Clinical features and laboratory variables in patients with primary and secondary hyperparathyroidism at a south american hospital

Jorge Hernandez; Luis Dulcey; Jaime Gomez; Juan Theran; Valentina Ochoa; Valentina Navas; Harold Torres

doi:10.1530/endoabs.109.P113

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Endocrine Abstracts (2025) 109 P113 | DOI: 10.1530/endoabs.109.P113

SFEBES2025 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Clinical features and laboratory variables in patients with primary and secondary hyperparathyroidism at a south american hospital

Jorge Hernández ¹ , Luis Dulcey ² , Jaime Gomez ³ , Juan Theran ¹ , Valentina Ochoa ¹ , Valentina Navas ¹ & Harold Torres ¹

Author affiliations

¹University of Santander, Bucaramanga, Colombia; ²University of Andes, Mérida, Venezuela; ³Autonomous University of Bucaramanga, Bucaramanga, Colombia

Introduction: This study aims to evaluate the role of neck gammagraphy in comparison with clinical features and laboratory parameters in patients with various types of primary and secondary hyperparathyroidism (HPT).

Objective: To analyze the clinical presentation and laboratory findings of patients diagnosed with primary or secondary HPT.

Materials and Methods: A retrospective single-center study included data from 100 consecutively selected patients diagnosed with primary or secondary HPT. This cohort comprised 48 patients with hypercalcemic primary hyperparathyroidism (hPHPT), 13 with normocalcemic primary hyperparathyroidism (nPHPT), and 25 with secondary hyperparathyroidism (SHPT) due to acquired vitamin D deficiency. The study was conducted at the Hospital Universitario de los Andes in Mérida, Venezuela, during 2021, utilizing neck ultrasonography results and known laboratory markers, alongside SPECT/CT imaging using technetium-99m methoxyisobutylisonitrile (99mTc-MIBI).

Results and Discussion: Among the 100 patients with HPT, 72% reported symptoms. Bone pain (P = 0.0031) and cramps (P = 0.004) were more prevalent in hPHPT. Maximum parathyroid hormone (PTH), phosphorus, and alkaline phosphatase levels were highest in patients with end-stage renal disease (ESRD), while total and ionized calcium peaked in hPHPT patients. The lowest incidence of vitamin D deficiency was in nPHPT patients. The sensitivity of SPECT/CT in detecting altered parathyroid glands was 97% for hPHPT and 92% for nPHPT. Ectopic pancreatic findings in hPHPT occurred in 18% of patients, with rapid adenoma detection in 36%. A correlation was found between radioisotope accumulation intensity in altered parathyroid glands and their diameter (P = 0.003).

Conclusion: SPECT/CT serves as a key method for visualizing altered parathyroid glands in the preoperative evaluation of patients with PHPT and SHPT in ESRD. This method is diagnostically valuable for patients with vitamin D deficiency and elevated PTH and calcium levels to identify nodular forms of pancreatic hyperplasia.

Keywords: primary hyperparathyroidism, secondary hyperparathyroidism