title: A hospital-based survey of primary hyperparathyroidism in the Asir Region: Low prevalence or underdiagnosis?
abstract: BACKGROUND
  The number of patients with primary hyperparathyroidism (PHP) seen at the Asir Central Hospital (ACH) is remarkably low. This observation has raised the question of whether there is a low prevalence of PHP in the Asir region, whether it is underdiagnosed, or perhaps a combination of both factors.
  
  
  METHODS
  A survey of 15 hospitals in the Asir region was conducted for cases of PHP. All case notes of the patients with PHP seen at ACH were reviewed. Also, a sample of patients seen at ACH was chosen randomly. The charts of those found to have hypercalcemia were reviewed for the inclusion of PHP in the diagnostic work-up.
  
  
  RESULTS
  Only 13 patients with PHP were discovered. The eight patients with PHP seen at ACH had advanced bone manifestations and seven of them had renal manifestations. Hypercalcemia was found in 39 out of 655 patients seen at ACH. None of these had been investigated for PHP.
  
  
  CONCLUSIONS
  The number of patients with PHP seen in hospitals in the Asir region is very low. Underdiagnosis seems to be an important factor. Therefore, it is felt that there is a need for greater awareness of the disease in the region. Furthermore, there is a need for a national survey to measure the prevalence of PHP in Saudi Arabia.
authors.affiliation: Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
authors.forename: M Y
authors.initials: MY
authors.lastname: Alshehri