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World Journal of Surgery

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01-11-2009

What Symptom Improvement Can Be Expected After Operation for Primary Hyperparathyroidism?

Authors: Nadine R. Caron, Janice L. Pasieka

Published in: World Journal of Surgery | Issue 11/2009

Abstract

Background

The only cure for primary hyperparathyroidism (pHPT) is operative resection of the parathyroid gland(s) responsible for the disease. The 1990 National Institute of Health’s (NIH) consensus development conference on asymptomatic pHPT and its subsequent workshop in 2001 established which clinical criteria warranted parathyroidectomy (PTx) versus observation. While there is no debate that these NIH criteria capture a group of patients likely to benefit from PTx, there is concern that these guidelines miss a significant percentage of pHPT patients who actually are symptomatic. Unfortunately, these additional symptoms are often subtle, nonspecific, not traditionally measured, frequently not assessed or considered in this patient population, and are usually attributed to other diagnoses or simply advanced age.

Methods

An evidence-based literature review was performed assessing symptoms and clinical conditions associated with bone, neuropsychiatry, cognition, quality of life, and the neuromuscular system. The level of evidence and grade of recommendations were assigned to key studies to help determine recommendations regarding indications and potential benefits of parathyroidectomy (PTx).

Results

Symptoms ranging from decreased bone mineral density, increased fracture risk, neuropsychiatric symptoms and cognitive changes, lower quality of life, and neuromuscular symptoms were found to be associated with pHPT. The effects of PTx on these symptoms was addressed in a variety of studies that varied in quality.

Conclusion

Although there are few Level I randomized clinical trials addressing the benefit of PTx in patients with pHPT, there are supportive data to suggest that most patients with pHPT would benefit from operative cure.

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Title: What Symptom Improvement Can Be Expected After Operation for Primary Hyperparathyroidism?
Authors: Nadine R. Caron
Janice L. Pasieka
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 11/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-9987-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

What Symptom Improvement Can Be Expected After Operation for Primary Hyperparathyroidism?

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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