Details

Autor(en) / Beteiligte

• Saponaro, F.
• Cetani, F.
• Repaci, A.
• Pagotto, U.
• Cipriani, C.
• Pepe, J.
• Minisola, S.
• Cipri, C.
• Vescini, F.
• Scillitani, A.
• Salcuni, A.
• Palmieri, S.
• Eller-Vainicher, C.
• Chiodini, I.
• Madeo, B.
• Kara, E.
• Castellano, E.
• Borretta, G.
• Gianotti, L.
• Romanelli, F.
• Camozzi, V.
• Faggiano, A.
• Corbetta, S.
• Cianferotti, L.
• Brandi, M. L.
• De Feo, M. L.
• Palermo, A.
• Vezzoli, G.
• Maino, F.
• Scalese, M.
• Marcocci, C.

Titel

Clinical presentation and management of patients with primary hyperparathyroidism in Italy

Ist Teil von

• Journal of endocrinological investigation, 2018-11, Vol.41 (11), p.1339-1348

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose Evaluation of the phenotype of primary hyperparathyroidism (PHPT), adherence to International Guidelines for parathyroidectomy (PTx), and rate of surgical cure. Method From January 2014–January 2016, we performed a prospective, multicenter study in patients with newly diagnosed PHPT. Biochemical and instrumental data were collected at baseline and during 1-year follow-up. Results Over the first year we enrolled 604 patients (age 61 ± 14 years), mostly women (83%), referred for further evaluation and treatment advice. Five hundred sixty-six patients had sporadic PHPT (93.7%, age 63 ± 13  years), the remaining 38 (6.3%, age 41 ± 17  years) had familial PHPT. The majority of patients (59%) were asymptomatic. Surgery was advised in 281 (46.5%). Follow-up data were available in 345 patients. Eighty-seven of 158 (55.1%) symptomatic patients underwent PTx. Sixty-five (53.7%) of 121 asymptomatic patients with at least one criterion for surgery underwent PTx and 56 (46.3%) were followed without surgery. Negative parathyroid imaging studies predicted a conservative approach [symptomatic PHPT: OR 18.0 (95% CI 4.2–81.0) P  < 0.001; asymptomatic PHPT: OR 10.8, (95% CI 3.1–37.15) P  < 0.001). PTx was also performed in 16 of 66 (25.7%) asymptomatic patients without surgical criteria. Young age, serum calcium concentration, 24 h urinary calcium, positive parathyroid imaging (either ultrasound or MIBI scan positive in 75% vs. 16.7%, P  = 0.001) were predictors of parathyroid surgery. Almost all (94%) of patients were cured by PTx. Conclusions Italian endocrinologists do not follow guidelines for the management of PHPT. Negative parathyroid imaging studies are strong predictors of a non-surgical approach. PTx is successful in almost all patients.