Clinical Spectrum and Pathology of Primary Hyperparathyroidism in Srinagarind Hospital

Abstract

Background and Objective: Primary hyperparathyroidism is now being diagnosed with increasing frequency.   Simultaneously there has been an apparent change in the presentation of the disease and indication for surgery.  The aim of this study was to examine the clinical presentation and pathology of parathyroid glands for primary hyperparathyroidism.

Methods : This retrospective descriptive study was carried out over 14 years,  from 1994 to 2008,  at Srinagarind Hospital,  Faculty of Medicine,  KhonKaen  University.  Information on the clinical presentation,    parathyroid hormone level, serum calcium level and pathological report of parathyroid glands was obtained from retrospective parathyroid surgical database.

Results: Out of 40 patients diagnosed with primary hyperparathyroidism at Srinagarind Hospital,  there were 27 female, mean age 47.22(13 – 73) years and 13 male patients.  Bone fracture was the most common clinical presentation found in 19 patients, the second was renal calculi found in 11 patients,  one patient was presented with bone fracture and renal calculi and 8 patients were presenteded with non-specific symptoms.  Pathological reports were adenoma in 39 glands of 39 patients and hyperplasia 4 glands in one patient.  Mean serum parathyroid hormone level 481.69 pg/ml (79 - 1361.7 pg/ml)and mean serum calcium level was 12.66 md/dl (9.5-16.5 mg/dl)calcium was 12.66 mg/dl (9.5 – 16.5 mg/dl)  and level

Conclusion: This study shows that severe bone disease with fractures are the most common presentation of primary hyperparathyroidism. The second is renal calculi. The most common pathological report was adenoma.

Keywords: Primary hyperparathyroidism; clinical spectrum, pathology