Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1339-1348 |
| Number of pages | 10 |
| Journal | Journal of Endocrinological Investigation |
| Volume | 41 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2018 |
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Keywords
- Parathyroid adenoma
- Parathyroid imaging
- Parathyroidectomy
- Serum calcium
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
Clinical presentation and management of patients with primary hyperparathyroidism in Italy. / 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.
In: Journal of Endocrinological Investigation, Vol. 41, No. 11, 2018, p. 1339-1348.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical presentation and management of patients with primary hyperparathyroidism in Italy
AU - Saponaro, F.
AU - Cetani, F.
AU - Repaci, A.
AU - Pagotto, U.
AU - Cipriani, C.
AU - Pepe, J.
AU - Minisola, S.
AU - Cipri, C.
AU - Vescini, F.
AU - Scillitani, A.
AU - Salcuni, A.
AU - Palmieri, S.
AU - Eller-Vainicher, C.
AU - Chiodini, I.
AU - Madeo, B.
AU - Kara, E.
AU - Castellano, E.
AU - Borretta, G.
AU - Gianotti, L.
AU - Romanelli, F.
AU - Camozzi, V.
AU - Faggiano, A.
AU - Corbetta, S.
AU - Cianferotti, L.
AU - Brandi, M. L.
AU - de Feo, M. L.
AU - Palermo, A.
AU - Vezzoli, G.
AU - Maino, F.
AU - Scalese, M.
AU - Marcocci, C.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Parathyroid adenoma
KW - Parathyroid imaging
KW - Parathyroidectomy
KW - Serum calcium
UR - http://www.scopus.com/inward/record.url?scp=85044759655&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044759655&partnerID=8YFLogxK
U2 - 10.1007/s40618-018-0879-z
DO - 10.1007/s40618-018-0879-z
M3 - Article
AN - SCOPUS:85044759655
VL - 41
SP - 1339
EP - 1348
JO - Journal of Endocrinological Investigation
JF - Journal of Endocrinological Investigation
SN - 0391-4097
IS - 11
ER -