PRIMARY HYPERPARATHYROIDISM – CASE SERIES AND CHALLENGES OF MANAGEMENT IN NIGERIA AND LOW INCOME COUNTRIES

Primary hyperparathyroidism (PHPT) is a rare endocrine disorder in which hypercalcemia is documented. They do not produce compressive symptoms, present usually with nonspecific symptoms or may be asymptomatic. The objective of this report is to draw attention to this disorder said to be rare especially in the low and middle income countries where PHPT diagnosis is made late when skeletal and renal complications have occurred. Two post menopausal Nigerian women with a diagnosis of PHPT made in the USA were referred to our endocrine practice in Aba, Nigeria. The older patient opted out of surgery while the younger patient had a successful parathyroidectomy in USA. There is a concern about other women/patients out there who may have PHPT but do not have access to medical services in USA and the developed world. There is, therefore, a need for a high index of suspicion by healthcare professionals and good laboratory support services in Nigeria and similar countries to clinch the diagnosis of PHPT before target organ damages (fractures, kidney stones and kidney failures) start manifesting. Keywords: primary hyperparathyroidism, challenges of diagnosis and management, low and middle income countries, Nigeria.