Table 3.
Main characteristics and treatments of PHPT in our series of MEN1 patients
| PHPT | Patients n. (%) |
Clinical presentation | Surgery | Pharmacological treatment (Calcimimetic) n. (%) |
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|---|---|---|---|---|---|---|---|---|
| Symptomatic n. (%) |
Asymptomatic n. (%) |
No surgery n. (%) |
TPT n. (%) |
SPT n. (%) |
PPT n. (%) |
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| Total patients with PHPT | 139 (95.87%) | 54 (37.24%) | 85 (58.62%) | 40 (28.78%) | 47 (33.81%) - 43 with tissue autograft in the non-dominant forearm - 4 without tissue autograft |
17 (12.23%) | 35 (25.18%) | 26 (18.70%) |
| PHPT as first clinical manifestation | 92 (63.45%) | 43 (29.66%) - 29 nephrocalcinosis (20%) - 7 nephrocalcinosis and osteoporosis (4.83%) - 5 osteoporosis (3.45%) - 2 nephrocalcinosis and osteopenia (1.38%) |
49 (33.79%) | 23 (16.55%) | 29 (20.86%) - 28 with tissue autograft in the non-dominant forearm - 1 without tissue autograft |
12 (8.63%) | 28 (20.14%) | 16 (11.51%) |
| Index cases (probands) | 85 (58.62%) | 37 (25.52%) - 26 nephrocalcinosis (17.93%) - 5 nephrocalcinosis and osteoporosis (3.45%) - 3 osteoporosis (2.07%) - 2 osteopenia (1.38%) - 1 nephrocalcinosis and osteopenia (0.69%) |
48 (33.10%) | 19 (13.67%) | 33 (23.74%) - 30 with tissue autograft in the non-dominant forearm - 3 without tissue autograft |
10 (7.19%) | 23 (16.55%) | 17 (12.23%) |
| Relatives | 54 (37.24%) | 16 (11.03%) - 9 nephrocalcinosis (6.21%) - 4 osteoporosis (2.76%) - 2 nephrocalcinosis and osteoporosis (1.38%) - 1 nephrocalcinosis and osteopenia (0.69%) |
38 (26.21%) | 21 (15.11%) | 14 (10.07%) - 13 with tissue autograft in the non-dominant forearm - 1 without tissue autograft |
7 (5.04%) | 12 (8.63%) | 9 (6.48%) |
Footnotes: PHPT Primary hyperparathyroidism, N number, TPT Total parathyroidectomy (all four glands removed), SPT Subtotal parathyroidectomy (three glands and part of the forth gland removed), PPT Partial parathyroidectomy (three or less glands removed)
Percentages of clinical presentation were calculated with respect to MEN1 clinically affected patients (145). Percentages of surgery and pharmacological treatment were calculated with respect to PHPT affected patients (139)
Surgical interventions in Table 3 included only the first parathyroid surgery (14 PPTs and 2 SPTs required a second parathyroid intervention for recurrences: 10 TPTs, 2 SPTs and 4 PPTs)