Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disease secondary to autonomous hypersecretion of parathyroid hormone (PTH) by one or more parathyroid glands. It is a predominantly female disease and most often asymptomatic. Its positive diagnosis is purely biological. Its curative treatment is surgical.

Patients & methods: This retrospective descriptive study encompasses 83 patients who were hospitalized and longitudinally monitored for primary hyperparathyroidism. The study was conducted at the Endocrinology Department of the Ibn Sina University Hospital of Rabat and the Endocrinology Department of the Mohamed V Military Training Hospital. The observational period spans seven years, from 2015 to 2022.

Results: The mean age of our patient cohort was 53.27±16.862 years, with a predominant representation of females accounting for 90.4% of cases. Clinical presentations exhibited variability, notably characterized by osteoarticular manifestations in 65.6% of cases, urinary signs in 10.8%, and general signs in 36.1%. Primary hyperparathyroidism remained asymptomatic in 39.7% of cases. The average blood calcium level was 122.8±21.4 mg/l, with normal levels observed in 9.6% of cases. Parathyroid hormone (PTH) was elevated in all cases, demonstrating a mean level of 261.7±186.8 pg/ml. Cervical ultrasound, conducted in all patients, exhibited a sensitivity of 89.1%, while 64 patients underwent MIBI scintigraphy, achieving a sensitivity of 92%. Management of primary hyperparathyroidism revolves around addressing hypercalcemia, with surgical intervention implemented when indicated. Surgical treatment was undertaken in 79 patients, constituting 95.18% of cases. Anatomopathological examination revealed parathyroid adenoma as the predominant finding in 81.92% of cases. The anatomopathological study showed a parathyroid adenoma in 81.92% of cases.

Discussion & Conclusion: Our study substantiates the observed predominance of primary hyperparathyroidism in females. It emphasizes the significance of routinely assessing serum calcium levels, especially in women aged over 50, to enable early detection of PHPT at its asymptomatic phase. This proactive approach aims to prevent complications that pose risks to vital prognosis and mitigate the onset of renal and skeletal complications.