Clinical and laboratory features of primary hyperparathyroidism in Tyumen region: retrospective data of a three-year follow-up

Background: The lack of accurate data on the prevalence of primary hyperparathyroidism (PHPT), the variety of clinical forms, the lack of routine biochemical screening of serum calcium levels, as well as the difficulty in the topical search for adenoma dictate the need for a detailed study of the clinical and laboratory features of PHPT.

Aim: Assess the clinical course and laboratory features of patients with PHPT in Tyumen region.

Materials and methods: A retrospective analysis of the case histories of 201 patients with PHPT who were hospitalized in the surgical department No. 2 at the Regional Clinical Hospital No. 1 in Tyumen in the period 2019–2021 was carried out. demographic and anthropometric data were studied, laboratory data (PTH, levels of total and ionized calcium, 25(OH)D) and instrumental (ultrasound) of the thyroid and parathyroid glands, CT and MRI of the neck organs with and without contrast were evaluated, scintigraphy of the parathyroid glands with technetrile) diagnostic methods.

Results: The incidence of PHPT in the Tyumen region was 5.8 cases per 100 thousand population in 2019, in 2020. — 3.2 cases in 2021 — 4.0 cases. The average age of all patients with PHPT was 60±11.05 years, 94.0% were women. The duration of the disease from the onset of the first symptoms to the time of diagnosis, on average, was 2.0±1.3 years. The manifest form of PHPT was detected in 80.1%, asymptomatic form in 17.9% of the examined, normocalcemic in 2.0% of patients. Among the main clinical manifestations of PHPT, the leading place is occupied by diseases of the cardiovascular system (n=157), ­manifested in the form of coronary heart disease, left ventricular hypertrophy, chronic heart failure in 68.1% of cases; in 86.9% arterial hypertension and cardiac arrhythmias in 6.9% of patients. Of the total number of patients, only 13.9% (n=28) had the level of 25(OH)D examined, of which 68% were diagnosed with a state of its deficiency or insufficiency.

Conclusion: Clinical manifestations of PHPT in the form of cardiovascular pathology dictate the need for a routine study of calcium levels in this category of patients, as well as clarification of the pathogenetic mechanisms underlying this relationship. The available data on the contribution of vitamin D deficiency to the development and progression of PHPT at the pre- and postoperative stage indicate need for study of 25(OH)D in this category of patients.

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