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Surgery for 'asymptomatic' mild primary hyperparathyroidism improves some clinical symptoms postoperatively

Claire Blanchard 1 Muriel Mathonnet 2 Frédéric Sebag 3 Cécile Caillard 4 Antoine Hamy 5 Christelle Volteau 6 Marie-Françoise Heymann 7, 8, 9 Vincent Wyart 10 Delphine Drui 11 Malanie Roy 12, 13 Bertrand Cariou 1 Françoise Archambeaud 14 Patrice Rodien 15 Jean-François Henry 3 Rasa Zarnegar 16 Jean-Benoit Hardouin 17 Eric Mirallié 4
Abstract :

OBJECTIVE AND BACKGROUND: Most primary hyperparathyroidism (pHPT) patients do not conform to the guidelines for parathyroidectomy established by an international panel of specialists and have a mild pHPT. This group is typically defined as 'asymptomatic'. The primary aim of this study was to determine symptom improvement in this 'asymptomatic' group after parathyroidectomy. Secondly, we aimed to create a preoperative clinical score predicting postoperative symptom resolution.

DESIGN: A prospective nonrandomized study included patients with mild pHPT.

METHODS: A questionnaire (22 items) was given to 'asymptomatic' patients preoperatively and at 3, 6, and 12 postoperative months. A logistic regression was performed to create a preoperative clinical score.

RESULTS: One hundred and sixteen patients were included. Postoperatively, HPT was resolved in 98% of patients. Twelve of 22 nonspecific symptoms were improved at 1 year. Subgroups analysis showed a greater improvement in patients <70 years and those with a serum calcium level ≥2.6 mmol/l preoperatively. A clinical score, based on age and five symptoms, was established to predict the clinical improvement after surgery in mild pHPT patients with a positive predictive value of 81%.

CONCLUSION: Patients with asymptomatic pHPT have clinical improvement of their symptoms postoperatively even after 1 year. Younger patients and those with higher preoperative calcium levels show the best improvement.

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https://hal.univ-angers.fr/hal-03269727
Contributeur : Okina Université d'Angers <>
Soumis le : jeudi 24 juin 2021 - 11:34:41
Dernière modification le : vendredi 25 juin 2021 - 03:31:56

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Claire Blanchard, Muriel Mathonnet, Frédéric Sebag, Cécile Caillard, Antoine Hamy, et al.. Surgery for 'asymptomatic' mild primary hyperparathyroidism improves some clinical symptoms postoperatively. European journal of endocrinology, 2013, 169 (5), pp.665-672. ⟨10.1530/EJE-13-0502⟩. ⟨hal-03269727⟩

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