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학술저널
저자정보
Choi Hye Ryeon (Department of Surgery Eulji Medical Center Eulji University School of Medicine Seoul Korea.) Choi Sun Hyung (Department of Family medicine Ilsan Paik Hospital Inje University College of Medicine Goyang Korea.) Hong Namki (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea.) Rhee Yumie (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea.) Kim Jin Kyong (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Lee Cho Rok (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Kang Sang-Wook (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Lee Jandee (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Jeong Jong Ju (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Nam Kee-Hyun (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Chung Woong Youn (Department of Surgery Yonsei University College of Medicine Seoul Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.37 No.13
발행연도
2022.4
수록면
1 - 11 (11page)
DOI
10.3346/jkms.2022.37.e99

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Background: Normocalcemic primary hyperparathyroidism (NPHPT) was first described in 2008. It is defined as consistently elevated serum parathyroid hormone (PTH) levels with normal serum calcium (sCa) concentration, after excluding secondary causes of PTH elevation. However, the exact definition and management strategy for NPHPT remain controversial. We retrospectively investigated the clinicopathological features and short-term outcomes of NPHPT patients. Methods: A total of 280 patients who were surgically indicated for primary hyperparathyroidism (PHPT) at the Yonsei Severance Medical Center between 2015 and 2019 were included. Patients were classified according to preoperative PTH, corrected sCa, and ionized calcium (iCa) levels as follows: typical primary hyperparathyroidism (TPHPT, elevated PTH, sCa, and iCa, n = 158) and NPHPT (elevated PTH, normal sCa, n = 122). Results: NPHPT was commonly seen in younger individuals (aged < 50 years, P = 0.025); nephrolithiasis and bone fractures were common. Preoperative PTH level was higher in the TPHPT group (P < 0.001). The NPHPT group had higher numbers of multiple parathyroid lesions (P = 0.004) that were smaller (P = 0.011). NPHPT patients were further divided into two subgroups according to iCa levels: the elevated (n = 95) and normal iCa (n = 27) groups. There was no significant difference between the two subgroups regarding symptoms and multiplicity of lesions. Conclusion: We found that NPHPT may be a heterogeneous disease entity of PHPT with high rates of multi-gland disease, which appears to be biochemically milder but symptomatic. Intraoperative PTH monitoring might help increase the surgery success rate. Moreover, the short-term outcomes of NPHPT after surgery did not differ from that of TPHPT.
#Primary Hyperparathyroidism #Normocalcemic Hyperparathyroidism #Typical Hyperparathyroidism

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