ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2006) 12 OC16

Symptomatic improvement after parathyroidectomy for primary hyperparathyroidism

R Mihai & GP Sadler


Dept. of Endocrine Surgery, John Radcliffe Hospital, Oxford, United Kingdom.


Introduction

There is growing interest in the impact of parathyroidectomy on quality of life in patients with primary hyperparathyroidism (PHPT). The aim of this study was to asses the symptomatic improvement in a cohort of patients with PHPT operated in a single centre in the UK.

Methods

A prospective study of consecutive unselected patients with biochemical diagnosis of PHPT was approved by the Local Ethical Committee. Pasieka’s Parathyroid Symptoms Score (PPSS) was calculated using a standardised questionnaire with 12 parameters assessed on a visual analogue scale (max score 1200). SF-36 questionnaire was used to quantify changes in quality of life.

Results

Between Nov 2005 and April 2006, 60 patients were diagnosed with PHPT. There were 18 men and 42 women, aged 24–89 yrs (median 65 yrs). Patients’ history revealed specific symptoms in 44/60 patients. Preoperative PPSS ranged 0–980 (median 475) and did not correlate with the number of symptoms identified by clinicians. Patients underwent minimally invasive parathyroidectomy (n=43) or bilateral cervical exploration (n=17). All were found to have a single parathyroid adenoma and were normocalcaemic at 3-months after parathyroidectomy. Follow-up assessment showed a significant reduction of PPSS from 440±230 preoperatively to 230±220 at 3 months postoperatively (n=60) and to 210±195 at 6 months postoperatively (n=38). This improvement correlated with changes in SF-36 scores in the vitality and mental health domains.

Conclusion

There is a significant self-reported improvement in symptoms at 3–6 months after parathyroidectomy that correlates with changes in quality of life after parathyroidectomy for PHPT.

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