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Sporadic primary hyperparathyroidism in young individuals: different disease and treatment?
MedLine Citation:
PMID:  19135685     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Younger individuals with hyperparathyroidism may experience severe disease with a higher incidence of multigland disease (MGD) and operative failure, thereby requiring subtotal parathyroidectomy. This study examines the characteristics and surgical outcome of younger compared with older patients with sporadic primary hyperparathyroidism (SPHPT). METHODS: Prospectively collected data of 1101 patients with SPHPT who underwent parathyroidectomy at a single institution were retrospectively reviewed. Patients with multiple endocrine neoplasia (MEN), familial, secondary, or tertiary hyperparathyroidism, parathyroid carcinoma, rickets, or lithium induced disease were excluded. Patients were subdivided into two groups: (1) younger individuals < or = 40 y of age (n = 110) and (2) older individuals > 40 y of age (n = 991). Both age groups were compared for gender, clinical manifestations, pre- and postoperative laboratory values, MGD, operative success, and recurrent disease. RESULTS: There was greater male predominance in younger compared with older patients treated for SPHPT (41% versus 25%, P = 0.0004). Of the clinical manifestations of SPHPT, kidney stones were more common in younger compared with older individuals (45% versus 29%, P = 0.0006). Conversely, bone pain was more common in older compared with younger patients (32% versus 14%, P = 0.0002). There was no statistical difference in biochemical values, MGD, and outcome between both groups. CONCLUSIONS: Despite male predominance and few differences in symptoms, SPHPT is a similar disease entity in both younger and older individuals. Patients from both age groups can be similarly treated for SPHPT with a high rate of operative success. Routine BNE and subtotal parathyroidectomy is not necessary in younger individuals.
Mark S Sneider; Carmen C Solorzano; Raquel E Montano; Charles Anello; George L Irvin; John I Lew
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Publication Detail:
Type:  Journal Article     Date:  2008-09-04
Journal Detail:
Title:  The Journal of surgical research     Volume:  155     ISSN:  1095-8673     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  100-3     Citation Subset:  IM    
DeWitt Daughtry Family Department of Surgery, Division of Endocrine Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida 33136, USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Hyperparathyroidism, Primary / epidemiology*,  surgery
Middle Aged
Parathyroidectomy / contraindications*
Retrospective Studies
United States / epidemiology
Young Adult

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