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How does normocalcaemic primary hyperparathyroidism progress? About a series of 17 cases Volume 31, issue 3-4, Mai-Août 2022

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Authors
1 CHU Hassan II de Fès, Service d’endocrinologie, diabétologie, maladies métaboliques et nutrition, Fès, Maroc
2 Université Sidi Mohamed Ben Abdellah, faculté de médecine et de pharmacie, laboratoire d’épidémiologie et de recherche en science de la santé, Fès, Maroc
* Tirés à part : F.Z. Lahmamssi

Primary hyperparathyroidism (PHPT) is usually diagnosed by the occurrence of hypercalcaemia. However, there are normocalcaemic forms, is this an early stage of primary hyperparathyroidism? The aim of our study is to describe the evolution of normocalcaemic hyperparathyroidism (nPH) and to evaluate the cardiovascular, bone and nephrological risk before and after surgery. Materials and methods: retrospective, descriptive and analytical study from September 2014 to September 2020, including patients followed up at the Endocrinology Diabetology and Nutrition Department of the Hassan II University Hospital of Fez for normocalcemic hyperparathyroidism. Results: 17 patients were identified who were followed up for HPTPn. The evolution was marked by the occurrence of complications indicating surgical treatment in 35% of cases. Post-operative follow-up showed a clear improvement in nephrolithiasis (p < 0.05), but no benefit on bone complications (p = 1.1). On the other hand, 65% of our patients did not benefit from surgical treatment, their follow-up showed the occurrence of osteoporosis in 11% of patients, nephrolithiasis in 23% and transient hypercalcaemia in 23% without progression to hypercalcaemic hyperparathyroidism. Conclusion: Our patients followed for nPPH did not progress to hypercalcaemic PPH, but rather presented with transient hypercalcaemia and other complications that may fall under the category of PPH complications.