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

• Published in: Journal of postgraduate medicine Vol. 56; no. 2; pp. 79 - 84
• Main Authors: Gopal, R. A, Acharya, S. V, Bandgar, T, Menon, P. S, Dalvi, A. N, Shah, N. S
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India 01-04-2010; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Adult; Alkaline Phosphatase - blood; Bone Diseases - complications; Bone Diseases - etiology; Calcium - blood; Care and treatment; Diagnosis; Female; Humans; Hypercalcemia, parathyroid adenoma, primary hyperparathyroidism; Hyperparathyroidism; Hyperparathyroidism, Primary - blood; Hyperparathyroidism, Primary - complications; Hyperparathyroidism, Primary - surgery; India; Male; Medical research; Middle Aged; Parathyroid Glands - diagnostic imaging; Parathyroid Glands - pathology; Parathyroid Hormone - blood; Parathyroidectomy; Radionuclide Imaging; Retrospective Studies; Surgical outcomes; Ultrasonography; Vitamin D Deficiency - complications; India
• ISSN: 0022-3859; 0972-2823
• DOI: 10.4103/0022-3859.65279

Background: 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. Aim : To present
the clinical profile of PHPT from western India. Settings and Design :
This retrospective study was conducted at a tertiary care referral
center. Materials and Methods : 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. Statistical Analysis : was
done with SPSS 16 software. Results : Seventy-nine patients (F: M-2:1)
with age ranging from 21 to 55 years (mean 33.5±8.82) were
analyzed. Skeletal manifestations (75.5%), renal calculi (40.5%) and
proximal muscle weakness (45.5%) 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±1.77 mg/dl), low inorganic phosphorus
(1.81±0.682 mg/dl), elevated total alkaline phosphatase (mean:
762.2; median: 559; range: 50-4930IU/L) and high parathyroid hormone
(PTH) (mean±SD: 866.61±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% and transient hypoparathyroidism developed in
62% patients. In comparison to PHPT in children there were no
significant differences with regard to clinical, laboratory and
radiological features. Conclusions : 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.