Parathyroid surgery for hypercalcaemic crisis in primary hyperparathyroidism-a retrospective study

Area of Science:

• Endocrinology
• Surgical Oncology
• Neurosurgery

Background:

• Hypercalcaemic crisis (HCC) is a severe complication of elevated serum calcium, often caused by parathyroid hormone (PTH) secreting tumors.
• Primary hyperparathyroidism (PHPT) is the most frequent etiology of HCC.
• This study investigates factors influencing parathyroid surgery outcomes in HCC patients.

Purpose of the Study:

• To analyze the outcomes of parathyroid surgery in patients with hypercalcaemic crisis.
• To identify factors affecting surgical success rates in HCC.
• To emphasize the importance of timely surgical intervention for HCC.

Main Methods:

• Retrospective data collection including demographics, biochemistry, histology, localization studies, and surgical outcomes.
• Patients were stratified into mild, moderate, and severe hypercalcaemia groups based on serum calcium levels.
• Operative cure was defined by post-operative PTH normalization and sustained normal adjusted calcium levels at 6 months.

Main Results:

• A total of 175 patients underwent parathyroid surgery for HCC between 2018 and 2025.
• Severe hypercalcaemia was associated with significantly higher preoperative adjusted calcium, PTH levels, and parathyroid gland weight.
• Disease-related admissions were significantly higher in patients with moderate and severe hypercalcaemia.

Conclusions:

• Parathyroid surgery achieved an overall 93% success rate in treating HCC, with no significant difference based on hypercalcaemia severity.
• Surgical intervention is effective in managing HCC, aligning with current clinical guidelines.
• Increased awareness and prioritization of surgical treatment for HCC are recommended for healthcare providers.