Clinical profile of primary hyperparathyroidism from western India: A single center experience

• Main Authors: Gopal R, Acharya S, Bandgar T, Menon P, Dalvi A, Shah N
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-01-01
• Series: Journal of Postgraduate Medicine
• Subjects: Hypercalcemia; parathyroid adenoma; primary hyperparathyroidism
• Online Access: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2010;volume=56;issue=2;spage=79;epage=84;aulast=Gopal
• ISSN: 0022-3859; 0972-2823

<b>Background</b>: Primary hyperparathyroidism (PHPT) has a variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in India. Data from western India is lacking. <b>Aim</b> : To present the clinical profile of PHPT from western India. <b>Settings and Design</b> : This retrospective study was conducted at a tertiary care referral center. <b>Materials and Methods</b> : We analyzed the clinical presentation, biochemical, radiological features, and operative findings in adult patients with PHPT (1986-2008) and compared with our published data of children and adolescent patients with PHPT. <b>Statistical Analysis</b> : was done with SPSS 16 software. <b>Results</b> : Seventy-nine patients (F: M-2:1) with age ranging from 21 to 55 years (mean 33.5&#177;8.82) were analyzed. Skeletal manifestations (75.5&#x0025;), renal calculi (40.5&#x0025;) and proximal muscle weakness (45.5&#x0025;) were the most common symptoms of presentation with mean duration of symptoms being 33.70 (median: 24, range 1-120) months. Biochemical features included hypercalcemia (total corrected calcium 12.55&#177;1.77 mg/dl), low inorganic phosphorus (1.81&#177;0.682 mg/dl), elevated total alkaline phosphatase (mean: 762.2; median: 559; range: 50-4930IU/L) and high parathyroid hormone (PTH) (mean&#177;SD: 866.61&#177;799.15; median: 639.5; range: 52-3820 pg/ml). Preoperative localization was achieved in 74 patients and single adenoma was found during surgery in 72 patients. Hungry bone disease was seen in 30.3&#x0025; and transient hypoparathyroidism developed in 62&#x0025; patients. In comparison to PHPT in children there were no significant differences with regard to clinical, laboratory and radiological features. <b>Conclusions</b> : PHPT in western India is symptomatic disorder with skeletal and renal mani-festations at a much younger age. Clinical profile of PHPT in children is similar to that of adults.