Abstract
Purpose It is assumed that primary hyperparathyroidism (pHPT) in
Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are
associated with multiple gland disease (MGD), persistence and recurrence.
The studies purpose was to determine frequencies, clinical presentation and
outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main
outcome measures were the rates of MGD and
persistence/recurrence.
Methods Retrospective analysis of medical records of 682 patients
with pHPT who had attended the University Hospital of Marburg between
01–01–2004 and 30–06–2013. All patients were
sent a questionnaire asking about their history of lithium medication.
Results Out of 682 patients, 557 underwent primary surgery (532
spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in
follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were
not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful
in 97.4%, revealed singular adenomas in 92.4%, double
adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD
in MEN1 (82.35%) were significantly higher than in spHPT
(3.8%), while there was no significant difference between LIHPT
(20%) and spHPT. Rates of persistence/recurrence did not
significantly differ due to type of surgery (bilateral/unilateral)
or type of HPT (spHPT/LIHPT/MEN).
Conclusions History of lithium medication is rare among pHPT
patients. While MGD is common in MEN1, rates of MGD, persistence or
recurrence in LIHPT were not significantly higher than in spHPT.