Endocrine Abstracts

JOINT2026

Introduction: Primary hyperparathyroidism (PHPT) is the leading cause of hypercalcemia. It is secondary to hypersecretion of parathyroid hormone (PTH) by the parathyroid glands. Today, PHTP is asymptomatic in 80–90% of cases. The aim of this work is to analyze the clinical, paraclinical and therapeutic profile of primary hyperparathyroidism (PHTP).

Materials and Methods: This is a retrospective study that collected 49 patient files followed for PHTP in our department, over a period of 5 years from 2016 to 2023.

Results: There were 16 men and 33 women (sex ratio = 2.3), the average age was 58 years (27 and 88 years). The circumstances of discovery were: bone pain in 83% of cases, hypercalcemia in 69% of cases and asthenia in 11% of patients. Biology showed a mean calcemia at 2.66 mmol/l (2.5 – 3.4). The mean value of parathyroid hormone was 386 pg/l. Vitamin D was measured in 16 patients; 71% of them had hypovitaminosis D. Imaging (cervical ultrasound and MIBI scintigraphy) showed a hypoechoic mass opposite the thyroid pole with a lower left location in 67% of cases. Symptomatic treatment of hypercalcemia was associated with surgical treatment in all cases. The mean value of postoperative calcemia was 2 mmol/l with a mean PTH value of 20 pg/l. The anatomopathological study concluded a parathyroid adenoma in 83%, parathyroid hyperplasia and an atypical adenoma in 10% of cases and a parathyroid carcinoma in 6% of cases.

Conclusion: Surgical management of the hyperfunctioning parathyroid gland(s) is the only curative treatment for HPTP. Medical management concerns patients for whom surgery is not indicated, who present a surgical contraindication or who refuse surgery. The diagnosis of HPTP warrants contact with an endocrinologist to ensure its management.