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Spontaneous remission of primary hyperparathyroidism: A case report and meta‐analysis of the literature
Author(s) -
Wootten Christopher T.,
Orzeck Eric A.
Publication year - 2006
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20316
Subject(s) - medicine , primary hyperparathyroidism , meta analysis , etiology , surgery , parathyroidectomy , parathyroid adenoma , head and neck , adenoma , hyperparathyroidism , parathyroid hormone , resection , calcium
Background. In a minority of patients, primary hyperparathyroidism spontaneously remits either by autoinfarction or by hemorrhage into or around the adenoma. We describe a case of autoparathyroidectomy occurring in a 63‐year‐old man 9 years after three parathyroid glands were removed during a total thyroidectomy. This case is compared with 50 previously reported cases of autoparathyriodectomy, and a meta‐analysis is performed. Methods. Case report, literature review, and meta‐analysis were done using statistical software (SigmaStat 2.0, SPSS, Chicago). Results. Fifty cases of autoparathyroidectomy were summarized according to the three etiologies. The greatest biochemical aberration was found in the acute intracapsular hemorrhage group, with [Ca ++ ] falling from a mean 15.1 mg/dL to 8.9 mg/dL. The average drop in parathyroid hormone was 69% across all groups, comparing favorably to surgical resection. Conclusions. Autoparathyroidectomy is a rare but described outcome of unoperated primary hyperparathyroidism that may delay or supplant operative management. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005