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Clinical spectrum of primary hyperparathyroidism
Nidal A Younes1, Imad S Al-Trawneh, Nader M Albesoul
1Department of Surgery, Jordan University Hospital, PO Box 13024, Amman, Jordan. niyounes@ju.edu.jo
Saudi Medical Journal
|April 12, 2003
Summary
Primary hyperparathyroidism (1HPT) often presents with severe bone disease in Jordan, frequently due to delayed diagnosis. Early screening and specialized management are crucial for better outcomes in HPT patients.
Area of Science:
- Endocrinology
- Surgical Pathology
- Neurosurgery
Background:
- Primary hyperparathyroidism (1HPT) diagnosis is increasing.
- Changes in disease presentation and surgical indications are noted.
- This study examines clinical presentation, surgical indications, and outcomes of 1HPT neck explorations.
Purpose of the Study:
- To analyze the clinical presentation of 1HPT.
- To review indications for surgery in 1HPT patients.
- To evaluate the outcomes of neck explorations for 1HPT.
Main Methods:
- Retrospective analysis of a surgical database from January 1990 to April 2002 at Jordan University Hospital.
- Inclusion of all patients undergoing neck exploration for 1HPT.
- Minimum 12-month follow-up for outcome assessment.
Main Results:
- Out of 40 patients, 35% were diagnosed 4 years after disease onset.
- Severe bone disease (fractures, cysts, brown tumors, osteoporosis) was the primary surgical indication (28 patients).
- Overall cure rate was 97.5% after addressing persistent hypercalcemia via reoperation for ectopic parathyroid.
Conclusions:
- Severe bone disease remains a common presentation of 1HPT in Jordan, likely due to diagnostic delays.
- Screening high-risk patients for 1HPT is essential.
- Referral to specialized centers is recommended for optimal management of 1HPT.