ArticleBMC endocrine disorders2024
Characteristics, management and outcomes of primary hyperparathyroidism from 2009 to 2021: a single centre report from South Africa.
Article in BMC endocrine disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Comparison of the two treatment methods in primary hyperparathyroidism due to solitary parathyroid adenoma, Ultrasound-guided percutaneous alcohol ablation vs. parathyroidectomy: a randomized controlled trial.BMC endocrine disorders · 2025Trial
- Diagnostic efficacy of ([Ca]×[Cl])/P combined with ALP in the diagnosis and subtype differentiation of primary hyperparathyroidism.Frontiers in endocrinology · 2026Article
- Three Malagasy Cases of Severe Bone Complications Revealing Primary Hyperparathyroidism.Case reports in endocrinology · 2026Article
- Case Report: Developmental-like skeletal deformities and transient osteosclerosis as rare presentations of primary hyperparathyroidism.Frontiers in endocrinology · 2026Article
- Postoperative hungry bone syndrome in primary hyperparathyroidism: risk factors and outcomes at a South African tertiary centre.BMC endocrine disorders · 2025Article
- Predictors of Hypocalcemia Post Parathyroidectomy for Primary Hyperparathyroidism; a Single Center Study.Endocrinology, diabetes & metabolism · 2025Article
- Preoperative phosphorus levels may serve as a predictor of recurrent/persistent lesions after surgery for primary hyperparathyroidism: a cross-sectional study.Gland surgery · 2025Article
- Impact of intraoperative intact PTH monitoring on reoperation rates and surgical success in primary hyperparathyroidism.BMC endocrine disorders · 2025Article
- Primary Hyperparathyroidism: An Analysis Amid the Co-Occurrence of Type 2 Diabetes Mellitus.Life (Basel, Switzerland) · 2025Review
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Abstract
backgroundThere has been a notable shift towards the diagnosis of less severe and asymptomatic primary hyperparathyroidism (PHPT) in developed countries. However, there is a paucity of recent data from sub-Saharan Africa (SSA), and also, no reported data from SSA on the utility of intra-operative parathyroid hormone (IO-PTH) monitoring. In an earlier study from Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa (2003-2009), majority of patients (92.9%) had symptomatic disease. The aim of this study was to evaluate the clinical profile and management outcomes of patients presenting with PHPT at IALCH.
methodsA retrospective chart review of patients with PHPT attending the Endocrinology clinic at IALCH between July 2009 and December 2021. Clinical presentation, laboratory results, radiologic findings, surgical notes and histology were recorded.
resultsAnalysis included 110 patients (87% female) with PHPT. Median age at presentation was 57 (44; 67.5) years. Symptomatic disease was present in 62.7% (n:69); 20.9% (n:23) had a history of nephrolithiasis and 7.3% (n:8) presented with previous fragility fractures. Mean serum calcium was 2.87 ± 0.34 mmol/l; median serum-PTH was 23.3 (15.59; 45.38) pmol/l, alkaline phosphatase 117.5 (89; 145.5) U/l and 25-hydroxyvitamin-D 42.9 (33.26; 62.92) nmol/l. Sestamibi scan (n:106 patients) identified an adenoma in 83.02%. Parathyroidectomy was performed on 84 patients with a cure rate of 95.2%. Reasons for conservative management (n:26) included: no current surgical indication (n:7), refusal (n:5) or deferral of surgery (n:5), loss to follow-up (n:5) and assessed as high anaesthetic risk (n:4). IO-PTH measurements performed on 28 patients indicated surgical success in 100%, based on Miami criteria. Histology confirmed adenoma in 88.1%, hyperplasia in 7.1% and carcinoma in 4.8%. Post-operative hypocalcaemia developed in 30 patients (35.7%), of whom, 14 developed hungry bone syndrome (HBS). In multivariate analysis, significant risk factors associated with HBS included male sex (OR 7.01; 95% CI 1.28, 38.39; p 0.025) and elevated pre-operative PTH (OR 1.01; 95% CI 1.00, 1.02; p 0.008).
conclusionsThe proportion of asymptomatic PHPT has increased at this centre over the past decade but symptomatic disease remains the dominant presentation. Parathyroidectomy is curative in the majority of patients. IO-PTH monitoring is valuable in ensuring successful surgery.
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