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A profile of patients with hyperparathyroidism undergoing lithium therapy for affective psychiatric disorders
Author(s) -
Kandil Emad,
Dackiw Alan P.,
Alabbas Haytham,
Abdullah Obai,
Tufaro Anthony P.,
Tufano Ralph P.
Publication year - 2011
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.21563
Subject(s) - parathyroidectomy , hyperparathyroidism , medicine , parathyroid gland , lithium (medication) , disease , parathyroid hormone , refractory (planetary science) , hyperplasia , surgery , population , anxiety , pathology , calcium , psychiatry , physics , environmental health , astrobiology
Background Our objective was to evaluate whether lithium‐induced hyperparathyroidism (LIHPT) is caused by single‐gland versus multigland disease. Methods Medical records of 7 patients who underwent parathyroidectomy for LIHPT were reviewed. Results The mean preoperative calcium was 11.1 ± 0.7 mg/dL. Six of 7 patients were rendered eucalcemic with surgery. Of the 6 patients successfully treated with surgery, 4 had single‐gland disease, 1 had double adenomas, and 1 had 4‐gland hyperplasia. Intraoperative intact serum parathyroid hormone (iPTH) accurately predicted resolution of hyperparathyroidism in 6 of 7 patients. One patient then subsequently developed persistent hyperparathyroidism refractory to further surgery. Localization studies defined the extent of disease in 5 of 7 patients. Conclusion LIHPT presents with a spectrum of disease ranging from single‐gland to multigland disease. The utility of preoperative localization studies and intraoperative iPTH in this population is uncertain. Bilateral exploration may be best to achieve a resolution of LIHPT. © 2011 Wiley Periodicals, Inc. Head Neck, 2011