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Primary hyperparathyroidism: insights from the Indian PHPT registry
Sanjay Kumar Bhadada1, Ashutosh Kumar Arya2, Satinath Mukhopadhyay3
1Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. bhadadask@rediffmail.com.
Journal of Bone and Mineral Metabolism
|April 2, 2017
Summary
Primary hyperparathyroidism (PHPT) in India predominantly affects symptomatic patients, with bone and kidney issues being common. Indian PHPT patients are younger with more severe biochemical issues and larger adenomas than Western counterparts.
Area of Science:
- Endocrinology
- Nephrology
- Bone Metabolism
Background:
- Primary hyperparathyroidism (PHPT) presentation varies globally.
- Understanding regional variations in PHPT is crucial for effective management.
Purpose of the Study:
- To analyze the clinical, biochemical, radiological, and histopathological characteristics of PHPT patients in India.
- To compare these characteristics across different geographical regions within India.
Main Methods:
- Retrospective analysis of data from the Indian PHPT registry (July 2005-June 2015).
- Inclusion of 464 histopathologically confirmed PHPT cases from 5 centers.
- Evaluation of clinical symptoms, biochemical markers, imaging, and histopathology.
Main Results:
- 95% of Indian PHPT patients were symptomatic, commonly presenting with weakness, bone pain, and renal stones.
- Mean serum calcium: 11.9 mg/dL, parathyroid hormone: 752.4 pg/mL, phosphorus: 2.8 mg/dL.
- Combined ultrasonography and sestamibi scanning achieved 93% accuracy in localizing parathyroid adenomas.
Conclusions:
- Most PHPT patients in India are symptomatic, with high rates of bone disease and renal impairment.
- Indian PHPT patients tend to be younger, with more severe biochemical abnormalities and larger adenomas compared to Western populations.
- Findings may be influenced by tertiary care data and lack of routine serum calcium screening.