Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Primary Hyperparathyroidism: A Single-Center Experience
Primer Hiperparatiroidi: Tek Merkez Sonuçları
Seher KIRa, Cafer POLATb
aOndokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Samsun, TURKEY
bOndokuz Mayıs University Faculty of Medicine, Department of General Surgery, Samsun, TURKEY
Turkiye Klinikleri J Med Sci. 2020;40(1):37-45
doi: 10.5336/medsci.2019-66557
Article Language: EN
Full Text
ABSTRACT
 Objective: Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia and elevated parathyroid hormone (PTH) levels. In this study, we aimed to report our clinical experience by presenting the demographic, laboratory, and clinical features of our PHPT patients. Material and Methods: A total of 217 patients who underwent parathyroidectomy from 2010 to 2018 at Ondokuz Mayıs University General Surgery Clinic were retrospectively reviewed, and PHPT patients who were diagnosed with parathyroid adenoma were further evaluated. Results: In total, 136 patients (85.3% females) with a mean age of 52.6±12.66 years were included. The prevalence of osteoporosis, nephrolithiasis, hypercalciuria, and vitamin D deficiency were 45.3%, 21.7%, 59.0%, and 63.8%, respectively. Postoperative hypocalcemia (21.3%) was only related with low preoperative calcium levels (p=0.002). Preoperative calcium was positively correlated with age (p=0.029), parathyroid adenoma weight (PAW) (p=0.009), and preoperative PTH (p<0.001) and negatively correlated with 25(OH)D3 (p=0.048). Preoperative PTH was positively correlated with PAW (p=0.002) and negatively correlated with 25(OH)D3 (p=0.009). There was no correlation between 25(OH)D3 and PAW (p=0.063). Conclusion: In our region, the prevalences of osteoporosis and nephrolithiasis were low, indicating moderate clinical presentation and early diagnosis of PHPT. Postoperative hypocalcemia was associated with lower preoperative calcium levels. Low 25(OH)D3 levels were associated with high calcium and PTH but not with PAW.

Keywords: Parathyroid neoplasm; hyperparathyroidism; parathyroidectomy
ÖZET
 Amaç: Primer hiperparatiroidizm (PHPT), hiperkalsemi ve yüksek paratiroid hormonu (PTH) seviyeleri ile karakterizedir. Bu çalışma ile PHPT hastalarımızın demografik, laboratuar ve klinik özelliklerini sunarak klinik deneyimimizi bildirmeyi amaçladık. Gereç ve Yöntemler: Ondokuz Mayıs Üniversitesi Genel Cerrahi Kliniği'nde 2010'dan 2018'e kadar paratiroidektomi yapılan toplam 217 hasta retrospektif olarak incelendi ve paratiroid adenomu tanısı alan PHPT hastaları ayrıntılı olarak değerlendirildi. Bulgular: Çalışmaya ortalama yaşı 52,6±12,66 yıl olan 136 hasta (%85,3 kadın) alındı. Osteoporoz, nefrolitiazis, hiperkalsiüri ve D vitamini eksikliği prevalansı sırasıyla %45,3, %21,7, %59,0 ve %63,8 idi. Postoperatif hipokalsemi (%21,3) sadece preoperatif düşük kalsiyum düzeyleri ile ilişkiliydi (p=0,002). Preoperatif kalsiyumun yaş (p=0,029), paratiroid adenom ağırlığı (parathyroid adenoma weight-PAW) (p=0,009) ve preoperatif PTH (p <0,001) ile pozitif, 25 (OH) D3 (p=0,048) ile negatif korelasyon gösterdiği bulundu. Preoperatif PTH, PAW (p=0,002) ile pozitif, 25 (OH) D3 (p=0,009) ile negatif korelasyon gösterdi. 25 (OH) D3 ve PAW arasında korelasyon yoktu (p=0,063). Sonuç: Bölgemizde orta derecede klinik prezentasyon ve erken dönemde PHPT tanısı konulmasını işaret edecek şekilde osteoporoz ve nefrolitiazis prevalansı düşüktü. Postoperatif hipokalsemi gelişimi düşük preoperatif kalsiyum düzeyi ile ilişkili olarak bulundu. Düşük 25 (OH) D3 seviyeleri yüksek kalsiyum ve PTH ile ilişkiliydi, fakat PAW ile ilişkili değildi.

Anahtar Kelimeler: Paratiroid tümörleri; hiperparatiroidizm; paratiroidektomi
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