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World Journal of Surgery

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01-10-2008

Appropriate Surgical Treatment of Lithium-Associated Hyperparathyroidism

Authors: Evie Carchman, Jennifer Ogilvie, Jennifer Holst, John Yim, Sally Carty

Published in: World Journal of Surgery | Issue 10/2008

Abstract

Background

Lithium is frequently used in the treatment of bipolar disease. Although lithium-associated hyperparathyroidism (LAH) is well documented, reports concerning its pathologic findings are sparse. Because of a high-reported incidence of multiglandular disease, focused exploration for LAH is controversial.

Methods

From 1995 to 2007, data from 1207 consecutive patients who underwent concise parathyroid exploration for sporadic primary hyperparathyroidism (PHP) directed by quick intraoperative parathyroid hormone monitoring (QPTH) were reviewed to identify patients with LAH. Anatomic findings were determined. All patients had >5 months of follow-up.

Results

The incidence of LAH was 16/1207 (1.3%). The rate of multiglandular disease was not higher in LAH: present in 25% (4/16) patients with LAH and 12.3% (146/1191) patients without LAH (p = 0.13 Fisher two-tailed test). Among 16 patients with LAH, 12 (75%) had a single adenoma. The use of QPTH allowed unilateral exploration in 8 of 12 patients with single adenoma. Parathyroid exploration resulted in durable biochemical cure for all 16 patients with LAH.

Conclusion

Multiglandular disease seems to be no more frequent in patients with LAH than in patients with primary hyperparathyroidism (PHP) without LAH. Patients with LAH can be safely and effectively managed with selective unilateral exploration directed by intraoperative PTH monitoring.

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Title: Appropriate Surgical Treatment of Lithium-Associated Hyperparathyroidism
Authors: Evie Carchman
Jennifer Ogilvie
Jennifer Holst
John Yim
Sally Carty
Publication date: 01-10-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 10/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9616-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Appropriate Surgical Treatment of Lithium-Associated Hyperparathyroidism

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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