The evolution of primary hyperparathyroidism

Ferraz-de-Souza, Bruno

doi:10.1590/2359-3997000000124

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Even though primary hyperparathyroidism (PHPT) is a common endocrine disorder that has been known for more than 100 years, its presentation has been changing over time, especially in the last four decades in developed countries. [1][2][3] Primary hyperparathyroidism is usually characterized by the presence of hypercalcemia and inappropriately normal or elevated parathyroid hormone (PTH) levels. 3,4 It is more common in female patients.…”

Section: Introductionmentioning

confidence: 99%

Rare Presentation of Primary Hyperparathyroidism in a Young Woman

Araújo¹,

Brochado²,

Carvalho³

et al. 2023

Acta Med Port

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Even though primary hyperparathyroidism (PHPT) is a common endocrine disorder, due to better and more regular screening, the usual presentation is only seen in less than 15% of cases of PHPT. The authors present the case of a young female patient with a previous medical history of depression and nephrolithiasis, with one year of bone pain, that had become progressively worse and disabling. In the initial work-up, several lytic bone lesions and moderate hypercalcemia were found, leading to admission of the patient in the Internal Medicine ward for investigation and treatment. The ensuing investigation revealed PHPT due to hyperfunctioning parathyroid adenoma. The patient underwent a parathyroidectomy and at the follow-up assessment two months after discharge, she reported no symptoms and a computer tomography scan showed regression of the lytic lesions. This case is a reminder that severe symptomatic PHPT, a rare form in developed countries nowadays, still exists, and even though it is a medical condition, collaboration with surgical specialties is necessary to ensure the best possible treatment and prognosis.

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Section: Introductionmentioning

confidence: 99%

Rare Presentation of Primary Hyperparathyroidism in a Young Woman

Araújo¹,

Brochado²,

Carvalho³

et al. 2023

Acta Med Port

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“…The reason for this change in presentation among individuals in those countries is the common use of biochemical screening tests that include the serum calcium measurement routinely. As a result, most patients diagnosed with PHPT do not have overt signs of kidney or bone disease, and are thus, termed asymptomatic [9]. This change in clinical presentation is relevant for Europe and North America where most published studies describe the asymptomatic form of the disease as the most common [1,3,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, most patients diagnosed with PHPT do not have overt signs of kidney or bone disease, and are thus, termed asymptomatic [9]. This change in clinical presentation is relevant for Europe and North America where most published studies describe the asymptomatic form of the disease as the most common [1,3,[6][7][8][9][10]. Since the 2000s, yet another PHPT presentation is recognized, namely normal total and ionized calcium concentration with high PTH in the absence of any secondary causes for the elevated PTH level [2,[10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Clinical phenotypes of primary hyperparathyroidism in hospitalized patients who underwent parathyroidectomy

Yanevskaya

Karonova

Sleptsov

et al. 2021

Endocrine Connections

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Objective. The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy. Materials and methods. Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. History and anthropometric data, laboratory results (iPTH, total and iCa, phosphorus, ALP, 24-h urinary calcium, 25(OH)D) and imaging data (ultrasonography, scintigraphy, CT/MRI scan, DXA) were analyzed. Results. Three hundred ninety-four patients were included in the final analysis. Median age was 60 years with 94.2 % being women. Symptomatic disease was evident in 222 (56.4%) patients, asymptomatic in 172 (43.6%). Skeletal involvement was more common for women, while frequency of other manifestations did not differ in both genders. There was no difference between symptomatic and asymptomatic patients in age. Serum iPTH level was higher in symptomatic patients (202.9 and 181.0 pg/ml, p=0.022). Serum 25(OH)D level was estimated in few patients and negatively correlated with PTH (r= -0.294, p=0.005), iCa (r= -0.268, p=0.010) and total Ca (r= -0.284, p=0.014) levels. Manifestations of CVD were observed in 67.7% of cases and affected equally both symptomatic and asymptomatic patients (70.7% and 63.4%, p=0.076). Both age and BMI were higher in patients with CVD, whether or not they were symptomatic (62 and 53 years, p<0.0001; 30.4 vs 26.0 kg/m2, p<0.0001, respectively). Conclusions. This experience illustrates that symptomatic phenotype is still the most common form of PHPT.

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“…В последнее время клиническая картина ПГПТ изменилась: так, если ранее заболевание, как правило, диагностировалось у пациентов с тяжелыми поражениями почек и костей, то сейчас все чаще выявляется при выявлении лабораторных изменений, а именно при биохимическом и гормональных исследованиях [5]. Учитывая, что данный процент представляет большой пул пациентов, большое значение для диагностики ПГПТ имеют лабораторные методы исследования [4].…”

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Quality of life in patients with primary hyperparathyroidism in the Chuvash Republic

Aizetullova,

Osipov,

Kichigin

2023

Endo Serg

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Anthropometric data, indicators of laboratory and instrumental examinations were prospectively studied in 80 patients with primary hyperparathyroidism who were treated at the Republican Clinical Hospital for War Veterans of the Ministry of Health of Chuvashia. The quality of life of all patients with primary hyperparathyroidism was assessed before and after surgical treatment using two questionnaires: the SF-36 questionnaire and the standardized quality of life questionnaire for patients with PGPT — PHQol, an adapted Russian version of the quality of life questionnaire for primary hyperparathyroidism. As a result of the study, primary hyperparathyroidism was found to be a disease with a low level of detectability due to low awareness of practitioners, therefore, it often takes up to 10 years from the onset of the disease to diagnosis. It is necessary to introduce screening programs to determine the level of calcium in the blood. The disease primary hyperparathyroidism is of medical and economic importance, which pushes us to pay closer attention to this disease, to create a register of patients with primary hyperparathyroidism. Assessment of the quality of life before and after surgical treatment makes it possible to assess the subjective state of the patient, and also contributes to a patient-oriented approach in the management of patients with PGPT. The standardized questionnaire for assessing the quality of life in hyperparathyroidismPHQoL, its adapted and validated Russian version is a reliable method for studying the quality of life before and after surgical treatment of patients with PGPT, as well as for evaluating the effectiveness of surgical treatment.

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The evolution of primary hyperparathyroidism

Cited by 5 publications

References 17 publications

Rare Presentation of Primary Hyperparathyroidism in a Young Woman

Rare Presentation of Primary Hyperparathyroidism in a Young Woman

Clinical phenotypes of primary hyperparathyroidism in hospitalized patients who underwent parathyroidectomy

Quality of life in patients with primary hyperparathyroidism in the Chuvash Republic

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