Open AccessPrimary Hyperparathyroidism is Underdiagnosed and Suboptimally Treated in the Clinical Setting
Author(s) -
Enell Jacob,
Bayadsi Haytham,
Lundgren Ewa,
Hennings Joakim
Publication year - 2018
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-018-4574-1
Subject(s) - medicine , primary hyperparathyroidism , abdominal surgery , vascular surgery , hyperparathyroidism , cardiothoracic surgery , parathyroidectomy , cardiac surgery , pediatrics , general surgery , surgery , parathyroid hormone , calcium
Purpose To evaluate whether patients presenting with laboratory results consistent with primary hyperparathyroidism (pHPT) are managed in accordance with guidelines. Methods The laboratory database at a hospital in Sweden, serving 127,000 inhabitants, was searched for patients with biochemically determined pHPT. During 2014, a total of 365 patients with biochemical laboratory tests consistent with pHPT were identified. Patients with possible differential diagnoses or other reasons for not being investigated according to international guidelines were excluded after scrutinizing records, after new blood tests, and clinical assessments by endocrine surgeons. Results Altogether, 92 patients had been referred to specialists and 82 had not. The latter group had lower serum calcium (median 2.54 mmol/L) and PTH (5.7 pmol/L). Out of these 82 cases, 9 patients were diagnosed with pHPT or had some sort of long‐term follow‐up planned as outpatients. Conclusion Primary hyperparathyroidism is overlooked and underdiagnosed in a number of patients in the clinical setting. It is important to provide local guidelines for the management of patients presenting with mild pHPT to ensure that these patients receive proper evaluation and follow‐up according to current research.