Primary hyperparathyroidism in Hong Kong: an analysis of 44 cases

FKW Chan, SC Tiu, KL Choi, TK Au Yong, LF Tang
Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong

Primary hyperparathyroidism is increasingly being diagnosed subsequent to the detection of hypercalcaemia using multichannel auto-analyser screening. This paper provides a local picture of the clinical presentation and management of primary hyperparathyroidism. A retrospective review was conducted of 44 patients with primary hyperparathyroidism who were treated at the Queen Elizabeth Hospital between January 1987 and July 1996. Twenty-five (56.8%) of the patients were asymptomatic. Only three (6.8%) patients gave radiograms that had features indicating primary hyperparathyroidism; seven (15.9%) had renal stones. The patients underwent one or more of the following localisation procedures: computerised tomography, ultrasonography, thallium-technetium subtraction scanning, and technetium Tc 99m sestamibi scanning. The latter method was the most sensitive (64.3%). Ten adenomas that could not be localised by any of these procedures were successfully removed during surgery. Surgery was successful in 94.4% of cases and surgical outcome was comparable to that reported in the literature.

Hong Kong Med J 1998;4:229-34

Key words: Hyperthyroidism/complications; Hyperthyroidism/diagnosis; Hyperthyroidism/therapy; Parathyroid neoplasms/pathology; Parathyroid neoplasms/radiography; Parathyroid neoplasms/radionuclide imaging; Parathyroid neoplasms/surgery; Technetium Tc 99m sestamibi/diagnostic use