A profile of patients with hyperparathyroidism undergoing lithium therapy for affective psychiatric disorders

✍ Scribed by Emad Kandil; Alan P. Dackiw; Haytham Alabbas; Obai Abdullah; Anthony P. Tufaro; Ralph P. Tufano

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 61 KB
• Volume: 33
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21563

✦ Synopsis

Abstract

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