Either Abstract

(Adults - Parathyroid/Bone & Calcium Metabolism), #220515823197

Clinical Characteristics of Parathyroid Hormone Dependent Hypercalcaemia Case Series: Serdang Experience

Syarifah Syahirah Syed Abas, Endocrine Unit, Hospital Serdang; Tharani Naidu, Medical Department, Hospital Serdang; Radhamani Rajakumar, Endocrine Unit, Hospital Serdang; Syahrizan Samsuddin, Endocrine Unit, Hospital Serdang

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Introduction

Primary hyperparathyroidism (PHPT) is characterized by hypercalcaemia with elevated or inappropriately normal parathyroid hormone (PTH) and can be due to parathyroid adenoma, hyperplasia, and carcinoma. Their presentation varies from asymptomatic to symptomatic disease with osteoporosis, pancreatitis, and nephrolithiasis. The aims of this review is to look at the common clinical characteristics of PTH dependent hypercalcaemia patient presented to Serdang Hospital.

Methods

Retrospective analysis was performed to identify patients with PTH dependent hypercalcaemia investigated and managed by Endocrine Unit Hospital Serdang from year 2018 to 2022. Their clinical characteristics, presentation, complications and outcome of hypercalcaemia were recorded for descriptive analysis.

Results

A total of 13 patients were recorded. Majority of patient with IPTH dependent hypercalcaemia were female (57.14%), with median age of 50 years old (IQR 41-61). 7 out of 13 patients were symptomatic at presentation, with 2 patients presented with neurological symptoms (fitting and altered mental status). Median serum calcium corrected at presentation were 3.1 mmol/L (IQR 2.9-3.6), and phosphate 0.8 mmol/L (IQR 0.66-0.91), eGFR 74.8 ml/min per 1.73m2 (IQR 35.8-97.3). Median level of Vitamin D was 43.16 nmol/L (IQR 29.69-56.12). Positive parathyroid ultrasound (USG) findings were found in 5 out of 13 patients, and the result concordence with their sestamibi scan, while another 4 have negative USG but positive sestamibi. Four patients have nephrocalcinosis at diagnosis. Total of 3 patients whom underwent parathyroid operation; 1 case of parathyroid carcinoma, 1 parathyroid adenoma and 1 parathyroid hyperplasia. 1 case was associated with mediastinal NET, 1 case is PHPT in pregnancy waiting for surgery.

Conclusion

In conclusion, majority of our PHPT patient in Serdang hospital have symptomatic disease and requiring surgery.

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