Asymptomatic vs Symptomatic Primary Hyperparathyroidism: Comparison of Clinico-investigative Profile and Surgical Outcomes in Resource-Limited Setting

This study was done to assess compare usefulness of localization (MIBI and USG) and surgical cure rates in APHPT with SPHT surgical. Multi-centric retrospective study. 57 APHPT and 156 SPHPT patients included. The demographic data &localisation studies between APHPT and SPHPT along with surgical cure rates in patients who had localized disease versus nonlocalized were compared. APHPT prevalence was 26.76%. APHPT affects older patients (p=<0.05). Serum calcium & PTH were higher in SPHPT (p=<0.05). USG & MIBI scans were positive in 88% and 90% in SPHPT. APHPT showed USG and MIBI positivity in 21.05% and 15.7%. Subset of APHPT patients (n=13) who underwent additional imaging showed true positive lesion in 38.5% (n=5). Bilateral neck exploration done in 73.7% of APHPT& 10.9% of SPHPT (p=0.0001). APHPT has smaller adenoma(p<0.05). In non-localized APHPT (n=42) five needed partial thyroidectomy (11.9%) and six partial thymectomy (14.2%). Intra operative success rate was 97.5% in SPHPT and 95.23% in non-localized APHPT (p=0.63). APHPT presents with mild disease and mostly with negative localization. Cure rates after bilateral neck exploration without additional imaging like PETCT/4D CT/MRI was similar to SPHPT

Automated summary

This study compared the demographic data and localization studies between APHPT and SPHPT, as well as the surgical cure rates in patients. Results showed that APHPT primarily affects older patients, while SPHPT has higher levels of serum calcium and PTH.