Long-term Outcome after Parathyroidectomy in Patients with Advanced Primary Hyperparathyroidism and Associated Vitamin D Deficiency

A range of hormonal manipulations have been proposed as adjunctive therapy during critical care. These therapies might be used to treat a pre-existing or acquired hormonal disorder. Additionally, hormonal manipulation has been suggested to alter the long-term outcome of critical illness, even in patients without structural abnormalities of endocrine glands. Currently, the effectiveness of these anabolic therapies has not been established and they might be harmful in some patient groups. Recently, it has been recognized that many critically-ill patients have low levels of vitamin D and this is associated with an adverse outcome. It is still unclear whether replacement of vitamin D will be effective in improving outcome. This chapter will also highlight the importance of recognizing and addressing hormonal deficiency in patients with known pituitary disease and with traumatic brain injury (TBI). TBI is associated with a high prevalence of acute and long-term pituitary dysfunction. The management of the rare, but important thyroid disorders requiring critical care, thyroid storm, and myxoedema coma, will also be discussed.

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Faculty Opinions recommendation of Prospective study of surgery for primary hyperparathyroidism (HPT) in multiple endocrine neoplasia-type 1 and Zollinger-Ellison syndrome: long-term outcome of a more virulent form of HPT.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1116797.572877 ◽

2008 ◽

Author(s):

Tobias Carling

Keyword(s):

Primary Hyperparathyroidism ◽

Prospective Study ◽

Multiple Endocrine Neoplasia ◽

Multiple Endocrine Neoplasia Type ◽

Term Outcome ◽

Long Term Outcome ◽

Endocrine Neoplasia ◽

Zollinger Ellison Syndrome

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Long-Term Outcome in Patients with Primary Hyperparathyroidism who Underwent Minimally Invasive Parathyroidectomy

World Journal of Surgery ◽

10.1007/s00268-011-1344-8 ◽

2011 ◽

Vol 36 (1) ◽

pp. 55-60 ◽

Cited By ~ 26

Author(s):

Raghunandan Venkat ◽

Guennadi Kouniavsky ◽

Ralph P. Tufano ◽

Eric B. Schneider ◽

Alan P. B. Dackiw ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Minimally Invasive ◽

Minimally Invasive Parathyroidectomy ◽

Term Outcome ◽

Long Term Outcome ◽

Invasive Parathyroidectomy

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Long-term Outcome of Patients With Elevated Parathyroid Hormone Levels After Successful Parathyroidectomy for Sporadic Primary Hyperparathyroidism

Archives of Surgery ◽

10.1001/archsurg.143.7.659 ◽

2008 ◽

Vol 143 (7) ◽

pp. 659 ◽

Cited By ~ 28

Author(s):

Carmen C. Solorzano

Keyword(s):

Parathyroid Hormone ◽

Primary Hyperparathyroidism ◽

Term Outcome ◽

Long Term Outcome ◽

Hormone Levels ◽

Sporadic Primary Hyperparathyroidism

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Long Term Outcome of Bisphosphonate Therapy in Patients with Primary Hyperparathyroidism

International Journal of Clinical Medicine ◽

10.4236/ijcm.2014.514111 ◽

2014 ◽

Vol 05 (14) ◽

pp. 829-835 ◽

Cited By ~ 2

Author(s):

Dalitso Segula ◽

Tanya Nikolova ◽

Eileen Marks ◽

Lakshminarayan Ranganath ◽

Vinita Mishra

Keyword(s):

Primary Hyperparathyroidism ◽

Bisphosphonate Therapy ◽

Term Outcome ◽

Long Term Outcome

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Primary hyperparathyroidism and vitamin D deficiency

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.10.201081 ◽

2021 ◽

Vol 93 (10) ◽

pp. 1221-1226

Author(s):

Gyuzel E. Runova ◽

Olga O. Golounina ◽

Irina V. Glinkina ◽

Valentin V. Fadeev

Keyword(s):

Vitamin D ◽

Primary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Severe Disease ◽

Preoperative Assessment ◽

Vitamin D Insufficiency ◽

Parathyroid Glands ◽

Cellular Mechanisms ◽

Vitamin D Levels

Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes mellitus and thyroid pathology. Recent epidemiological and experimental data have shown that long-term maintenance of low vitamin D levels in the blood can lead to the development of hyperplastic processes in the cells of the parathyroid glands, followed by autonomous production of parathyroid hormone. In PHPT vitamin D insufficiency or deficiency according to various sources occurs with a frequency of 5377% of cases. The literature review indicates more severe disease in patients with concomitant vitamin D deficiency. The expediency of preoperative assessment of vitamin D levels in all patients with PHPT in order to minimize the risk of hypocalcemia after parathyroidectomy is discussed. This article presents the relationship between vitamin D deficiency and PHPT, as well as possible methods for correcting vitamin D deficiency in PHPT. Molecular and cellular mechanisms of the occurrence of pathological processes in the parathyroid glands under conditions of low vitamin D levels are presented.

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