Surgery. 2013 Dec;154(6):1232-7; discussion 1237-8. doi: 10.1016/j.surg.2013.06.051.
The electronic medical record (EMR) of a large, tertiary referral center was examined to study the prevalence of undiagnosed and unrecognized primary hyperparathyroidism (PHPT).
The EMR was queried for outpatient serum calcium >10.5 mg/dL over a 2-year period.
Of 2.7 million patients, 54,198 (2%) had hypercalcemia (>10.5 mg/dL). In a 2-year sample of 7,269 patients, 1.3% (95 patients) had a recorded diagnosis of PHPT, and 0.3% (16 patients) had parathyroidectomy. Of the remaining patients, parathyroid hormone (PTH) values were recorded in 32% (2,337 patients). Of patients with PTH measured, 71% (1,662 patients) had PHPT (PTH > 30 pg/mL). Patients with calcium of 11.1–11.5 mg/dL were most likely to have PHPT (55%). Patients with calcium >12 mg/dL were most likely to have PTH measured (52%). Of hypercalcemic patients, 67% never had PTH obtained, 28% of whom were likely to have PHPT. It is estimated that 43% of hypercalcemic patients are likely to have PHPT. The estimated prevalence of PHPT in the general population is 0.86%.
PHPT is a more common disorder than previously documented. It is crucial to evaluate even mild hypercalcemia, because 43% of these patients have PHPT. PHPT is underdiagnosed and undertreated.
检查了一个大型三级转诊中心的电子病历（EMR），以研究未诊断和未识别的原发性甲状旁腺功能亢进症（PHPT）的患病率。
在两年期间，对门诊血清钙> 10.5mg/dL 的 EMR 进行了查询。
在 270 万患者中，有 2%（54198 人）存在高钙血症（> 10.5mg/dL）。在 7269 例患者的两年样本中，有 1.3%（95 例）记录了 PHPT 的诊断，有 0.3%（16 例）接受了甲状旁腺切除术。在其余患者中，有 32%（2337 例）记录了甲状旁腺激素（PTH）值。在测量了 PTH 的患者中，有 71%（1662 例）患有 PHPT（PTH> 30pg/mL）。血钙为 11.1-11.5mg/dL 的患者最有可能患有 PHPT（55%）。血钙> 12mg/dL 的患者最有可能测量 PTH（52%）。在高钙血症患者中，有 67%的患者从未获得过 PTH，其中有 28%可能患有 PHPT。估计有 43%的高钙血症患者可能患有 PHPT。一般人群中 PHPT 的估计患病率为 0.86%。
PHPT 比以前记录的更为常见。评估甚至轻度高钙血症至关重要，因为其中 43%的患者患有 PHPT。PHPT 诊断不足且治疗不足。
