title: Primary hyperparathyroidism: insights from the Indian PHPT registry.
abstract: The presentation of primary hyperparathyroidism (PHPT) is variable throughout the world. The present study explored retrospective data submitted to the Indian PHPT registry ( http://www.indianphptregistry.com ) between July 2005 and June 2015 from 5 centres covering four different geographical regions. The clinical, biochemical, radiological and histopathological characteristics of PHPT patients across India were analysed for similarity and variability across the centres. A total of 464 subjects (137 men and 327 women) with histopathologically proven PHPT were analysed. The mean age was 41 ± 14 years with a female:male ratio of 2.4:1. The majority (95%) of patients were symptomatic. Common clinical manifestations among all the centres were weakness and fatigability (58.7%), bone pain (56%), renal stone disease (31%), pancreatitis (12.3%) and gallstone disease (11%). Mean serum calcium, parathyroid hormone and inorganic phosphorus levels were 11.9 ± 1.6 mg/dL, 752.4 ± 735.2 pg/mL and 2.8 ± 0.9 mg/dL, respectively. Sestamibi scanning had better sensitivity than ultrasonography in the localisation of parathyroid adenoma; however, when these two modalities were combined, 93% of the cases were correctly localised. Mean parathyroid adenoma weight was 5.6 ± 6.5 g (0.1-54 g). It was concluded that the majority of PHPT patients within India are still mainly symptomatic with >50% of patients presenting with bone disease and one-third with renal impairment. Compared to Western countries, Indian patients with PHPT are younger, biochemical abnormalities are more severe, and adenoma weight is higher. As our observation is largely derived from a tertiary care hospital (no routine screening of serum calcium level), the results do not reflect racial differences in susceptibility to PHPT.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. bhadadask@rediffmail.com.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Bhadada
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Ashutosh Kumar
authors.initials: AK
authors.lastname: Arya
authors.affiliation: Department of Endocrinology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, India.
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khadgawat
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Suja
authors.initials: S
authors.lastname: Sukumar
authors.affiliation: Department of Endocrinology, Fortis Hospital, Jaipur, India.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Lodha
authors.affiliation: Department of Endocrinology, Fortis Hospital, Jaipur, India.
authors.forename: Deependra N
authors.initials: DN
authors.lastname: Singh
authors.affiliation: Vijaya Hospital/MMM Hospital, Chennai, Tamilnadu, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Sathya
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
mesh_terms: D000328:Adult; D044466:Asian People; D001842:Bone and Bones / Q000473:pathology; D003710:Demography; D005260:Female; D041981:Gastrointestinal Tract / Q000473:pathology; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000473:pathology* / Q000601:surgery; D007194:India; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000473:pathology; D016105:Parathyroidectomy; D011182:Postoperative Care; D012042:Registries; D012189:Retrospective Studies
keywords: Hypercalcaemia; Multicentre study; Primary hyperparathyroidism; Registry