Endocrine Abstracts

We audited the management of primary hyperparathyroidism (PHP) at our institution between 2000 and June 2004, to determine our adherence to the Consensus Development Conference on the Management of Asymptomatic PHP (2002) guidelines.

Sixteen patients were referred with PHP during the period in question, 12 female. Average age at diagnosis was 59 years (range 36-81), average PTH level 155 ng/mL, and average corrected serum calcium 2.76 mmol/L (normal 2.1-2.55 mmol/L). 2 patients considered unsuitable for surgery due to medical co-morbidities did not have a complete work-up. 2 patients were lost to follow-up.

All of the remaining 12 patients had at least one indication for surgical referral. 6 of the 12 met just one criterion for surgery, emphasising the importance of a complete evaluation prior to deciding regarding surgical intervention. Elevated 24-hour urinary calcium was the criterion in 3 of these cases, reduced bone density in 2, and age less than 50 years in 1.

All PHP patients considered fit for surgery and not lost to follow-up were evaluated appropriately prior to surgical referral in our institution, and no patient was inappropriately followed without surgery. Imaging for occult renal calculi was not performed in our patients, but this did not adversely impact on patient management.