Screening of an Elderly Population in Primary Care for Primary Hyperparathyroidism

Abstract

In order to assess the diagnostic outcome of a screening for primary hyperparathyroidism (PHPT) in an elderly population, we determined ionized calcium in serum from 368 individuals participating in a health control at Mölnlycke Primary Care Centre (200 women, 168 men; age range 75–95 years); four-fifths of the individuals living in their homes, the remainder in homes for aged or nursing homes.

Intact parathyroid hormone was determined in the samples with oinized calcium concentration > mean ± 3SD of the truncated population sample, and these individuals were also recalled for another blood sample. Moderate hypercelcaemia, probably due to PHPT, was found in eight individuals (2% of the complete sample, 3% of the women), five having neuropsychiatric or neuromuscular symptoms consistent with PHPT.

Surgical intervention is probably indicated in only a small proportion of elderly patients. We conclude that optimal benefits in relation to costs of screening for PHPT in old people will depend on the availability of a safe and simple pharmacological treatment that could determine any causal relationship between hypercalcaemia and symptoms.

Key Words:

• hypercalcaemia
• primary hyperparathyroidism
• screening
• ionized calcium
• intact parathyroid hormone