Abstract
Primary hyperparathyroidism (PHPT) is currently the most common endocrine disorder in Czech Republic after diabetes and thyroid diseases particularly in postmenopausal women. Over the past 40 years PHPT has changed from a rare severe disease of the bones and kidneys to common disease with hypertension, peptic ulcer, pancreatitis, easy fatigue and proximal muscle weakness. During 43 years we have examined one of the greatest groups of patients with PHPT. In the early 1970 the estimated incidence of PHPT in former Czechoslovakia was approximately 8 cases per 100 000 persons per year. Our data showed that the incidence of PHPT increased sharply to 24 cases per 100 000 persons per year in same community with the introduction of automated serum calcium and iPTH measurement. The disease is four times more frequent in women as in man. The ratio women to men did not changed since 1981. However the incidence of PHPT changed in Czech Republic from previous years, it develops around the fifth decade of life and is increasingly discovered with advancing age. The incidence of hypertension, diabetes mellitus, cholelithiasis, pancreatitis and peptic ulcer among patients with PHPT is higher as compared with the incidence of these diseases in the general population. However there are still patients suffering from bone and renal complication of PHPT. Removing the adenoma by an experienced surgeon is the first choice of treatment of patients with PHPT. The study offers valuable data on the actual state of hyperparathyroid patients in the Czech Republic.
Highlights
Primary hyperparathyroidism (PHPT) is currently the most common endocrine disorder after diabetes and thyroid diseases in postmenopausal women
The patients with primary hyperparathyroidism had a significantly higher median level of iPTH measured by different methods (Table 1)
The incidence of PHPT in Czech Republic increases from the fifth to the seventh decade of life and the number of cases peaks in elderly women (Figure 1). 40 years ago in former Czechoslovakia the PHPT mostly occurred in middle aged postmenopausal women
Summary
Primary hyperparathyroidism (PHPT) is currently the most common endocrine disorder after diabetes and thyroid diseases in postmenopausal women. The clinical presentation of PHPT has dramatically changed in the last 40 years. The change in clinical presentation was largely due to the introduction of automated serum calcium and iPTH (intact parathyroid hormone) measurement. The incidence of PHPT has changed dramatically. In the early 1970 the estimated incidence of PHPT in former Czechoslovakia was approximately 8 cases per 100 000 persons per year. Our data showed that the incidence of PHPT increased sharply to 24 cases per 100 000 persons per year in same community with the introduction of automated serum calcium and iPTH measurement. Earlier PHPT was considered a rare illness characterized by bone disease and urinary calculi. Primary hyperparathyroidism is a relatively common endocrine disorder which in 80 percent of cases is caused by a single adenoma arising in one of the four parathyroid glands
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