Diagnosis and treatment of primary hyperparathyroidism (20 years of own experience and literature review)

Authors

  • Yu.I. Karachentsev State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv Academy of Postgraduate Education of the Ministry of Health of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0003-1317-6999
  • M.E. Sazonov State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0001-9000-7115
  • V.V. Khaziev State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0003-1721-0381
  • V.N. Dubovik State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0003-4260-6070
  • O.A. Goncharova State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv Academy of Postgraduate Education of the Ministry of Health of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5864-5686
  • I.V. Gopkalova State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0001-8389-2232

DOI:

https://doi.org/10.22141/2224-0721.17.5.2021.241515

Keywords:

primary hyperparathyroidism, screening, questionnaires

Abstract

Background. Currently, primary hyperparathyroidism (pHPT) is the third most common endocrine disease after thyroid gland pathology and diabetes mellitus. Untimely diagnosis leads to a severe course of the disease with the development of disabling deformations — osteoporotic fractures, recurrent stone formation in the urinary tract, gastrointestinal bleeding, etc., as well as to an increased risk of premature death. The purpose of the study is to assess the dynamics of detection of thyroid disease (thyroid) for the period 2000–2019. Materials and methods. Since 2000, based on the surgical department of the clinic of the State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, 205 surgeries have been carried out for pHPT (in 188 women and 17 men: 91.7 and 8.3 %). Results. Since 2008, there has been a steady increase in the number of cases. The incidence of pHPT in women increases with age and becomes significantly higher at the age of 50–69 years. At the same time, the gap between women and men is widening, the reason for which needs to be studied. The proportional ratio of the number of patients with asymptomatic and clinically pronounced course persists for 20 years and is approximately 2 : 1. In countries where blood calcium screening has been introduced, the proportion of asymptomatic forms reaches 80 %. The obtained data confirm the fact of untimely diagnosis of pHPT in Ukraine, which requires the introduction of large-scale population screening in the form of a questionnaire survey and study of serum calcium. Conclusions. A positive contribution to the timely detection of pHPT can be made by activating the work of postgraduate (continuous) education institutions in this direction, primarily the departments of endocrinology based on endocrinological clinics with surgical departments.

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References

Dedov II, Melnichenko GA, Mokrysheva NG, et al. Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment. Problemi Endocrinologii. 2016;62(6):40-77. doi:10.14341/probl201662640-77. (in Russian).

Mokrysheva NG, Eremkina AK, Mirnaya SS, Kovaleva EV. Challenges in differential diagnosis between primary and secondary forms of hyperparathyroidism. Obesity and metabolism. 2017;14(3):48-53. doi:10.14341/omet2017348-53. (in Russian).

Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2017 Jan;28(1):1-19. doi:10.1007/s00198-016-3716-2.

Primary hyperparathyroidism. Nat Rev Dis Primers. 2016 May 19;2:16034. doi:10.1038/nrdp.2016.34.

Zhu CY, Sturgeon C, Yeh MW. Diagnosis and Management of Primary Hyperparathyroidism. JAMA. 2020 Mar 24;323(12):1186-1187. doi:10.1001/jama.2020.0538.

Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018 Feb;14(2):115-125. doi:10.1038/nrendo.2017.104.

Kaminskyi O. Parathyroid ultrasonography: methodology, clinical evaluation. Mìžnarodnij endokrinologìčnij žurnal. 2020;16(5):396-407. doi:10.22141/2224-0721.16.5.2020.212743. (in Ukrainian).

Madkhali T, Alhefdhi A, Chen H, Elfenbein D. Primary hyperparathyroidism. Ulus Cerrahi Derg. 2016 Mar 1;32(1):58-66. doi:10.5152/UCD.2015.3032.

Bouziane T, Belmahi N, El Ouahabi H. Primary hyperparathyroidism and Gougerot disease. Eur J Rheumatol. 2018 Mar;5(1):72-74. doi:10.5152/eurjrheum.2017.16127.

Farkhutdinova LM. Primary hyperparathyroidism: modern conception and clinical observation. Russian Archives of Internal Medicine. 2020;10(2):94-101. doi:10.20514/2226-6704-2020-10-2-94-101. (in Russian).

Tee MC, Holmes DT, Wiseman SM. Ionized vs serum calcium in the diagnosis and management of primary hyperparathyroidism: which is superior? Am J Surg. 2013 May;205(5):591-6;discussion 596. doi:10.1016/j.amjsurg.2013.01.017.

Norman J, Goodman A, Politz D. Calcium, parathyroid hormone, and vitamin D in patients with primary hyperparathyroidism: normograms developed from 10,000 cases. Endocr Pract. 2011 May-Jun;17(3):384-394. doi:10.4158/EP09346.OR.

Tay YD, Liu M, Bandeira L, et al. Occult urolithiasis in asymptomatic primary hyperparathyroidism. Endocr Res. 2018 May;43(2):106-115. doi:10.1080/07435800.2018.1431275.

Black CE, Berg RL, Urquhart AC. 24-hour urinary calcium in primary hyperparathyroidism. Clin Med Res. 2013 Dec;11(4):219-225. doi:10.3121/cmr.2013.1164.

Walker MD, Silverberg SJ. Primary hyperparathyroidism . Nat Rev Endocrinol. 2018 Feb;14(2):115-125. doi:10.1038/nrendo.2017.104.

Walker MD, Cong E, Lee JA, et al. Vitamin D in primary hyperparathyroidism: effects on clinical, biochemical, and densitometric presentation. J Clin Endocrinol Metab. 2015 Sep;100(9):3443-3451. doi:10.1210/jc.2015-2022.

Simonds WF. Genetics of hyperparathyroidism, including parathyroid cancer. Endocrinol Metab Clin North Am. 2017 Jun;46(2):405-418. doi:10.1016/j.ecl.2017.01.006.

Bilezikian JP, Potts JT Jr, Fuleihan Gel-H, et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab. 2002 Dec;87(12):5353-5361. doi:10.1210/jc.2002-021370.

Wermers RA, Khosla S, Atkinson EJ, Hodgson SF, O'Fallon WM, Melton LJ 3rd. The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965-1992. Ann Intern Med. 1997 Mar 15;126(6):433-440. doi:10.7326/0003-4819-126-6-199703150-00003.

Christensson T, Hellström K, Wengle B, Alveryd A, Wikland B. Prevalence of hypercalcaemia in a health screening in Stockholm. Acta Med Scand. 1976;200(1-2):131-137. doi:10.1111/j.0954-6820.1976.tb08208.x.

Baranova IA, Klemushina TV, Zykova TA. Epidemiology of primary hyperparathyroidism - invisible part of the iceberg (literature rewiew). Medical Herald of the South of Russia. 2016;(2):4-8. doi:10.21886/2219-8075-2016-2-4-8. (in Russian).

Bilezikian JP. Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2018 Nov 1;103(11):3993-4004. doi:10.1210/jc.2018-01225.

Cherenko S. Primary hyperparathyroidism: a modern laboratory diagnosis and differential diagnosis. Mìžnarodnij endokrinologìčnij žurnal. 2014;(62):174-181. doi:10.22141/2224-0721.6.62.2014.76949. (in Ukrainian).

Weber T, Dotzenrath C, Dralle H, et al. Management of primary and renal hyperparathyroidism: guidelines from the German Association of Endocrine Surgeons (CAEK). Langenbecks Arch Surg. 2021 May;406(3):571-585. doi:10.1007/s00423-021-02173-1.

National Guideline Centre (UK). Hyperparathyroidism (primary): diagnosis, assessment and initial management. London: National Institute for Health and Care Excellence (UK); 2019 May.

Palermo A, Naciu AM, Tabacco G, et al. Clinical, Biochemical, and Radiological Profile of Normocalcemic Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2020 Jul 1;105(7):dgaa174. doi:10.1210/clinem/dgaa174.

Reid L, Muthukrishnan B, Patel D, et al. Presentation, diagnostic assessment and surgical outcomes in primary hyperparathyroidism: a single centre's experience. Endocr Connect. 2018 Aug 23;7(10):1105-1115. doi:10.1530/EC-18-0195.

Yadav SK, Johri G, Bichoo RA, Jha CK, Kintu-Luwaga R, Mishra SK. Primary hyperparathyroidism in developing world: a systematic review on the changing clinical profile of the disease. Arch Endocrinol Metab. 2020 Apr;64(2):105-110. doi:10.20945/2359-3997000000211.

Wu JX, Yeh MW. Asymptomatic primary hyperparathyroidism: diagnostic pitfalls and surgical intervention. Surg Oncol Clin N Am. 2016 Jan;25(1):77-90. doi:10.1016/j.soc.2015.08.004.

Cusano NE, Maalouf NM, Wang PY, et al. Normocalcemic hyperparathyroidism and hypoparathyroidism in two community-based nonreferral populations. J Clin Endocrinol Metab. 2013 Jul;98(7):2734-2741. doi:10.1210/jc.2013-1300.

Vignali E, Cetani F, Chiavistelli S, et al. Normocalcemic primary hyperparathyroidism: a survey in a small village of Southern Italy. Endocr Connect. 2015 Sep;4(3):172-178. doi:10.1530/EC-15-0030.

Soon PS, Delbridge LW, Sywak MS, Barraclough BM, Edhouse P, Sidhu SB. Surgeon performed ultrasound facilitates minimally invasive parathyroidectomy by the focused lateral mini-incision approach. World J Surg. 2008 May;32(5):766-771. doi:10.1007/s00268-007-9436-1.

Nilsson IL. Primary hyperparathyroidism: should surgery be performed on all patients? Current evidence and residual uncertainties. J Intern Med. 2019 Feb;285(2):149-164. doi:10.1111/joim.12840.

Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol. 2012 Feb;19(2):577-583. doi:10.1245/s10434-011-1870-5.

Nafisi Moghadam R, Amlelshahbaz AP, Namiranian N, et al. Comparative Diagnostic Performance of Ultrasonography and 99mTc-Sestamibi Scintigraphy for Parathyroid Adenoma in Primary Hyperparathyroidism; Systematic Review and Meta- Analysis. Asian Pac J Cancer Prev. 2017 Dec 28;18(12):3195-3200. doi:10.22034/APJCP.2017.18.12.3195.

Giusti M, Dolcino M, Vera L, et al. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue. J Zhejiang Univ Sci B. 2009 May;10(5):323-330. doi:10.1631/jzus.B0820372.

Vestergaard P, Mosekilde L. Cohort study on effects of parathyroid surgery on multiple outcomes in primary hyperparathyroidism. BMJ. 2003 Sep 6;327(7414):530-534. doi:10.1136/bmj.327.7414.530.

Kouvaraki MA, Greer M, Sharma S, et al. Indications for operative intervention in patients with asymptomatic primary hyperparathyroidism: practice patterns of endocrine surgery. Surgery. 2006 Apr;139(4):527-534. doi:10.1016/j.surg.2005.09.006.

Khosla S, Melton LJ 3rd, Wermers RA, et al. Primary hyperparathyroidism and the risk of fracture: a population-based study. J Bone Miner Res. 1999 Oct;14(10):1700-1707. doi:10.1359/jbmr.1999.14.10.1700.

Šiprová H, Fryšák Z, Souček M. Primary hyperparathyroidism, with a focus on management of the normocalcemic form: to treat or not to treat? Endocr Pract. 2016 Mar;22(3):294-301. doi:10.4158/EP15704.OR.

Irvin GL 3rd, Dembrow VD, Prudhomme DL. Operative monitoring of parathyroid gland hyperfunction. Am J Surg. 1991 Oct;162(4):299-302. doi:10.1016/0002-9610(91)90135-z.

Irvin GL 3rd, Carneiro DM, Solorzano CC. Progress in the operative management of sporadic primary hyperparathyroidism over 34 years. Ann Surg. 2004 May;239(5):704-708; discussion 708-711. doi:10.1097/01.sla.0000124448.49794.74.

Published

2022-01-04

How to Cite

Karachentsev, Y., Sazonov, M., Khaziev, V., Dubovik, V., Goncharova, O., & Gopkalova, I. (2022). Diagnosis and treatment of primary hyperparathyroidism (20 years of own experience and literature review). INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 17(5), 377–384. https://doi.org/10.22141/2224-0721.17.5.2021.241515

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