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Background <p>Primary hyperparathyroidism is a common endocrine disorder which leads to elevated levels of serum calcium in the setting of increased or inappropriately normal parathyroid hormone levels. While systemic manifestations are common, there has been a decrease in incidence of symptomatic presentations, with most patients now being asymptomatic or diagnosed incidentally.</p> Methods <p>We present a series of 5 cases of primary hyperparathyroidism managed at our institute. Each patient had distinct clinical and laboratory presentations, ranging from incidental diagnosis and mild symptoms to acute pancreatitis and severe hypercalcemic crisis with skeletal involvement. All patients underwent comprehensive biochemical and radiological evaluation, followed by surgical management by either focused parathyroidectomy or bilateral exploratory neck dissection. All patients underwent extensive postoperative observation and were asymptomatic at three-month follow-up.</p> Conclusion <p>This case series highlights the variability in clinical presentations of primary hyperparathyroidism underscoring the need for high level of clinical vigilance and comprehensive population in vulnerable patients. With the rise of asymptomatic cases, it is essential to determine the cause of hypercalcemia, in order to differentiate PHPT from other causes of hypercalcemia. Early identification and timely intervention remain the mainstay in treatment of PHPT. Newer techniques such as 4D-CT and improved immunoassays with increased sensitivity have helped in early diagnosis in asymptomatic cases with high degree of clinical suspicion. Regular biochemical monitoring must be done to monitor for residual disease or recurrence.</p>

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Variable Presentations of Primary Hyperparathyroidism: an Experience of 5 Cases from a Tertiary-Care General Surgery Unit of Northern India

  • 期刊论文

  • 发表日期：

    2025年8月13日

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  • Sukesh Kudumallige Sudhakara,
  • Urvij Jaiswal,
  • Shubhajeet Roy,
  • Kushagra Gaurav,
  • Akshay Anand,
  • Abhinav Arun Sonkar

摘要

Background

Primary hyperparathyroidism is a common endocrine disorder which leads to elevated levels of serum calcium in the setting of increased or inappropriately normal parathyroid hormone levels. While systemic manifestations are common, there has been a decrease in incidence of symptomatic presentations, with most patients now being asymptomatic or diagnosed incidentally.

Methods

We present a series of 5 cases of primary hyperparathyroidism managed at our institute. Each patient had distinct clinical and laboratory presentations, ranging from incidental diagnosis and mild symptoms to acute pancreatitis and severe hypercalcemic crisis with skeletal involvement. All patients underwent comprehensive biochemical and radiological evaluation, followed by surgical management by either focused parathyroidectomy or bilateral exploratory neck dissection. All patients underwent extensive postoperative observation and were asymptomatic at three-month follow-up.

Conclusion

This case series highlights the variability in clinical presentations of primary hyperparathyroidism underscoring the need for high level of clinical vigilance and comprehensive population in vulnerable patients. With the rise of asymptomatic cases, it is essential to determine the cause of hypercalcemia, in order to differentiate PHPT from other causes of hypercalcemia. Early identification and timely intervention remain the mainstay in treatment of PHPT. Newer techniques such as 4D-CT and improved immunoassays with increased sensitivity have helped in early diagnosis in asymptomatic cases with high degree of clinical suspicion. Regular biochemical monitoring must be done to monitor for residual disease or recurrence.