Artículo original Hiperparatiroidismo primario. Experiencia en el Hospital de Especialidades Centro Médico Nacional Siglo XXI

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder. It is characterized by chronic and excessive secretion of parathyroid hormone (PTH) originating from one or more parathyroid glands. The PHPT is associated with hypercalcemia and elevated levels of PTH. The incidence is variable and it is more frequent in post menopausic women (3:1). In the last decades the diagnosis of asymptomatic PHPT has increased since the introduction of automatized determinations of serum calcium . The symptomatology is related with the levels of calcium and PTH as well as the duration of the disease. Surgery is the primary option in treatment. It is important to assess the surgical criteria in asymptomatic patients. The successful treatment of this disease depends on a highly specialized team of parathyroid surgeons. Material and methods: We reviewed the clinical and biochemical background of patients that were subject to parathyroidectomy from January 1998 to December 2009 in our medical center. We analyzed the clinical and laboratory data, the final histopathologic diagnosis, and the surgery outcome. Results: 145 patients were included, with an average age of 53.2 years (± 13), including 25 men and 120 women. The greatest frequency of PHPT was observed in patients between 40 and 69 years of age. The average calcium level at diagnosis was 11.8 mg/dL (± 1.34) and the level of PTH was of 316.5 (50-4627 pg/mL). The histopathology diagnosis was: adenoma in 110 (76.6%), hyperplasia in 28 (19.3 %) and carcinoma in 6 (4.1%) patients. The disease was considered to be cured in 138 patients (95.2%) after the first surgery. Conclusions: PHPT is a surgically curable disease, it is necessary to confirm the diagnosis and decide the surgical treatment in accordance with the established criteria even if the disease is asymptomatic.