Información del artículo
El hiperparatiroidismo primario (HPTP) es una enfermedad endocrina de presentación frecuente. Se debe sospechar HPTP en pacientes con hipercalcemia en ocasiones leve en ausencia de otras causas. Es la causa más frecuente de hipercalcemia en pacientes ambulatorios, y se descubre de forma casual en análisis habituales. En la actualidad la mayoría de los pacientes están asintomáticos. El tratamiento quirúrgico es el único tratamiento efectivo de forma permanente para los pacientes con HPTP, con un elevado porcentaje de éxitos (95%) y escasas complicaciones perioperatorias (5%). Las técnicas de localización no son necesarias para el diagnóstico de HPTP. El papel de las técnicas de localización en la primera cirugía no está claro, ya que la exploración bilateral del cuello por un cirujano experto consigue un alto índice de curación. La localización preoperatoria del adenoma por ecografía o gammagrafía con sestamibi permite realizar cirugía mínimamente invasiva. Es obligatorio realizar técnicas de localización en pacientes con HPTP persistente o recurrente tras la primera cirugía.
Palabras clave:
Hiperparatiroidismo
Ecografía
Gammagrafía con sestamibi
Primary hyperparathyroidism (PHPT) is a common endocrine disease. The presence of PHPT should be suspected in patients with persistent, often mild, hypercalcemia in the absence of any other apparent etiology. Hyperparathyroidism is the most frequent cause of hypercalcemia in the outpatient setting and is usually discovered incidentally by routine laboratory testing. Currently, most patients are asymptomatic. The only permanently effective therapy for patients with PHPT is surgery, with a high cure rate (95%) and few perioperative complications (5%). Parathyroid imaging is not required in the diagnosis of PHPT. The role of preoperative localization in patients undergoing initial neck exploration is unclear, since a bilateral approach in the hands of experienced surgeons achieves a high cure rate. Preoperative localization of adenomas with ultrasonography or sestamibi scanning allows a minimally invasive approach to be used. Localization studies are required when PHPT persists or recurs after surgery.
Key words:
Hyperparathyroidism
Ultrasonography
Sestamibi scan
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