Long‐term Outcome after Parathyroidectomy in Patients with Advanced Primary Hyperparathyroidism and Associated Vitamin D Deficiency

Abstract

In India, PHPT presents at an advanced stage and is associated with vitamin D deficiency. Persistent vitamin D deficiency after operation delays bone recovery. Replenishment of vitamin D stores in the follow-up has to be continuously ensured. Recovery from renal disease is gradual and may never occur in some patients; in others, it may progress to ESRD. Patients recover fully from pancreatitis.

Systematic Review of Primary Hyperparathyroidism in India: The Past, Present, and the Future Trends

“…Publications on PHPT from India are limited to few select centers [4–10]. The majority (twenty-one) of publications were from Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (SGPGIMS) from which the data of the first 100 cases is included in this study [4, 5]. Figure 1 shows the decade-wise publications from India since the first publication in 1980 [11].…”

“… Figure 4 shows a case where a brown tumor was excised and replaced by prosthesis as the diagnosis of PHPT was missed. Data from SGPGIMS, India [4, 5] revealed fractures in 57% of the patients, brown tumors in 49%, and 27% of patients were crippled (due to multiple fractures). Combined bone and kidney disease was seen in 36% of patients, psychiatric symptoms in 38%, and palpable neck masses in 33%.…”

Worsening of bone disease after curative surgery in primary hyperparathyroidism

“…Usually after curative surgery for PHPT, most of the symptoms are relieved and co-morbidities gradually decrease or disappear 10. However, in most instances in our setting, the renal stone disease or nephrocalcinosis is just forgotten, as there is no formation of new renal calculus and patients are usually asymptomatic after normalisation of hypercalcaemia.…”

Comment on: Eucalcemic Parathyroid Hormone Elevation After Parathyroidectomy for Primary Sporadic Hyperparathyroidism: Risk Factors, Trend, and Outcome

“…We also found that parathyroid hormone (PTH) levels and recovery of bones after surgery were influenced by vitamin D (Vit D) deficiency. 2 We have certain comments and queries regarding this study.…”