Primary Hyperparathyroidism: Report of Cases in Asymptomatic Older Adults in Honduras

Maradiaga Montoya RY

Department of Internal Medicine, Catholic University of Honduras, Honduras

^*Correspondance to: Ramon Yefrin Maradiaga Montoya 

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Abstract:

Introduction: Primary Hyperparathyroidism (PHPT) is characterized by hypercalcemia, hypophosphatemia, and elevated PTH levels. The profile is a woman over 50 years of age, postmenopausal, and is detected in her asymptomatic presentation by performing screening studies measuring calcium and serum phosphates. The 85% of cases are asymptomatic and are due to a PTHproducing parathyroid adenoma. The symptomatic case may have kidney damage, osteoporosis and cardiovascular involvement. Imaging studies are performed to look for adenomas; management can be surgical or conservative. Clinical case one: 77-year-old female, with arterial hypertension, asymptomatic. He went for routine evaluation with vitamin D 10.6 ng/ml, serum creatinine 1.7 mg/dl, serum calcium 11.9 mg/ dl, albumin 4.5 g/dl, phosphorus 2.26 mg/d, PTH 163.30 pg/ml, ultrasound neck without masses, normal abdominal ultrasound and normal electrocardiogram. Conservative management with bisphosphonate was decided. Clinical case two: 75-year-old female, hypertensive, obese, and asymptomatic with routine tests with calcium 12 mg/dl, phosphorus 2.36 mg/dl, vitamin D 17.1 ng/ml, PTH 340 pg/mL, electrocardiogram with sinus bradycardia, Normal abdominal ultrasound, and thyroid ultrasound with a 1.4 cm by 1.6 cm nodule. Conservative management with bisphosphonate was decided. Conclusion: Screening should measure calcium, phosphorus and PTH levels in patients over 50 years of age. In asymptomatic older adults, conservative management can be performed and in symptomatic patients, treatment is surgical.

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Cite the Article:

Maradiaga Montoya RY. Primary Hyperparathyroidism: Report of Cases in Asymptomatic Older Adults in Honduras. Clin Case Rep Int. 2024; 8: 1698.