A HISTOPATHOLOGICAL AUDIT OF HYPERPARATHYROIDISM IN THE SOUTH AFRICAN SETTING.

BACKGROUND: Hyperparathyroidism is a common endocrine disorder. Parathyroidectomy is indicated for primary and tertiary hyperparathyroidism. Parathyroid adenoma is the cause in close to 85% of cases of primary hyperparathyroidism.

METHOD: An audit based on histopathology records of patients who had parathyroidectomy from January 2011 to December 2015 in academic hospitals linked to Wits was conducted. Data collected included patients' demographics and histopathological findings. Categorical data was expressed in number and percentage whereas the mean or median if appropriate was used for continuous data. Chi-square test was used for comparison and a p-value was set at less than 0.05 for significance. The study was partly done by GEMP 3 students and permission to conduct the study was received from HREC at Wits (M160477).

RESULTS: A total of 69 records were found of which 67.6% (46/68) were females. Average age for females was 55.0 years (range 25-83) whereas for males was 60.0 years (25-80). Parathyroid adenoma was reported in 75.4% and 69.6% of specimen from females and males, respectively. In 1.5% (1/86) the resected parathyroid was reported to be normal. Concomitant thyroidectomy was done in 17.4% (8/46) of specimens from females and 8.7% (2/23) from males.

CONCLUSION: Male patients with hyperparathyroidism present at younger age compared to females. Fewer than expected parathyroidectomies for primary hyperparathyroidism are being performed in the Wits circuit. The commonest findings following parathyroidectomy is parathyroid adenoma. No case of parathyroid cancer was reported. Concomitant thyroidectomy is likely in females.