ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P512 | DOI: 10.1530/endoabs.63.P512

Primary hyperparathyroidism: diagnosis and management

Ben Dorel Kyabaambu Nkenda1,2, Siham El Aziz1,2,3 & Asma Chadli1,2,3

1Endocrinology, Diabetology and Metabolic Diseases Department IBN ROCHD University Hospital, Casablanca, Morocco; 2Neurosciences and Mental Health Laboratory, Casablanca, Morocco; 3Faculty of Medicine and Pharmacy- University Hassan II, Casablanca, Morocco.

Introduction: Primary hyperparathyroidism is due to excessive and inappropriate production of parathyroid hormone. The treatment is essentially surgical. The objective of this work is to specify the clinical and paraclinical characteristics of this pathology and specify the methods of management.

Methods: A descriptive retrospective study conducted at the Department of Endocrinology Diabetology and Metabolic Diseases of the University Hospital of Casablanca for a period of 4 years (2014–2018) including all patients followed for primary hyperparathyroidism.

Results: Twenty-five patients were followed during this period for primary hyperparathyroidism. The average age was 56.7 years (34–76) with a clear female predominance (84%). 40% had hypertension, 20% diabetes. The clinical picture was variable, dominated by bone pain with pathological fractures in 53% followed by general signs. Serum calcium was elevated in 21 patients (84%) and parathyroid hormone in all patients. A cervical ultrasound was performed in all patients and objectified a picture in favor of a parathyroid adenoma in 40% of cases. MIBI scintigraphy, performed in 9 patients (36%) showed hyperfixation in 66% of cases including one case of ectopia. Tomodensitometry was performed in 10 patients and revealed an adenoma in 5 cases, one of which was ectopic. A single IRM was done that objectified an ectopic adenoma. 14 patients (56%) underwent surgery, the immediate operative follow-up marked by hypocalcemia. The pathological examination found a parathyroid adenoma in more than 95% of cases. The success rate of our surgical strategy was 100%. No cases of recurrence have been diagnosed.

Conclusion: Hyperparathyroidism is an increasingly common pathology affecting more women, the positive diagnosis is purely biological and the diagnosis of location is radiological and isotopic. Surgical treatment is the rule.

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