PRIMARY HYPERPARATHYROIDISM SYMPTOMS RELATED TO AGE, SEX, CALCEMIA, ANATOMIC LESIONS AND WEIGHT OF THE GLANDS

Objectives: Primary hyperparathyroidism is a polymorphic disease, We e valuated the effect of different factors on clinical expression. Metho ds: Clinical expression in 259 patients who underwent surgery for prim ary hyperparathyroidism were analyzed as a function of patient age, se x, calcium level, anatomic lesions and weight of the diseased glands, Results: Behaviour disorders and bone images were more frequent in wom en and urinary lithasis and gastric ulcers were more frequent in men, Behaviour disorders, bone images, chondrocalcinosis, renal failure and acute episodes were more frequent in elderly patients, Inversely, uri nary lithiasis was more frequent in young subjects, The prevalence of asymptomatic forms was not related to the level of calcaemia, even for very high levels, Calcium levels above 3.5 mmol/l led to a significan tly higher rate of behaviour disorders and acute episodes, Moderately elevated calcium levels were associated most frequently with urinary l ithiasis. There was no evidence that anatomic lesions were related to symptomatology, particularly cancer which was not related with more fr equent or more severe forms. Finally, nephrocalcinosis, renal failure and acute episodes were particularly frequent when the weight of the p arathyroid tissue was greatest. Conclusion: The main therapeutic concl usion concerned primary hyperparathyroidism with moderately elevated c alcium levels: since there is no difference between the clinical expre ssion of primary hyperparathyroidism with moderately elevated calcaemi a, the same surgical approach is recommended.