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

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dc.contributor.authorOliveira, Ulisses Eliseu Maia de [UNIFESP]
dc.contributor.authorOhe, Monique Nakayama [UNIFESP]
dc.contributor.authorSantos, Rodrigo Oliveira [UNIFESP]
dc.contributor.authorCervantes, Onivaldo [UNIFESP]
dc.contributor.authorAbrahão, Márcio [UNIFESP]
dc.contributor.authorLazaretti-Castro, Marise [UNIFESP]
dc.contributor.authorVieira, Jose Gilberto Henriques [UNIFESP]
dc.contributor.authorHauache, Omar Magid [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionInstituto Fleury
dc.date.accessioned2015-06-14T13:36:51Z
dc.date.available2015-06-14T13:36:51Z
dc.date.issued2007-04-01
dc.description.abstractPrimary 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.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina
dc.description.affiliationInstituto Fleury
dc.description.affiliationUnifespUNIFESP, EPM
dc.description.sourceSciELO
dc.format.extent519-526
dc.identifierhttp://dx.doi.org/10.1590/S0100-879X2007000400010
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 4, p. 519-526, 2007.
dc.identifier.doi10.1590/S0100-879X2007000400010
dc.identifier.fileS0100-879X2007000400010.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2007000400010
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/3657
dc.identifier.wosWOS:000245440000010
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPrimary hyperparathyroidismen
dc.subjectHypercalcemiaen
dc.subjectClinical presentationen
dc.subjectParathyroidectomyen
dc.subjectBone mineral densityen
dc.titleAnalysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidismen
dc.typeinfo:eu-repo/semantics/article
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