The prevalence of primary hyperparathyroidism in Korea: a population-based analysis from patient medical records

PURPOSE: Because primary hyperparathyroidism (PHPT) is difficult to recognize, it has a high likelihood of being underdiagnosed. In this study, we estimated the incidence of PHPT and evaluated PHPT diagnosis in Korea. METHODS: To calculate the prevalence of PHPT, we examined the medical records of patients that were hospitalized for urolithiasis between 2013 and 2016 at a single institute, and then identified those who were diagnosed with PHPT from the same group. A Korea-wide insurance claim database was used to ascertain the number of urolithiasis patients and the number of parathyroidectomies performed in Korea. The incidence of PHPT in the Korean population was estimated using the ratio of patients who presented with urolithiasis as the initial symptom of PHPT. RESULTS: During the 4-year study period, 4 patients from the 925 urolithiasis patients enrolled in this study (0.4%) were diagnosed with PHPT. During this same period, there were 85,267 patients with urolithiasis in Korea, and the estimated number of PHPT patients was 341, which was 0.4% of 85,267. Considering that 12% to 23% of patients with PHPT are initially diagnosed with urolithiasis, the total number of PHPT patients was estimated to range from 1,483 to 2,842. The number of patients who underwent parathyroidectomy due to PHPT was 1,935 during the study period. CONCLUSION: The number of patients we estimated to have PHPT corresponded closely with the number of patients undergoing parathyroidectomy during the study period. Considering the number of nonsymptomatic PHPT patients, PHPT may be properly diagnosed in Korea.