Diagnostic Issues of Primary Hyperparathyroidism in Indian Patients: The Perspectives and Imperatives—A Case Report

Abstract

In the last few decades, there has been remarkable progress in the diagnosis as well as treatment of primary hyperparathyroidism (PHPT) worldwide due to the advent of automated serum calcium estimation and radioimmunoassay of parathormone. Consequently, a fairly good number of asymptomatic and incidentally detected cases of PHPT who could have been missed otherwise are now being evaluated and treated successfully. Although this turn around is more pronounced in the West, the scenario has not appreciably changed in India. Lack of awareness and clinical suspicion among the clinicians and negligible use of biochemical screening tests are the common factors responsible for the diagnostic delay as is evident in our case report. Such delay in diagnosis and institution of treatment results in overtly symptomatic disease with affection of several target organs. We report the diagnostic dilemma and delay in treatment in one of our cases; a 28-year-old female who despite having severe PHPT at the time of diagnosis could be managed successfully with parathyroidectomy.