Sporadic Primary Hyperparathyroidism in Young Individuals

Different Disease and Treatment?1

Mark S. Sneider, Carmen C. Solorzano, Raquel E. Montano, Charles Anello, George L. Irvin, John Lew

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Younger individuals with hyperparathyroidism may experience severe disease with a higher incidence of multigland disease (MGD) and operative failure, thereby requiring subtotal parathyroidectomy. This study examines the characteristics and surgical outcome of younger compared with older patients with sporadic primary hyperparathyroidism (SPHPT). Methods: Prospectively collected data of 1101 patients with SPHPT who underwent parathyroidectomy at a single institution were retrospectively reviewed. Patients with multiple endocrine neoplasia (MEN), familial, secondary, or tertiary hyperparathyroidism, parathyroid carcinoma, rickets, or lithium induced disease were excluded. Patients were subdivided into two groups: (1) younger individuals ≤40 y of age (n = 110) and (2) older individuals >40 y of age (n = 991). Both age groups were compared for gender, clinical manifestations, pre- and postoperative laboratory values, MGD, operative success, and recurrent disease. Results: There was greater male predominance in younger compared with older patients treated for SPHPT (41% versus 25%, P = 0.0004). Of the clinical manifestations of SPHPT, kidney stones were more common in younger compared with older individuals (45% versus 29%, P = 0.0006). Conversely, bone pain was more common in older compared with younger patients (32% versus 14%, P = 0.0002). There was no statistical difference in biochemical values, MGD, and outcome between both groups. Conclusions: Despite male predominance and few differences in symptoms, SPHPT is a similar disease entity in both younger and older individuals. Patients from both age groups can be similarly treated for SPHPT with a high rate of operative success. Routine BNE and subtotal parathyroidectomy is not necessary in younger individuals.

Original languageEnglish
Pages (from-to)100-103
Number of pages4
JournalJournal of Surgical Research
Volume155
Issue number1
DOIs
StatePublished - Jul 1 2009

Fingerprint

Primary Hyperparathyroidism
Parathyroidectomy
Hyperparathyroidism
Therapeutics
Age Groups
Multiple Endocrine Neoplasia
Parathyroid Neoplasms
Rickets
Kidney Calculi
Lithium
Bone and Bones
Pain
Incidence

Keywords

  • bilateral neck exploration (BNE)
  • focused parathyroidectomy
  • multigland disease (MGD)
  • operative success, recurrent disease
  • sporadic primary hyperparathyroidism (SPHPT)
  • young individuals

ASJC Scopus subject areas

  • Surgery

Cite this

Sporadic Primary Hyperparathyroidism in Young Individuals : Different Disease and Treatment?1. / Sneider, Mark S.; Solorzano, Carmen C.; Montano, Raquel E.; Anello, Charles; Irvin, George L.; Lew, John.

In: Journal of Surgical Research, Vol. 155, No. 1, 01.07.2009, p. 100-103.

Research output: Contribution to journalArticle

Sneider, Mark S. ; Solorzano, Carmen C. ; Montano, Raquel E. ; Anello, Charles ; Irvin, George L. ; Lew, John. / Sporadic Primary Hyperparathyroidism in Young Individuals : Different Disease and Treatment?1. In: Journal of Surgical Research. 2009 ; Vol. 155, No. 1. pp. 100-103.
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abstract = "Background: Younger individuals with hyperparathyroidism may experience severe disease with a higher incidence of multigland disease (MGD) and operative failure, thereby requiring subtotal parathyroidectomy. This study examines the characteristics and surgical outcome of younger compared with older patients with sporadic primary hyperparathyroidism (SPHPT). Methods: Prospectively collected data of 1101 patients with SPHPT who underwent parathyroidectomy at a single institution were retrospectively reviewed. Patients with multiple endocrine neoplasia (MEN), familial, secondary, or tertiary hyperparathyroidism, parathyroid carcinoma, rickets, or lithium induced disease were excluded. Patients were subdivided into two groups: (1) younger individuals ≤40 y of age (n = 110) and (2) older individuals >40 y of age (n = 991). Both age groups were compared for gender, clinical manifestations, pre- and postoperative laboratory values, MGD, operative success, and recurrent disease. Results: There was greater male predominance in younger compared with older patients treated for SPHPT (41{\%} versus 25{\%}, P = 0.0004). Of the clinical manifestations of SPHPT, kidney stones were more common in younger compared with older individuals (45{\%} versus 29{\%}, P = 0.0006). Conversely, bone pain was more common in older compared with younger patients (32{\%} versus 14{\%}, P = 0.0002). There was no statistical difference in biochemical values, MGD, and outcome between both groups. Conclusions: Despite male predominance and few differences in symptoms, SPHPT is a similar disease entity in both younger and older individuals. Patients from both age groups can be similarly treated for SPHPT with a high rate of operative success. Routine BNE and subtotal parathyroidectomy is not necessary in younger individuals.",
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