Pathology and outcome of surgical treatment for lithium-associated hyperparathyroidism

Abdullah, Noor Hisham; Bliss, Richard; Guinea, Ana I.; Delbridge, Leigh

doi:10.1046/j.1365-2168.1999.00977.x

Cited by 47 publications

(45 citation statements)

References 12 publications

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“…Of these, 71 patients had surgically verified hyperparathyroidism of whom 42 patients were found to have adenomas (Garfinkel et al, 1973;Christensson, 1976;MacGregor, 1977;Toffaletti et al, 1979;Graze, 1981;Ananth and Dubin, 1983;McHenry et al, 1990;Nordenstrom et al, 1992;Abdullah et al, 1999;Awad et al, 2003;Dalan et al, 2007;Rizwan and Perrier, 2009;Szalat et al, 2009). In addition, 29 patients were found to have diffuse parathyroid hyperplasia (Cairns et al, 1985;Krivitzky et al, 1986;McHenry et al, 1990;Feldman and Pachman, 1990;Tissel et al, 1991;Nordenstrom et al, 1992;Abdullah et al, 1999;Awad et al, 2003;Hundley et al, 2005;Rizwan and Perrier, 2009;Szalat et al, 2009). In the remaining case reports, hyperparathyroid states were not surgically verified (Cervi-Skinner, 1977;Toffaletti et al, 1979;Herman, 1981;Davis et al, 1981;Rothman, 1982;Shen and Sherrard, 1982;Ananth and Dubin, 1983;Prasad, 1984;Mallette and Eichhorn, 1986;Rifai et al, 2001;Bilanakis and Gibiriti, 2004;Sloand and Shelly, 2006).…”

Section: Resultsmentioning

confidence: 96%

“…Among cross-sectional studies of hypercalcemia and hyperparathyroidism in lithium-treated patients, duration of lithium therapy has ranged from 1 month to 30 years (Table 1). Lithium-associated hyperparathyroidism also does not appear to be related to lithium dosing and is not a result of lithium toxicity (Abdullah et al, 1999;El Khoury et al, 2002).…”

Section: Epidemiology Of Lithium-associated Hyperparathyroidismmentioning

confidence: 97%

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Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?

Lehmann

Lee

2013

Journal of Affective Disorders

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Section: Resultsmentioning

confidence: 96%

Section: Epidemiology Of Lithium-associated Hyperparathyroidismmentioning

confidence: 97%

Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?

Lehmann

Lee

2013

Journal of Affective Disorders

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“…Four of the included studies recommended MIP [5,7,9,10], and 5 recommended bilateral exploration [11,12,27,28,29] (table 7). …”

Section: Discussionmentioning

confidence: 99%

Lithium-Associated Hyperparathyroidism: A Pooled Analysis

Ibrahim

Mohamed²,

Deniwar³

et al. 2015

ORL

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Background: Lithium treatment has been associated with hyperparathyroidism (HPT). However, there are conflicting data regarding the rate of single- (SGD) versus multiple-gland disease (MGD) as well as the optimum surgical approach in these cases. Methods: Published data were identified through systematic electronic literature searches. Studies that fulfilled the preset inclusion criteria were analyzed (n = 12). Results: These studies documented 210 lithium-associated HPT (LAH) cases. Of these, 103 (49%) were due to SGD and 107 (51%) due to MGD. The unadjusted odds ratio of having multiple LAH compared to sporadic HPT was 3.44 (95% confidence interval 2.5907-4.5633; p < 0.0001). The sensitivity of preoperative sestamibi and sonography for SGD was 66-100 and 75-82%, respectively. The sensitivity for MGD was 9-67% for both. Intraoperative parathyroid hormone monitoring was utilized in 6 studies. Three studies recommended minimally invasive parathyroidectomy (MIP), while the other 3 recommended bilateral exploration. Conclusion: LAH is a relatively frequent condition among patients on lithium, and calcium monitoring should be performed initially and longitudinally. Almost half of the LAH cases are due to SGD. MIP should be the optimum surgical approach.

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“…McHenry et al (33) also report three cases of associated thyroid carcinoma among a series of eight patients undergoing parathyroidectomy for LAH and Abdullah et al also describe one case of occult PTC among 11 patients with LAH (20). An increased prevalence of up to 2% associated occult thyroid malignancy and PTA in patients undergoing neck surgery for parathyroidectomy (34), and it was suggested that thyroid evaluation before such a surgical procedure is mandatory and simultaneous thyroidectomy should be considered.…”

Section: The Association Of Lah and Thyroid Carcinomamentioning

confidence: 99%

Lithium-associated hyperparathyroidism: report of four cases and review of the literature

Szalat¹,

Mazeh²,

Freund³

2009

European Journal of Endocrinology

110

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Context: Lithium-associated hyperparathyroidism (LAH) was first described in 1973 but many issues remain in question regarding the pathophysiology as well as the appropriate management of this condition. Objective: Report of four new cases and review of the literature. Results: We describe two males and two females, treated for more than 10 years with lithium due to bipolar disorder, who developed LAH. All underwent parathyroidectomy. In three cases (75%), pathology revealed multiglandular disease, with hyperplasia or two parathyroid adenomas. We observed a cure status in three (75%) of the operated patients. The fourth patient had a residual disease, but had controlled hypercalcemia under the calcimimetic drug cinacalcet. We also observed the association of LAH with incidental papillary thyroid carcinoma in two patients. Review of the literature identified a higher prevalence of LAH in women than men (four out of one) and a controversy in regard to the prevalence of multiglandular disease. As a result, there is no consensus regarding the preferred surgical procedure. The use of cinacalcet as an effective treatment of LAH was previously described in only five cases. Conclusion: In our view, there are apparently two different mechanisms leading to LAH: exacerbation of a pre-existing state of hyperparathyroidism and multiglandular disease. For uncontrolled hypercalcemia, parathyroidectomy is recommended. The issue of routine four-gland exploration and subtotal parathyroidectomy versus intraoperative PTH-determination-guided excision of enlarged glands is still unresolved. The use of the recently developed calcimimetics may offer an alternative to patients who are not candidates for surgery.

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Pathology and outcome of surgical treatment for lithium-associated hyperparathyroidism

Cited by 47 publications

References 12 publications

Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?

Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?

Lithium-Associated Hyperparathyroidism: A Pooled Analysis

Lithium-associated hyperparathyroidism: report of four cases and review of the literature

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