Characteristics, Management and Outcome of Primary Hyperparathyroidism in a Predominantly Vitamin D Deficient Population: A Single-Center Experience.

Autor: Dar, Parvez Mohi Ud Din, Malik, Liaqat Ahmad, Wani, Afshan Anjum, Kaur, Supreet, Wani, Sajid Mohammad, Wani, Muneer A., Masoodi, Shariq R., Wani, Khursheed Alam, Gulshan, wani Naveed
Zdroj: Hellenic Journal of Surgery; Jan2020, Vol. 92 Issue 1, p7-12, 6p
Abstrakt: Background: Primary hyperparathyroidism (PHPT) has variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in Indian subcontinent. Now, there is a decreasing trend of symptomatic cases and increasing number of asymptomatic cases with time. 25-hydroxy vitamin D has no correlation with serum calcium and PTH. Objective: To study patients with hyperparathyroidism and its relation to vitamin D. Methods: We studied 78 consecutive patients with PHPT in whom vitamin D level was measured. Results: Out of the 78 study patients, 67 (85.7%) were females and 11 (14.2%) were males. The age ranged from16 to 70 years. Nephrolithiasis was the single most common presentation (48.2%) followed by bone pain in 44%. Only 5% were asymptomatic with a decreasing trend of symptomatic cases and increasing number of asymptomatic cases with time. Mean serum calcium level was 11.5±1.0, mean serum PTH level 377±386.1 pg/ml and mean 25-hydroxy vitamin D level 37.2±58.1 ng/ml. Forty eight percent of patients were vitamin D deficient. 25-hydroxy vitamin D had no correlation with serum calcium and PTH, but had a negative correlation with tumour size. Neck ultrasonography was suggestive of parathyroid pathology (laterality) in 89.8% and exact site of parathyroid pathology in 63.3%. MIBI scan showed parathyroid pathology in 92.5% and exact site in 85.7% of patients. Single parathyroid gland was involved in 90% of cases, double glands in 8% and multiple/hyperplasia in 1.6%. Parathyroid adenoma was in 86.3%, parathyroid hyperplasia in 7.8%. Temporary post-operative hypocalcaemia was seen in 36%; cure rate was achieved in 98.37% of patients without operative mortality. Conclusion: Primary hyperparathyroidism is still a symptomatic disease in Kashmir Valley but now there is a decreasing trend of symptomatic cases and an increasing number of asymptomatic cases with time. 25-hydroxy vitamin D level has no correlation with serum calcium, iPTH and tumour size. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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