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Medical management of primary hyperparathyroidism appropriate in older patients

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AUSTIN, Texas — Medical management may be appropriate for adults aged 80 years and older with primary hyperparathyroidism due to lower 24-hour urine calcium levels, higher vitamin D levels and lower prevalence of nephrolithiasis compared with younger patients.

“Age is a factor in the presentation of primary hyperparathyroidism,” Xiangbing Wang, MD, PhD, from the department of medicine at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, told Endocrine Today. “Our results suggest that the elderly [primary hyperparathyroidism] patients have a less severe form of disease.”

Wang and colleagues compared clinical presentation of patients with primary hyperparathyroidism, based on age. The study included 555 adults evaluated at Robert Wood Johnson University Hospital from January 2000 to December 2013.

Participants were divided into five groups based on age: younger than 50 years (n = 113), 50 to 59 years (n = 167), 60 to 69 years (n = 152), 70 to 79 years (n = 79) or 80 years and older (n = 44).

Higher 25-hydroxyvitamin D levels were observed in patients aged 80 years and older compared with participants aged 50 years and younger (P < .05). Further, 24-hour urine calcium levels and prevalence of nephrolithiasis were lower in participants aged 80 years and older compared with younger participants.

“We believe that these findings will impact the treatment strategy employed for different age groups,” Wang said. “A less severe presentation of [primary hyperparathyroidism] in the elderly suggests that a conservative treatment (medical management as opposed to surgical) may be appropriate in these patients. However, a larger cohort of patients is needed to confirm our results.” – by Amber Cox

Reference:

Wong B, et al. Abstract #535. Presented at: AACE Annual Scientific and Clinical Congress; May 3-7, 2017; Austin, Texas.

Disclosure : Endocrine Today was unable to confirm any relevant financial disclosures.