be a multi-glandular disease (15-18%). Treatment is surgical.

Objective: the aim is to evaluate therapeutic results after surgery for primary hyperparathyroidism.

Method: This is a retrospective study including 84 patients operated on for primary hyperparathyroidism in our department over a period from 2015 to 2023.

Results: The mean age of our patients was 49 years, with a clear female predominance. Patients presented osteoarticular signs in 60% of cases, renal signs in 29%, digestive signs in 15% and neuropsychic signs in 5%. Hyperparathyroidism was discovered incidentally on biology data in 32% of patients (27 cases). Mean calcemia was 2.8 mmol/l. Normocalcic forms were noted in 8.4% of cases. Malignant hypercalcemia was noted in 5.9% of cases. Hypovitaminosis D was found in 48% of cases. The mean PTH level was 411µg/l. Postoperatively, the rate of improvement in osteoarticular signs, renal signs, digestive signs and neuropsychic signs was 62%, 58%, 54% and 75% respectively. We noted normalization of PTH levels within 72 hours of surgery in 90.5% of cases. Failure was noted in 6 cases. This failure was related to incomplete surgery for a triple adenoma in 1 case, hyperplasia in 3 cases, glandular ectopy in 1 case and multiple endocrine neoplasia in 1 case.

Conclusion: Parathyroidectomy is the only curative treatment option available in primary hyperparathyroidism with high cure rates. This surgery can reduce symptoms and prevent further complications.