Back to Journals » Therapeutics and Clinical Risk Management » Volume 14

Management and outcomes of hyperparathyroidism: a case series from a single institution over two decades

Authors Al-Thani H, El-Matbouly M, Al-Sulaiti M, Asim M, Majzoub A, Tabeb A, El-Menyar A

Received 27 December 2017

Accepted for publication 30 April 2018

Published 31 July 2018 Volume 2018:14 Pages 1337—1345

DOI https://doi.org/10.2147/TCRM.S160896

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Hoa Le

Peer reviewer comments 3

Editor who approved publication: Professor Garry Walsh


Hassan Al-Thani,1 Moamena El-Matbouly,1 Maryam Al-Sulaiti,1 Mohammad Asim,2 Ahmad Majzoub,1 Abdelhakem Tabeb,1 Ayman El-Menyar2,3

1Department of Surgery, Hamad General Hospital, Doha, Qatar; 2Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar; 3Clinical Medicine, Weill Cornell Medical College, Doha, Qatar

Background: Hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestations and outcomes. We aimed to evaluate clinical presentations, management and outcomes of hyperparathyroidism.
Methods: A retrospective study was conducted to include all patients presented with hyperparathyroidism between 1995 and 2014 at a single tertiary hospital with an average follow-up period of 46 months. Data were reviewed for clinical presentations, diagnostic work-up, intraoperative findings, management, and outcomes.
Result: We identified 161 patients with hyperparathyroidism; 69% were females and the mean age was 49.4±15 years. Patients presented mainly with musculoskeletal (65.8%), renal (37.3%), gastrointestinal tract (53.8%) and neuropsychiatric (8.8%) manifestations. At presentation, mean serum calcium and parathyroid hormone levels were elevated while mean vitamin D level was lower. Sestamibi-99mTc (MIBI) scintigraphy was done for 134 patients (83.2%) and was positive in 94 (70%). Primary hyperparathyroidism (67.7%) was the most frequent diagnosis followed by secondary (29.8%) and tertiary hyperparathyroidism (2.5%). The frequent indication for surgery was hypercalcemia (67.3%), bone disease (35.6%) and renal calculi (28.9%). The main postoperative pathology was parathyroid adenoma (63.1%) followed by hyperplasia (37.3%). Fourteen (8.9%) and 18 (11.4%) patients had persistent and recurrent hyperparathyroidism, respectively. Autotransplantation of parathyroid tissue was done in 36 cases.
Conclusion: Primary hyperparathyroidism is the most frequent cause of the parathyroid disease. Parathyroidectomy is the effective surgical approach in symptomatic patients. Further studies are needed to establish the association between vitamin D levels, renal disorders and persistent or recurrent hyperparathyroidism.

Keywords: hyperparathyroidism, parathyroidectomy, renal disorders, Qatar

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]