Normocalcemic Primary Hyperparathyroidism
Journal Title: Journal of Endocrinology and Diabetes - Year 2016, Vol 3, Issue 3
Abstract
The prevalence and the natural history of Normocalcemic Primary Hyperparathyroidism (NCHPT) are not well known. Therefore the aim of this retrospective study was to determine the prevalence and natural history of (NCHPT). We reviewed the electronic medical records of patients with normal serum calcium level (8-10.5 mg/dl) and elevated serum Parathyroid Hormone (PTH) level (>72 pg/ ml) over a period of 10 years (2003 to 2013), mean period of 4.6 years, ranging 1-8 years at Michigan State University outpatient clinics. During this time, no patient was sent for parathyroidectomy but simply followed. We identified 332 patients to have primary hyperparathyroidism out of which 50 were normocalcemic. Out of these twenty-seven (54%) patients were found to have vitamin D deficiency (25 Hydroxy vitamin D level< 30ng/ml), and 2 patients taking hydrocholorothiazide were excluded. Thus the prevalence of NCPHPT is 21 /332 (6.3%). Bone mineral density had been determined in 13 patients. 6/13 (46.1%) showed osteoporosis, 5/13 (38.46%) had osteopenia and 2/13 were normal. Two patients 2/21 (9.5%) had history of recurrent fractures, and 6 (28.5%) had recurrent kidney stones. Among those with Vitamin D deficiency, PTH level returned to normal only in 7 patients over a period of 3 months to 4 years after the correction of the deficiency. In 20 patients, PTH remained elevated throughout the follow up ranging from 2 months to 7 years. This retrospective analysis shows that among all patients with hyperparathyroidism about 6.3% may have NCHPT. Our data also shows that NCPHPT is not a benign entity and may be associated with increased risk of osteopenia, osteoporosis and kidney stones.
Authors and Affiliations
Mamta Ojha, G. Mathew Hebdon, Saleh Aldasouqi, Ved Gossain
Keywords
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- EP ID EP333667
- DOI 10.15226/2374-6890/3/3/00149
- Views 94
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