Detection of primary hyperparathyroidism through opportunity screening

Abstract

Primary hyperparathyroidism (PHPT), which was once considered rare, is a common disease of mineral metabolism and is currently the third most common pathology of thyroid disease and diabetes. Screening in the health care system is the active identification of a disease in persons who were considered or considered themselves to be healthy, that is, detection of the disease at a preclinical stage. The main goal of screening is to detect the disease before it causes symptoms and complications and, if possible, to completely cure it. Goal. Development of a questionnaire for opportunistic screening of primary hyperparathyroidism. Materials and methods. To assess the significance and prevalence of patients' complaints, the first group consisted of 50 patients (49 women and 1 man, aged 54.07 ± 4.6 years) who were operated on during 2021-2023 with a diagnosis of PHPT, including 37 with a mild clinical picture and 12 with pronounced clinical manifestations. The control group/comparison group consisted of 138 patients (108 women and 30 men aged 53.71 ± 5.8 years) without PHPT, who sought medical help during 2021-2023 in connection with thyroid pathology at the clinical units of the State University " IPEP". The obtained data made it possible to assess the importance of one or another symptom for the development of PHPT. When analyzing complaints in different age groups, significant differences in the clinical profile of patients were found. In people under the age of 40, the leading clinical manifestation was disorders of a mental and intellectual nature, a decrease in visual acuity, then bone-destructive phenomena (pain in the limbs, change in gait, etc.), the presence of hypertension, loosening and loss of healthy teeth. In the groups of 40-60 years and people over 60 years of age, the survey shows a more classic clinical picture: the main complaints were bone-degenerative manifestations. There was no significant difference found between patients with PHPT and conditionally healthy persons or persons with other pathologies. Conclusions. 1) The developed version of the survey questionnaire makes it possible to detect PHPT at an early stage. 2) Taking into account the variety of manifestations of the disease, in connection with which patients are often patients of doctors of various specialties, there is a need to screen patients using a questionnaire at the stage of primary care. 3) Cognitive disorders in young patients may indicate the early onset of PHPT.