Spivacow Francisco R, Palumbo Claudia
Instituto de Investigaciones Metabólicas, Universidad del Salvador, Buenos Aires, Argentina. E-mail:
Instituto de Investigaciones Metabólicas, Universidad del Salvador, Buenos Aires, Argentina.
Medicina (B Aires). 2017;77(3):196-200.
Primary hyperparathyroidism may have different characteristics. One is the asymptomatic form. This is a mild variant of hypercalcemic hyperparathyroidism, characterized by a calcemia not greater than 1 mg/dl above the upper limit of the method, a high intact parathyroid hormone (iPTH), absence of renal stones, renal function impairement, and osteoporosis, less than 50 years of age, and less than 400 mg/day calciuria. It is not a surgical entity, but its evolution may require it. Twenty-four postmenopausal women, all older than 50 years, with a diagnosis of asymptomatic hyperparathyroidism, were studied. Clinical manifestations, densitometric changes, biochemical parameters and bone remodeling were analyzed and the results were compared with the classic and normocalcemic variants of the disease. Diagnostic criteria were established and observed that only 2 (8.3%) of patients, during a follow up of 44 ± 12 months, had need for a parathyroidectomy. In conclusion, the asymptomatic primary hyperparathyroidism is a benign disorder, of periodic clinical follow-up, which rarely may require surgery.
原发性甲状旁腺功能亢进可能有不同的特征。一种是无症状形式。这是高钙血症性甲状旁腺功能亢进的一种轻度变体，其特征为血钙高于检测方法上限不超过1mg/dl，甲状旁腺激素（iPTH）升高，无肾结石、肾功能损害和骨质疏松，年龄小于50岁，尿钙小于400mg/天。它并非手术治疗的疾病实体，但其病情进展可能需要手术。对24名年龄均超过50岁、诊断为无症状性甲状旁腺功能亢进的绝经后女性进行了研究。分析了临床表现、骨密度变化、生化参数和骨重塑情况，并将结果与该疾病的典型和血钙正常变体进行了比较。制定了诊断标准，发现在44±12个月的随访期间，只有2名（8.3%）患者需要进行甲状旁腺切除术。总之，无症状性原发性甲状旁腺功能亢进是一种良性疾病，需要定期进行临床随访，很少需要手术治疗。
