Spontaneous remission of primary hyperparathyroidism: A case report and meta-analysis of the literature

✍ Scribed by Christopher T. Wootten; Eric A. Orzeck

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 136 KB
• Volume: 28
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20316

✦ Synopsis

Background:

In a minority of patients, primary hyperparathyroidism spontaneously remits either by autoinfarction or by hemorrhage into or around the adenoma. we describe a case of autoparathyroidectomy occurring in a 63-year-old man 9 years after three parathyroid glands were removed during a total thyroidectomy. this case is compared with 50 previously reported cases of autoparathyriodectomy, and a meta-analysis is performed.

Methods:

Case report, literature review, and meta-analysis were done using statistical software (sigmastat 2.0, spss, chicago).

Results:

Fifty cases of autoparathyroidectomy were summarized according to the three etiologies. the greatest biochemical aberration was found in the acute intracapsular hemorrhage group, with [ca(++)] falling from a mean 15.1 mg/dl to 8.9 mg/dl. the average drop in parathyroid hormone was 69% across all groups, comparing favorably to surgical resection.

Conclusions:

Autoparathyroidectomy is a rare but described outcome of unoperated primary hyperparathyroidism that may delay or supplant operative management.