Surgical treatment of primary hyperparathyroidism in the elderly.

Heath, D. A.; Wright, A. D.; Barnes, A. D.; Oates, G. D.; Dorricott, N. J.

doi:10.1136/bmj.280.6229.1406

Cited by 52 publications

(21 citation statements)

References 5 publications

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“…In general, complication rates following parathyroidectomy are reportedly low, mostly in the range of 0.7% to 8.3% 8, 9, 16–22. Comparable to the reports in the literature, the present study also demonstrated low rates of complications, including an overall 7.3% rate of minor complications and 1.6% rate of major complications.…”

Section: Discussionsupporting

confidence: 61%

Parathyroidectomy in the elderly population: Does age really matter?

Young¹,

Osborne²,

Fleming³

et al. 2009

The Laryngoscope

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Nearly 700 parathyroidectomies were performed at our institution over 10 years. Elderly patients comprised one third of this population. They were likely to have longer hospital and recovery room stays, and postoperative normocalcemia with elevated PTH, which may actually be a normal finding for these patients, but it warrants further study. The rate, timing, and types of complications were similar between age groups, although elderly patients had more cardiac complications. When properly indicated, parathyroidectomy remains a safe and effective option for management of hyperparathyroidism in elderly patients.

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Section: Discussionsupporting

confidence: 61%

Parathyroidectomy in the elderly population: Does age really matter?

Young¹,

Osborne²,

Fleming³

et al. 2009

The Laryngoscope

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“…The highest score (25) was in a man who had recently been involved in a severe road traffic accident; two further high values (17 and 14) were in patients with recent bereavements. There was no relationship between the 10 overall score and either the serum calcium or the serum parathyrin in both groups of patients with hyperparathyroidism.…”

Section: Resultsmentioning

confidence: 71%

Psychiatric morbidity in primary hyperparathyroidism

McAllion

Paterson²

1989

Postgraduate Medical Journal

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Summary Psychiatric symptoms are well recognized as a feature of patients with primary hyperparathyroidism. We have applied a standardized psychiatric interview to 15 patients before and after surgery. Thirteen had a lower ‘psychiatric score’ (less psychiatric morbidity) after surgery and improvements were particularly seen in symptoms of fatigue, depression, irritability, sleep disturbance and lack of concentration. The levels of intellectual impairment and of anxiety were unchanged after surgery. The ‘psychiatric scores’ in an additional group of 21 hyperparathyroid patients, in whom a decision to treat conservatively had been made independently, were similar to those in the surgically treated patients after surgery. Among all the untreated patients no relationship was found between overall ‘psychiatric score’ and serum levels of calcium or parathyrin.

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“…Além disso, o hiperparatiroidismo pode ter sido responsável pela osteoporose e as fraturas espontâneas. Na segunda paciente tantos os sintomas neuropsiquiátricos como a perda de massa óssea, apresentaram melhora significativa, demonstrando mais uma vez que o diagnóstico e pronto tratamento podem trazer benefícios importantes para os pacientes (13).…”

Section: Hiperparatiroidismo Primário No Idosounclassified

Manifestações neuropsiquiátricas do hiperparatiroidismo primário no idoso: relato de casos e revisão da literatura

Frisoli

D’Amorin

Szejnfeld

et al. 2001

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 45 nº 3 Junho 2001 302 RESUMOA osteoporose e os distúrbios neuropsiquiátricos surgem com maior freqüência entre os pacientes idosos, quando comparados com as demais faixas etárias. Manifestações concomitantes destas síndromes podem apresentar causas comuns. Neste artigo, nós descrevemos os casos de duas mulheres com osteoporose estabelecida e idades de 75 e 80 anos, que desenvolveram sinais e sintomas neuropsiquiátricos (apatia, fraqueza, depressão e perda de memória) associados a hipercalcemia [cálcio iônico de 1,43mmol/L e 1,65mmol/L (1,14 -1,30mmol/L), respectivamente]. Na investigação laboratorial foi observado que os níveis da fração intacta do paratormônio (PTHi) estavam dentro dos limites da normalidade (64 e 63pg/ml, respectivamente) ou não suprimidos. Após exploração cirúrgica cervical foram removidas, de cada paciente, massas tumorais únicas, cujo anátomo-patológico revelou adenoma de paratireóide. As duas pacientes apresentaram melhora dos sintomas e sinais neuropsiquiátricos após a cirurgia e a segunda paciente obteve ganho de massa óssea significativo, sem uso de qualquer droga antireabsortiva. A outra paciente não pode ser avaliada através da densitometria óssea, devido às deformidades na coluna torácica. A possibilidade de HPTP deve ser sempre considerada, principalmente em pacientes com níveis de paratormônio dentro da faixa de normalidade, ou não suprimidos apesar de cálcio ionizado elevado. Isso ocorre devido a alguns tumores de paratireóide apresentarem set point alterado em relação aos níveis de cálcio mas sem aumento significativo da produção de paratormônio. Outra correlação observada é que quanto menor forem os adenomas, maior a chance de serem hipersecretores e autônomos. Em conclusão, a aferição do cálcio iônico em pacientes idosos com osteoporose e ou sintomas e sinais neuropsiquiátricos deve ser feita de rotina com o objetivo de se excluir doenças que possam ser tratadas prontamente e com bons resultados. ABSTRACTOsteoporosis and neuropsychiatric disorders occur more frequently in elderly than in young people. When they appear together there is a possibility of a common etiology. We report two cases of elderly women at the ages of 75 and 80y with established osteoporosis and neuropsychiatric manifestations (apathy, weakness, depression and loss of memory) caused by hypercalcemia (ionic calcium of 1.43mmol/L and 1.65mmol/L, respectively) due to primary hyperparathyroidism (PHPT). Other laboratory results showed normal levels of the intact fraction of parathormone (iPTH), i.e. 64 and 63pg/ml, respectively. They were submitted to parathyroidectomy and only one tumoral mass was removed from each woman. Pathologic examination showed parathyroid adenoma. Shortly after the surgery they got better of the neuropsychiatric signs and symptoms. Six months later the bone mineral density (BMD) of the apresentação de caso

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Surgical treatment of primary hyperparathyroidism in the elderly.

Cited by 52 publications

References 5 publications

Parathyroidectomy in the elderly population: Does age really matter?

Parathyroidectomy in the elderly population: Does age really matter?

Psychiatric morbidity in primary hyperparathyroidism

Manifestações neuropsiquiátricas do hiperparatiroidismo primário no idoso: relato de casos e revisão da literatura

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