Background: The prevalence and presentation of the Primary hyperparathyroidism (PHPT) geographically varies. There is a paucity of published literature on PHPT in Saudi Arabia, so this study aimed to investigate the characteristic features and the surgical outcome of PHPT patients.
Methods: A retrospective review of PHPT patients underwent parathyroidectomy at King Faisal Specialist Hospital & Research Center, from 2010 to 2016.
Results: There were 88 patients; 72 (81.8%) were female and 16 (18.2%) were male. The mean age was 46 ±15 year. The mean preoperative serum level was 2.85 ±0.33 for calcium and 407 ±475 for parathyroid hormone. The majority of the cases presented with bone symptoms 50 patients (56.8%), followed by no symptoms in 25 patients (28.4%), fatigability 7 (7.9%), renal symptoms 4 (4.6%), and gastric symptoms 2 (2.3%). Sestamibi scanning localized the diseased gland in 71 cases (81.6%). The causes of PHPT were single adenoma in 75 (85.2%), double adenoma in 6 (6.8%), and hyperplasia in 7 (8%). There was no major difference between males and females or patients younger and older than 40 years old or between patients with single adenoma and those with the multiple gland disease. The persistent rate was 1.1%, and the recurrent rate was 2.2%.
Conclusion: While half of PHPT patients in Saudi Arabia still present with bone symptoms, 1/4th of them are asymptomatic, and 1/3ed of the cases are younger than 40 years old. Routine screening test is recommended to avoid late presentations, and genetic test may need for the younger population