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. 2018 Feb;403(1):103-109.
doi: 10.1007/s00423-017-1647-9. Epub 2018 Jan 2.

Predictors of multiglandular disease in primary hyperparathyroidism

Mark Thier  1   2 , Sébastien Daudi  3 , Anders Bergenfelz  3 , Martin Almquist  3
Affiliations

Predictors of multiglandular disease in primary hyperparathyroidism

Mark Thier et al. Langenbecks Arch Surg. 2018 Feb.

Abstract

Background: Primary hyperparathyroidism (pHPT) is caused by single- or multiglandular disease (MGD). Patients with MGD have an increased risk of complications at surgery and for persistence and recurrence after surgery. The study evaluated whether preoperative clinical and biochemical characteristics could predict MGD in patients with pHPT.

Methods: We retrospectively evaluated patients operated 1989-2013 for first-time, non-hereditary pHPT. MGD was defined in patients with more than one pathological gland excised at surgery or with persistent hypercalcemia after the excision of a single pathological parathyroid gland, confirmed by histopathology. Clinical and biochemical variables were compared in patients with single- and multiglandular disease. Logistic regression was used to identify variables predicting MGD, yielding odds ratios (OR) with 95% confidence intervals (CI).

Results: There were 707 patients, of which 79 (11%) had MGD. Patients with MGD were more likely to have negative sestamibi scintigraphy than patients with single-gland disease, 15 of 49 (31%) vs. 70 of 402 (17%; p = 0.03), to suffer from diabetes (12 of 74, 16%) vs. 45 out of 626 patients (7.2%; p < 0.01) and had lower preoperative levels of urinary calcium (3.80 vs. 4.44 mmol/L; p = 0.04). Multivariable analysis identified negative scintigraphy (OR 2.42; 95% CI 1.18 to 4.79), diabetes (OR 2.75; 95% CI 1.31 to 4.97) and elevated levels of osteocalcin (OR 3.79, 95% CI: 1.75 to 8.21) as predictors of MGD.

Conclusion: Negative sestamibi scintigraphy, diabetes and elevated osteocalcin levels were predictors of MGD.

Keywords: Multiglandular disease; Negative scintigraphy; Parathyroid hyperplasia; Prediction; Primary hyperparathyroidism.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

References

    1. Barczynski M, et al. Sporadic multiple parathyroid gland disease—a consensus report of the European Society of Endocrine Surgeons (ESES) Langenbeck’s Arch Surg. 2015;400:887–905. doi: 10.1007/s00423-015-1348-1. - DOI - PMC - PubMed
    1. Bergenfelz A, Lindblom P, Tibblin S, Westerdahl J. Unilateral versus bilateral neck exploration for primary hyperparathyroidism: a prospective randomized controlled trial. Ann Surg. 2002;236(5):543–551. doi: 10.1097/00000658-200211000-00001. - DOI - PMC - PubMed
    1. Bagul A, Patel HP, Chadwick D, Harrison BJ, Balasubramanian SP. Primary hyperparathyroidism: an analysis of failure of parathyroidectomy. World J Surg. 2014;38(3):534–541. doi: 10.1007/s00268-013-2434-6. - DOI - PubMed
    1. Nasiri S, Soroush A, Hashemi AP, Hedayat A, Donboli K, Mehrkhani F. Parathyroid adenoma localization. Med J Islam Repub Iran. 2012;26(3):103–109. - PMC - PubMed
    1. Tezelman S, Shen W, Shaver JK, Siperstein AE, Duh QY, Klein H, Clark OH. Double parathyroid adenomas. Clinical and biochemical characteristics before and after parathyroidectomy. Ann Surg. 1993;218(3):300–307. doi: 10.1097/00000658-199309000-00009. - DOI - PMC - PubMed

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