چكيده لاتين :
Over the past half century, the pattern of clinical presentation of primary hyperparathyroidism (PHPT) has changed dramatically in Western countries; indeed it has evolved from a severe disease to an asymptomatic condition. The story is completely different in Eastern countries, where PHPT still presents with the traditional pattern
of bones and stones. The aim of the present review is to analyze Iranian experiences in the clinical, biochemical, radiological, and pathological
findings of PHPT and to compare these features with those of patients from developed and developing nations.
Materials & Methods: An extensive search of PHPT literature was carried out. Of the relevant publications from 1980-2006 (3 international, 3 local) five yielded compressive data in large series of Iranian patients. The information was evaluated, analyzed, summarized and compared
to that of patients from other Eastern and Western countries.
Results: A total of 356 patients were included in these studies; there were 317 females and 49 males, age range 11 to 72 years, mean age
38.2±12.4 years with a female to male ratio of 6.4 to 1. Most patients presented with advanced skeletal involvement. Nephrolithiasis was diagnosed in 14-47% patients. Majority of patients had high serum PTH and low serum phosphorus levels; nearly all displayed some radiological
changes suggestive of hyperparathyroid bone disease. Osteoporosis, subperiosteal bone resorption, salt and pepper appearance, brown tumor
and pathologic fractures were frequent x-ray findings. Single adenoma was discovered in most patients. There were few cases with parathyroid
carcinoma. Mean parathyroid gland weight, reported in 177 cases, was 4.1 grams, (range 0.8 - 25 grams).
Conclusion: PHPT is a severe, symptomatic disease with serious complications and high morbidity in Iran. Advanced skeletal disease is the most common pattern of presentation at a young age.
