Primary hyperparathyroidism –case series and challenges of managementin nigeriaand low-incomecountries.

Abstract

Primary  hyperparathyroidism  (PHPT)  is  a  rare  endocrine  disorder  in which  hypercalcemia  is  documented.  They  do not  produce  compressive symptoms,   present   usually   with   nonspecific   symptoms   or   may   be asymptomatic.  The  objective  of  this  report  is  to  draw  attention  to  this disorder  said  to  be  rare  especially  in  the  low-and  middle-income countries  where  PHPT  diagnosis  is  made  late  when  skeletal  and  renal complications  have  occurred.  Two  post-menopausal  Nigerian  women with a diagnosis of PHPT made in the USA were referred to our endocrine practice in Aba, Nigeria. The older patient opted out of surgery while the younger  patient  had  a  successful  parathyroidectomy  in  USA.  There  is  a concern  about  other  women/patients  out  there  who  may  have  PHPT  but do not have access to medical services in USA and the developed world. There  is,  therefore,  a  need  for  a  high  index  of  suspicionby  healthcare professionals and good laboratory support services in Nigeria and similar countries  to  clinch  the  diagnosis  of  PHPT  before  target  organ  damages (fractures, kidney stones and kidney failures) start manifesting