Surgery for 'asymptomatic' mild primary hyperparathyroidism improves some clinical symptoms postoperatively

TitreSurgery for 'asymptomatic' mild primary hyperparathyroidism improves some clinical symptoms postoperatively
Type de publicationArticle de revue
AuteurBlanchard, Claire, Mathonnet, Muriel, Sebag, Frédéric, Caillard, Cécile, Hamy, Antoine , Volteau, Christelle, Heymann, Marie-Françoise, Wyart, Vincent, Drui, Delphine, Roy, Malanie, Cariou, Bertrand, Archambeaud, Françoise, Rodien, Patrice , Henry, Jean-François, Zarnegar, Rasa, Hardouin, Jean-Benoit, Mirallié, Eric
PaysRoyaume-Uni
EditeurBioScientifica
VilleBristol
TypeArticle scientifique dans une revue à comité de lecture
Année2013
LangueAnglais
DateNov 2013
Numéro5
Pagination665-672
Volume169
Titre de la revueEuropean Journal of Endocrinology
ISSN1479-683X
Mots-clésAge Factors, Aged, Aged, 80 and over, Calcium, Creatinine, Female, Follow-Up Studies, Humans, Hydroxycholecalciferols, Hyperparathyroidism, Primary, Male, Middle Aged, Parathyroidectomy, Postoperative Period, Prospective Studies, Treatment Outcome
Résumé en anglais

OBJECTIVE AND BACKGROUND: Most primary hyperparathyroidism (pHPT) patients do not conform to the guidelines for parathyroidectomy established by an international panel of specialists and have a mild pHPT. This group is typically defined as 'asymptomatic'. The primary aim of this study was to determine symptom improvement in this 'asymptomatic' group after parathyroidectomy. Secondly, we aimed to create a preoperative clinical score predicting postoperative symptom resolution.

DESIGN: A prospective nonrandomized study included patients with mild pHPT.

METHODS: A questionnaire (22 items) was given to 'asymptomatic' patients preoperatively and at 3, 6, and 12 postoperative months. A logistic regression was performed to create a preoperative clinical score.

RESULTS: One hundred and sixteen patients were included. Postoperatively, HPT was resolved in 98% of patients. Twelve of 22 nonspecific symptoms were improved at 1 year. Subgroups analysis showed a greater improvement in patients <70 years and those with a serum calcium level ≥2.6 mmol/l preoperatively. A clinical score, based on age and five symptoms, was established to predict the clinical improvement after surgery in mild pHPT patients with a positive predictive value of 81%.

CONCLUSION: Patients with asymptomatic pHPT have clinical improvement of their symptoms postoperatively even after 1 year. Younger patients and those with higher preoperative calcium levels show the best improvement.

URL de la noticehttp://okina.univ-angers.fr/publications/ua12940
DOI10.1530/EJE-13-0502
Lien vers le document

http://dx.doi.org/10.1530/EJE-13-0502

Autre titreEur. J. Endocrinol.
Identifiant (ID) PubMed23956299