POS-090 PRIMARY HYPERPARATYHROIDISM: A NEPHROLOGIST EXPERIENCE

Abstract

Primary hyperparathyroidism (PHPT) is a common endocrine disorder frequently encountered in everyday practice. It classically presents with hypercalcemia which is the hallmark of the disease in association with inappropriately normal to high levels of PTH . The clinical presentation may vary from asymptomatic to symptomatic disease with eventual complications, for instance skeletal and renal abnormalities. It may be due to a single benign parathyroid adenoma which is by far the most common cause or a multiglandular disease in the familial forms Herein is a retrospective and descriptive single-center study of PHPT observed among patients between 2010 and 2020 realized in our department of nephrology in Monastir Tunisia. 10 patients were gathered. The mean age was 58.5 years ranging from 27 to 87 years . The sex ratio was1 :1. Hypertension was found in 5 patients (50 %) : 3 females and 2 males. 1 patient was found to have diabetes. Lithiasis occured in 3 patients all of whom were women and nephrocalcinosis occured in 2 patients. There were no vascular calcifications nor pain in any patient. The average hemoglobin was 9.2 g/dl ranging from 8 to 11.3 g/dl. All patients had hypercalcemia with a mean of 3.09 mmol/l. 5 patients had hypophosphatemia (50 %). PAL was available in 5 patients all of whom had elevated levels with a mean of 190.8 UI/ml. The mean creatinine level was 196.2 umol/l. Cervical ultrasound was performed in all patients and came back normal in 6 patients (60%). In the remaining patients, it has shown bilateral or unilateral lobules. Scintigraphy was also performed in all patients and findings were consistent with those found in the 4 patients with ultrasound abnormalities but has shown anomaly in 4 of the 6 patients (66%) in whom ultrasound came back normal. One patient had developed a brown tumor. Total parathyroidectomy was performed in 6 patients and partial parathyroidectomy in 2 patients. In the post-operative follow-up, all of the patients have normalized their calcemia levels , 5 patients have normalized their kidney function (50%) and the diagnosis of acute kidney injury secondary to hypercalcemia was retained. PHPT affects women 3 to 4 times more than men but in our study they were similar. Hypercalcemia was the most important biological sign.