Endocrine Abstracts

Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by excess secretion of parathyroid hormone (PTH), resulting from the growth of one or more parathyroid adenomas. The biochemical hallmarks of PHPT are hypercalcemia and high/ inappropriately normal PTH. PHPT can lead to osteoporosis, chronic kidney disease and nephrocalcinosis. The aim of this audit was to assess whether imaging concordance would correlate with the development of PHPT complications. Patients attending the endocrinology outpatient clinic in Bantry General Hospital with PHPT from 12/8/2024 to 24/2/2025 were screened. Data collected included patient demographics, location of parathyroid adenoma based on ultrasound neck (US) and Technetium-99m sestamibi scan, serum calcium level on diagnosis, estimated glomerular filtration rate (eGFR), presence of nephrocalcinosis on renal imaging (US/CT), history of fragility fractures and osteoporosis. 31 patients were identified as having PHPT, 74.2% female. The mean age was 60.9 (range 30-82). 7/31 (23%) were under 50. 5/31 (16%) had concordant imaging. Of these, one demonstrated nephrocalcinosis, two had osteoporosis, and one had chronic kidney disease (CKD). 3/31 (10%) had discordant imaging - one had nephrocalcinosis, one had osteoporosis. 8/31 (26%) had a parathyroid adenoma shown only on one imaging modality - one had nephrocalcinosis, two had osteoporosis, two had fragility fractures, six had CKD. 4/31 (13%) had no abnormality seen on either imaging modality - two had nephrocalcinosis, two had osteoporosis, and two had CKD. 11/31 (35%) patients underwent only one imaging modality. Our audit did not identify any association between imaging concordance and presence of complications of PHPT.