Indian J Gastroenterol (March–April 2011) 30(2):100–101 DOI 10.1007/s12664-011-0101-0
LETTER
High prevalence of cholelithiasis in primary hyperparathyroidism: a retrospective analysis of 120 cases Sanjay Kumar Bhadada & Anil Bhansali & Viral N. Shah & A. Behera & M. Ravikiran & R. Santosh
Published online: 28 May 2011 # Indian Society of Gastroenterology 2011
Primary hyperparathyroidism (PHPT) due to parathyroid adenoma is the most common cause of hypercalcemia, which is characterized by high parathyroid hormone (PTH) level despite elevated serum calcium levels [1]. With the advent of autoanalyzer and serum calcium is a part of routine screening in West. The presentation of PHPT is asymptomatic and hence, attention has been diverted to the features like hypertension, mental changes, peptic ulcer disease and gallstone disease [2, 3]. Few studies have shown the association of cholelithiasis with PHPT [4, 5]. Hypercalcemia and elevated PTH have been implicated as a cause for cholelithiasis in patients with PHPT. This retrospective study was conducted by the Endocrinology department at our institution. PHPT was diagnosed based on elevated calcium and PTH levels. Patients with hyperparathyroidism due to secondary and tertiary causes were excluded. Cholelithiasis was diagnosed by either ultrasonographic evidence of gallstone(s) and/or history of cholecystectomy. Prevalence of cholelithiasis in PHPT patients was compared with that in the normal north Indian population using a study [6] conducted by the Gastroenterology and Hepatology department of our institution. Serum calcium (reference range [RR]: 8.5–10.2 mg/dL), phosphate (RR: 3.5–5 mg/dL), alkaline phosphatase (RR 28–129 IU/L), and creatinine (RR: 0.5–1.4) were measured S. K. Bhadada (*) : A. Bhansali : V. N. Shah : M. Ravikiran : R. Santosh Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India e-mail:
[email protected] A. Behera Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India
by standard methods. Serum iPTH (RR: 15–65 pg/mL) was measured by chemiluminescence assay and vitamin D (RR: 9–37 ng/mL) by radioimmunoassay (RIA) using commercially available kits. SPSS 10® software was used to analyze the data. Continuous variables were described as mean (SD) and categorical data were expressed in n (%). Correlation analysis was used to correlate two variables. P