Clinical, biochemical, and radiological profile of adult patients with primary hyperparathyroidism operated at a single tertiary care center in North India

ABSTRACT Objective: Limited studies have examined the profile of only those primary hyperparathyroidism (PHPT) patients who had parathyroid surgery in the Indian context. This study aimed to analyse the clinical, biochemical, and radiological profile of adult patients with PHPT who underwent parathyroid surgery at a single tertiary care center. Materials and Methods: In this prospective descriptive study, adult patients who were diagnosed with PHPT and underwent parathyroid surgery were included. Radiological and nuclear imaging to localize abnormal parathyroid was done in all patients preoperatively. All patients underwent ultrasonography (USG) by a single experienced radiologist and were operated by a single endocrine surgeon. Results: A total of 105 patients, 81 females; age 54.9 ± 12.8 years were included. The majority (95.2%) of the patients were symptomatic. The common symptoms were musculoskeletal weakness (62.8%), bone pain (61.9%), fatigue (60.0%), nausea/vomiting (51.4%), and dyspepsia (41.9%). Albumin-corrected serum total calcium and intact parathyroid hormone levels were 12.3 ± 1.3 mg/dL and 153.4 (61.5–1739.4 pg/dL), respectively. USG neck alone could localize the abnormal gland in 92.4% of subjects, and sestamibi scan alone in 72.5% of subjects, whereas when both were combined, the concordance was 95% to correctly localize the abnormal gland. Except two, all other patients had biochemical remission postparathyroid surgery. The most common histological diagnosis was solitary parathyroid adenoma (95.2%). Conclusion: In our study, most patients with PHPT undergoing parathyroid surgery were symptomatic, with a high success rate when performed by a high-volume parathyroid surgeon.