Primary hyperparathyroidism (PHPT) is the third most frequent endocrine disorder and has a variable clinical presentation. Asymptomatic PHPT became the predominant form of the disease with increase of its incidence after the introduction of automated serum calcium measurement in North America and Europe. Data from Russia is lacking.
Aim: To present the clinical profile of PHPT in Russia.
Materials and methods: This retrospective study was conducted at endocrinology centers in 8 regions of Russia. We analyzed the clinical presentation, and treatment options in patients with confirmed PHPT (19952010).
Results: Seven hundred and thirty-eight patients (F:M-8:1) with age ranging from 13 to 83.4 years (mean 54.3) were included: 54% from Moscow (n=397), 11% from Moscow region (n=79) and 35% from 53 regions of Russia (n=262). 33% of patients were in 5059 years age-group. PHPT was diagnosed in woman more often in 5059 years (23.8%) and 6069 years (28.8%) age groups while in men it was irrespective of age. Symptomatic PHPT was the most common form (74%) and was revealed with osteoporosis in 56%, nephrolithiasis in 45% and ulcer disease in 18%. Our data showed an increase in the incidence of PHPT after 2005 compared with earlier period (from 429 per year to 93 in 2006) with peak in 2009 (n=126) and a tendency to more frequent detection of mild PHPT in the last decade (from 15 to 41%). 64.9% of patients were treated surgically, 17 patients undergone repeated parathyroid surgery. 28.3% received bisphosphonates, calcitonin and/or cinacalcet. 11.5% was observed without treatment.
Conclusions: PHPT still remains symptomatic disorder in our country most frequently with skeletal and renal manifestations. Although our data demonstrates marked changes in diagnostics of PHPT in the course of time, apparently many cases (especially the mild forms of PHPT) are unrecognized.