title: Clinical and laboratory profile of primary hyperparathyroidism in Kashmir Valley: A single-center experience.
abstract: BACKGROUND
  Although primary hyperparathyroidism (PHPT) has become an asymptomatic disease in the West, in India, PHPT is still an uncommonly diagnosed, overtly symptomatic disease with skeletal, muscular, and renal manifestations.
  
  
  OBJECTIVE
  To describe the profile and surgical outcome of 78 consecutive PHPT patients over a period of two decades at a single center.
  
  
  METHODS
  All patients who underwent evaluation and surgery for PHPT from January 1996 to December 2015 were included. Evaluation included measurement of serum total calcium, inorganic phosphorus, alkaline phosphatase, intact parathyroid hormone, 25-hydroxy Vitamin D, 24 hour urinary calcium and radiological survey. Ultrasonography neck and technetium-99m sestamibi scan were used for preoperative localization.
  
  
  RESULTS
  A total of 78 patients were identified during the two decades of whom 29 patients were studied retrospectively and 49 patients prospectively. Mean age of patients was 44.72 ± 12.46, and male:female ratio was 1:6. The most common presenting features were nephrolithiasis and/or nephrocalcinosis (64.10%), bone pain (44.1%), abdominal pain (39%), constipation (26%), and myopathy (14.10%). Fractures were present only in 10.25%, and brown tumors in 6.41% patients. The cure rate in our series was 96.15%. The mean parathyroid gland weight was 2.05 ± 3.03 g. None of the 41 patients in whom long-term follow-up was available, had recurrence of PHPT.
  
  
  CONCLUSIONS
  The profile of PHPT is changing with older age at presentation, and emergence of renal stone disease and decline in overt skeletal disease as common presentation. The parathyroid weight in our study resembles that reported from developed countries.
authors.affiliation: Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Raiz Ahmad
authors.initials: RA
authors.lastname: Misgar
authors.affiliation: Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Parvez Mohiuddin
authors.initials: PM
authors.lastname: Dar
authors.affiliation: Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Shariq Rashid
authors.initials: SR
authors.lastname: Masoodi
authors.affiliation: Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Munir
authors.initials: M
authors.lastname: Ahmad
authors.affiliation: Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Khursheed Alam
authors.initials: KA
authors.lastname: Wani
authors.affiliation: Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Arshad Iqbal
authors.initials: AI
authors.lastname: Wani
authors.affiliation: Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Mir Iftikhar
authors.initials: MI
authors.lastname: Bashir
keywords: Fractures; hypercalcemia; nephrolithiasis; parathyroid adenoma; primary hyperparathyroidism