title: Study of primary hyperparathyroidism.
abstract: BACKGROUND
  The clinical spectrum of primary hyperparathyroidism (PHPT) has undergone a striking change with asymptomatic form predominant in developed countries, whereas symptomatic form predominant in developing countries. In this study, we have analyzed clinical presentation, investigations, management, operative findings in patients with PHPT at our center.
  
  
  METHODS
  A retrospective, review of medical records of all patients with PHPT between 2000 and July 2012 at our institute was undertaken. A total of 96 patients were included in this study.
  
  
  RESULTS
  The mean age of patients was 50.8 years. Of the 96 patients, 63 were females (65.6%) and 33 were males (34.4%). Among them, 17.7% were asymptomatic and 82.3% were symptomatic. Bone pain was the most common complaint (52%) followed by renal stones (27%). Nearly 10.4% were part of familial PHPT, whereas others were sporadic adenomas. All patients had hypercalcemia (range 10.5-19.4 mg/dl) with elevated parathyroid (PTH) levels (range 32-3820 pg/ml). 25(OH) VitD levels were available in 86 patients (89.6%). There was no correlation between VitaminD levels and symptomatology. Sestamibi scan was true positive in 95.6%, false negative 2.2%, and inconclusive in 2.2%. Ultrasonography (USG) results were true positive in 84.2%, false positive in 6.3%, and false negative in 9.5%. Intraoperative PTH levels were measured in 83.3% patients. Postoperative complications were reported in 20.8% patients.
  
  
  CONCLUSIONS
  Clinical spectrum of PHPT varies but bones and stones are still the predominant manifestations even in affluent society. Asymptomatic form also exists and can be detected by routine measurement of serum calcium. There was no correlation seen between the 25 VitD levels and clinical symptoms.
authors.affiliation: P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai - 400 016, India.
authors.forename: Parmar
authors.initials: P
authors.lastname: Girish
authors.forename: M
authors.initials: M
authors.lastname: Lala
authors.forename: M
authors.initials: M
authors.lastname: Chadha
authors.forename: N F
authors.initials: NF
authors.lastname: Shah
authors.forename: P H
authors.initials: PH
authors.lastname: Chauhan
keywords: Primary hyperparathyroidism; sestamibi scan; ultrasonography parathyroid
references.citation: Br J Surg. 2001 May;88(5):708-14
references.pmid: 11350446
references.citation: J Clin Endocrinol Metab. 2009 Feb;94(2):335-9
references.pmid: 19193908
references.citation: J Am Coll Surg. 2011 Sep;213(3):410-4
references.pmid: 21723154
references.citation: Int J Endocrinol. 2011;2011:921814
references.pmid: 21747854