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Original Papers

Patients with primary hyperparathyroidism undergoing surgical intervention in two tertiary care hospitals in Sri Lanka

Authors:

R. S. Mohamed ,

Teaching Hospital Kandy, LK
About R. S.
Department of Diabetes and Endocrinology
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R. P. S. N. Abeynayake,

Teaching Hospital Kandy, LK
About R. P. S. N.
Department Of Oncological Surgery
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R. Manathunga,

Teaching Hospital Kandy, LK
About R.

Department Of Oncological Surgery

Diabetes and endocrine unit, Provincial General Hospital Badulla

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T. Samarasekara,

Provincial General Hospital Badulla, LK
About T.
Diabetes and endocrine unit
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C. N. Antonypillai

Teaching Hospital Kandy, LK
About C. N.
Department of Diabetes and Endocrinology
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Abstract

Introduction

Autonomous production of parathyroid hormone results in primary hyperparathyroidism. Sri Lankan studies analyzing cases of hyperparathyroidism are scarce.

 

Objective

To describe clinical, biochemical, radiological and pathological characteristics of patients with primary hyperparathyroidism undergoing surgical intervention in two tertiary care hospitals in Sri Lanka.

 

Design

Data was collected from the available records of all patients who has undergone surgery for primary hyperparathyroidism at Teaching Hospital, Kandy and General Hospital, Badulla from 2016.10.27 to date. A total of ten patients with primary hyperparathyroidism were enrolled for analysis. Out of the ten patients, six were females. Ages ranged from 23 to 65 years (Mean- 44.2). Mode of presentation was fragility fractures in four patients, renal calculi in five patients and acute pancreatitis in one patient. Bone complications (fractures, osteoporosis) were seen in four patients and renal complications (renal calculi, nephrocalcinosis) were seen in six patients. Pre-operative total serum calcium levels ranged from 10.52 to 14.16 mg/dl (mean-12.6). Pre-operative serum phosphate levels ranged from 0.74 to 1.07 mmol/L (mean -0.868).

X-ray evidence of skeletal changes of hands were seen in 6 patients (60%), of which 4 showed bony deformities and 2 showed pathological fractures. Renal calculi or nephrocalcinosis was detected by X-ray in five out of six patients and ultrasonically in all 6 patients. Ultrasound scans revealed a parathyroid adenoma in 8 patients (80%), while 2 were negative. Technetium-99-methoxyisonitrile (99m Tc-Sestamibi) scans were performed in 4 patients and three had positive images. Histological analysis revealed 8 patients with single parathyroid adenoma, 1 with parathyroid carcinoma, and one patient with four gland hyperplasia.

 

Discussion and Conclusions

All patients had symptoms at the time of diagnosis. Ultrasound scan was a useful tool for the localization.
How to Cite: Mohamed, R.S., Abeynayake, R.P.S.N., Manathunga, R., Samarasekara, T. and Antonypillai, C.N., 2019. Patients with primary hyperparathyroidism undergoing surgical intervention in two tertiary care hospitals in Sri Lanka. Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 9(2), pp.39–43. DOI: http://doi.org/10.4038/sjdem.v9i2.7397
Published on 12 Dec 2019.
Peer Reviewed

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