Clinical evaluation, diagnosis, and management of primary hyperparathyroidism: A retrospective analysis of 152 patients

Abstract

Objective: Primary hyperparathyroidism is a common endocrine disease with autonomic production of parathormone from one or more of the parathyroid glands. PTx is recommended for patients who meet the criteria for surgical treatment in the guidelines. The purpose of the present study was to evaluate the clinical and biomarker characteristics of patients with PHPT who underwent PTx in the light of policies.

Material and Methods: The present study was conducted with 152 patients that were followed in our clinic between 2015 and 2022. The patients' data were obtained retrospectively from patient files and electronic records. Demographic characteristics, laboratory findings, and surgical and pathology reports were collected. In PHPT, PTx was performed in line with surgical indications according to the surgical guideline.

Results: Most of the patients were diagnosed in the asymptomatic stage. Scintigraphy localized 76.3% of parathyroid adenomas, which were consistent with USI. Histopathologically, parathyroid adenoma was 94.0%, and parathyroid hyperplasia was 5.9% (n=9). Transient hypocalcemia was the most common postoperative problem. More rarely, there were Hungry Bone Syndrome, transient hoarseness, and permanent vocal cord paralysis.

Conclusion: Serum calcium and neck imaging have recently been performed with increasing frequency. This approach enables PHPT patients to be detected at an asymptomatic stage. The compatibility of scintigraphy and USI in predicting parathyroid adenoma localization is very successful for correct topographic localization.