Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism

Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism

Author Oliveira, Ulisses Eliseu Maia de Autor UNIFESP Google Scholar
Ohe, Monique Nakayama Autor UNIFESP Google Scholar
Santos, Rodrigo Oliveira Autor UNIFESP Google Scholar
Cervantes, Onivaldo Autor UNIFESP Google Scholar
Abrahão, Márcio Autor UNIFESP Google Scholar
Lazaretti-Castro, Marise Autor UNIFESP Google Scholar
Vieira, Jose Gilberto Henriques Autor UNIFESP Google Scholar
Hauache, Omar Magid Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Instituto Fleury
Abstract Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93% of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97% of patients were cured, with increases in bone mineral density of 19.4% in the lumbar spine and 15.7% in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients.
Keywords Primary hyperparathyroidism
Hypercalcemia
Clinical presentation
Parathyroidectomy
Bone mineral density
Language English
Date 2007-04-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 4, p. 519-526, 2007.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 519-526
Origin http://dx.doi.org/10.1590/S0100-879X2007000400010
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000245440000010
SciELO ID S0100-879X2007000400010 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3657

Show full item record




File

Name: S0100-879X2007000400010.pdf
Size: 484.8Kb
Format: PDF
Description:
Open file

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account