Analysis of Clinical Characteristics and Misdiagnosis Cause of Parathyroid Adenoma Complicated with Primary Hy-perparathyroidism
YU Jun-xia
OUYANG Zhao-qiang
ZHANG Xia
XING You-gui
ZHOU Ling-li
Abstract：Objective We summarized the clinical manifestation, diagnostic method and early monitoring measures of parathyroid adenoma with primary hyperparathyroidism (PHPT), which was beneficial to analyze the cause of misdiagnosis and develop preventive measures. Methods A retrospective study of patients diagnosed with of parathyroid adenoma with PHPT confirmed by surgical excision and biopsy in the People's Hospital of Beijing University during January 2006 and Decem-ber 2013 was undertaken. Clinical presentation, medical history, biochemistry, radiology, biopsy and surgical notes were re-corded. Results A total of 28 cases of PHPT were reviewed. Mean serum calcium concentration was (3.03 ±0.40)mmol/L, while mean serum intact PTH concentration was (468.0 ±425.0)pg/ml. Ultrasonography was per-formed on 24 patients and the diagnostic sensitivity was 75. 0%. Neck CT scanning was carried out in 17 cases and the diag-nostic positive rate was 76. 4%. 99m Tc-MIBI was performed on 21 patients and diagnostic positive rate was 100%. Blood calci-um monitoring combined with ultrasonography diagnostic positive rate was 95. 8%. All the patients were divided into 4 groups according to the target organs affected:blood calcium heightening group, bone injury group, urethral calculi group, bone inju-ry and urethral calculi group. No significant differences were detected among groups about age, gender, course of disease, blood calcium, blood phosphorus, 24 h urine calcium, 24 h urine phosphorus and ALP levels (P>0. 05). Linear regression analysis showed that blood calcium and parathyroid hormone did not have significant correlation with groups, age, gender, blood phosphorus, 24 h urine calcium, 24 h urine phosphorus, and ALP levels. There was no significant correlation between blood calcium levels and intact PTH. Misdiagnosis rate of this group was 71. 4% (20 cases). Among them, 8 patients were misdiagnosed as having pure urinary calculi, 4 patients were misdiagnosed as having osteoarthritis, 3 patients were misdiag-nosed as having diabetes mellitus, 2 patients were misdiagnosed as having bone tumors, 2 patients were misdiagnosed as hav-ing primary osteoporosis patients, and 1 patient was misdiagnosed as having lumbar disc. Conclusion Blood calcium and in-tact PTH do not predict the selectivity and degree of damage of target organs of PHPT. Blood calcium monitoring combined with parathyroid Ultrasound is simple and easy to operate. Early screening of parathyroid beat is beneficial in reducing severe bone lesions, kidney structure and functional changes.
Keywords：Parathyroid neoplasmHypoparathyroidismMisdiagnosisUrinary calculiOsteoarthritis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 21-25 )