Comparative analysis of clinical manifestations of primary hyperparathyroidisis by results of hospitalizations and screening for hypercalcia in the Arkhangelsk region

Abstract

Objective: to compare the forms and clinical course of primary hypeparathyroidism in hospitalized patients over a ten-year period, with patients identified by a routine analysis of blood calcium in Arkhangelsk region.Material and methods: At the first stage, a retrospective analysis of 48 case histories of patients who received inpatient treatment for PHPT in two multidisciplinary hospitals in Arkhangelsk from 2005 to 2015 was carried out. At the second stage, a screening of blood calcium was performed in patients of large outpatient clinic in Arkhangelsk from March 1 to March 31, 2015, as a result of which 21 cases of the first established PHPT were detected. A comparative analysis of the clinical course was carried out in two groups of patients with PHPT compared with the control group.Results: patients with PHPT detected during screening showed a higher incidence of mild forms of the disease (38 %), a higher level of bone mineral density in all parts of the skeleton according to dual-energy X-ray absorptiometry, and a lower incidence of nephrolithiasis (24 % vs. 69 %) compared with hospitalized patients, among which the manifest forms of the disease prevailed (88 %), fibrocystic osteitis was detected in 44 % of cases, and coral nephrolithiasis - in 10% of cases.Conclusion: a routine study of blood calcium levels helps to identify primary hyperparathyroidism at earlier stages to prevent the development of severe complications and invalidisation of patients.

Keywords

• primary hyperparathyroidism
• screening
• blood calcium
• osteoporosis
• nephrolithiasis