ECTS Abstracts (2015) 1 P435

Vitamin D Deficiency and Primary Hyperparathyroidism

Kawtar Nassar, Wafae Rachidi, Saadia Janani & Ouafa Mkinsi

Rheumatology department, Ibn Rochd University Hospital, Casablanca, Morocco.

Background: Parathyroid hormone at high concentrations, increases the activity and the number of osteoclasts and bone resorption. Due to its osteoclast activity, it promotes excessive loss of bone mass. The prevalence of vitamin D deficiency appears to be important in the early hyperparathyroidism (PHP). There is little data on the prevalence of this deficiency in PPH cases, the severity of bone involvement, on the benefits and safety of vitamin substitution. The aim of our study was to assess the prevalence of vitamin D deficiency in patients followed for PHP.

Methods: This is an analytical study, single center cross of 63 patients followed in rheumatology, especially in consultation embrittling osteopathies for hyperparathyroidism. Were included patients in whom the diagnosis of primary hyperparathyroidism was confirmed by clinical and laboratory data, radiologic studies (cervical ultrasound, cervical Sista-MIBI scintigraphy) or after the results of the surgery. Were excluded patients followed for secondary hyperparathyroidism. The age and menopausal status were not determining factors. All patients benefited before treatment, a phospho-calcic analysis, 25(vitamin D) and parathyroid. The body mass index was calculated. Patients were thus classified into two groups, those with a normal value of vitamin D, and the second a vitamin D deficiency were compared at the end the mean value of the parathyroid in each group. Normal significance of the 25 (OH) vitamin D was retained> 26 ng/ml.

Results: Of the patients, 24 met the inclusion criteria. These were 22 women and two men. The mean age was 62 years. 18 women were postmenopausal. The mean body mass index was 22. The mean value of parathyroid hormone was 314,5 pg/ml. The mean value of serum calcium was 103.72 g/l. 11 patients had normal levels of vitamin D, and 13 were in deficit. The average value of parathyroid hormone was 282 pg/ml in the group with deficit versus 192.4 pg/ml in the group with normal vitamin D. In 11 cases, the treatment necessitated the surgery according to the NIH Consensus, 2009.

Conclusion: Our results are consistent with those of the literature. More than half of patients with hyperparathyroidism are deficient in vitamin D, the upper bound value of hyperparathyroidism and therefore the osteodensitometric bone loss. In PHP, the deficient of vitamin D is a risk factor of hypocalcaemia and “hungry bone syndrome” after surgery, and are increased in the absence of vitamin substitution. The carful vitamin D supplementation would decrease serum levels of parathyroid hormone and bone turnover. It would promote the recovery of the bone density. In addition, vitamin D is involved in other chronic diseases, and dosage is recommended in patients with osteoporosis or at risk for osteoporosis.

Disclosure: The authors declared no competing interests.

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