Evaluation of coagulation parameters in patients with parathyroid adenoma

The parathyroid gland is an organ that plays important roles in the endocrine system. Parathyroid adenoma is responsible for 80-85% of primary hyperparathyroidism. Primary hyperparathyroidism (PHPT) is a disease that develops as a result of autonomous excessive parathormone (PTH) secretion from the parathyroid glands. Symptoms include overt bone disease secondary to hypercalcemia, kidney stones and nonspecific gastrointestinal, cardiovascular and neuromuscular dysfunction. A normal working coagulation system is an indispensable phenomenon for a healthy life. The more important it is to stop bleeding for any reason, the more important it is to clear the clot. PT, aPTT, TT and bleeding time, Protein-C, Protein-S, AT-III levels can be used in the diagnosis of hemostasis disorders. In this study; We aimed to evaluate the relationship between coagulation parameters and parathyroid adenoma in patients with parathyroid adenoma who were followed in the endocrinology outpatient clinic of Yüzüncü Yıl University Medical Faculty Hospital. Material and Methods: In this study, 30 patients aged 22-88 years with the diagnosis of Parathroid adenomas who were followed up in the outpatient clinic of the Endocrinology Department of Dursun Odabaş Medical Center, Faculty of Medicine, Yüzüncü Yıl University (YYU) between February 2018 and December 2019 were prospectively evaluated. Thirty healthy human aged 19-78 years without any inherited, acquired disease and without Parathroid adenomas were included as the control group. Parathormone (PTH), calcium (Ca), phosphorus (P), albumin, calcium in spot urine, creatinine in spot urine levels were studied. Fibrinogen, Aptt, INR, D-Dimer, Protein-C, Protein-S and Anti-thrombin 3 (AT-3) measurements were also evaluated for coagulation parameters. Results: Demographic parameters such as age, weight, height (centimeters) and BMI (kg / m²) were similar between case and control groups, and no statistically significant difference was found. Systolic blood pressure and diastolic blood pressure values were significantly higher in the case group compared to the control group. (Table 5) In the case group, only Protein-S 68.5 ± 14.2% (p: 0.04) was found to be significantly lower than the control group (p: 0.04). . Ca 10.9 ± 0.92 mg / dl (p: 0.001), P 2.46 ± 0.83 mg / dl (p: 0.001), PTH 201.39 ± 80.8 pg / dl (p: 0.001) , Spot i Ca / Creatinine 0.21 ± 0.15 mg / g creatinine (p: 0.002), albumin 4.31 ± 0.42 mg / dl (p: 0.008), fibrinogen 332.1 ± 66.2 mg / dl (p: 0.029) was significantly higher than the control group. D-Dimer (p: 0.57), Aptt (p: 0.718), INR (p: 0.586), Protein-C (p: 0.624), AT-III (p: 0.105) levels differed between the case group and the control group (Table 6). A significant negative correlation was observed between adenoma volume and phosphorus level. A significant positive correlation was observed between adenoma length and PTH. Conclusion: Increased levels of fibrinogen in patients with parathyroid adenoma may pave the way for clotting and may increase the risk of atherosclerotic and atherothrombotic complications in patients with parathyroid adenoma because fibrinogen is an independent risk factor for cardiovascular disease. In our study, low levels of Protein-S levels in patients with parathyroid adenoma indicate that they may be prone to clotting and may increase the risk of VTE and ischemic stroke in these patients.