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Hyperthyroidism after surgery for primary hyperparathyroidism

Lindblom, P LU ; Valdemarsson, S LU ; Westerdahl, J LU ; Tennvall, J LU and Bergenfelz, A LU (1999) In Deutsche Zeitschrift für Chirurgie 384(6). p.75-568
Abstract

BACKGROUND: The coexistence of hyperthyroidism and primary hyperparathyroidism (pHPT) has been reported. We have questioned whether hypercalcemia or surgical trauma contribute to transient hyperthyroidism following parathyroid surgery.

METHODS: Twenty-six pHPT and eleven breast cancer patients were compared regarding pre-, peri- and postoperative thyrotropin (TSH), free thyroxine (T4) and free triiodothyronine (T3) concentrations. Thyroglobulin concentration, occurrence of autonomous thyroid nodules, and variables reflecting surgical trauma were compared in pHPT patients with and without postoperative hyperthyroidism.

RESULTS: Postoperatively, eleven pHPT patients demonstrated T4 and T3 concentrations above normal, and nine... (More)

BACKGROUND: The coexistence of hyperthyroidism and primary hyperparathyroidism (pHPT) has been reported. We have questioned whether hypercalcemia or surgical trauma contribute to transient hyperthyroidism following parathyroid surgery.

METHODS: Twenty-six pHPT and eleven breast cancer patients were compared regarding pre-, peri- and postoperative thyrotropin (TSH), free thyroxine (T4) and free triiodothyronine (T3) concentrations. Thyroglobulin concentration, occurrence of autonomous thyroid nodules, and variables reflecting surgical trauma were compared in pHPT patients with and without postoperative hyperthyroidism.

RESULTS: Postoperatively, eleven pHPT patients demonstrated T4 and T3 concentrations above normal, and nine developed symptoms of mild thyrotoxicosis. A parallel rise in TSH and T4 concentrations was seen during both parathyroid and breast cancer surgery. Compared with patients with no postoperative hyperthyroidism, patients with postoperative hyperthyroidism showed a parallel rise in mean thyroglobulin and T4/T3 concentrations as well as higher thyroglobulin concentrations. However, there was no difference in variables assessing surgical trauma nor in occurrence of autonomous thyroid nodules. The peri-operative rise in TSH was preceded by a decrease in calcium.

CONCLUSION: Transient hyperthyroidism after parathyroid surgery is not infrequent. The condition seems to be self-limiting, since symptoms invariably subsided without treatment. Manipulation of the thyroid gland is most likely the major contributing factor to postoperative hyperthyroidism. However, it may not be the sole explanation, since our data suggest a more multifactorial scenario.

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publication status
published
subject
keywords
Aged, Breast Neoplasms, Female, Humans, Hyperparathyroidism, Hyperthyroidism, Male, Parathyroidectomy, Postoperative Complications, Thyroid Hormones, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
in
Deutsche Zeitschrift für Chirurgie
volume
384
issue
6
pages
8 pages
publisher
Springer
external identifiers
  • scopus:0033398426
ISSN
1435-2443
language
English
LU publication?
no
id
b27abfc2-0c0c-4fc3-9552-37b77e18bc7f
date added to LUP
2017-05-10 17:37:06
date last changed
2017-05-14 04:51:08
@article{b27abfc2-0c0c-4fc3-9552-37b77e18bc7f,
  abstract     = {<p>BACKGROUND: The coexistence of hyperthyroidism and primary hyperparathyroidism (pHPT) has been reported. We have questioned whether hypercalcemia or surgical trauma contribute to transient hyperthyroidism following parathyroid surgery.</p><p>METHODS: Twenty-six pHPT and eleven breast cancer patients were compared regarding pre-, peri- and postoperative thyrotropin (TSH), free thyroxine (T4) and free triiodothyronine (T3) concentrations. Thyroglobulin concentration, occurrence of autonomous thyroid nodules, and variables reflecting surgical trauma were compared in pHPT patients with and without postoperative hyperthyroidism.</p><p>RESULTS: Postoperatively, eleven pHPT patients demonstrated T4 and T3 concentrations above normal, and nine developed symptoms of mild thyrotoxicosis. A parallel rise in TSH and T4 concentrations was seen during both parathyroid and breast cancer surgery. Compared with patients with no postoperative hyperthyroidism, patients with postoperative hyperthyroidism showed a parallel rise in mean thyroglobulin and T4/T3 concentrations as well as higher thyroglobulin concentrations. However, there was no difference in variables assessing surgical trauma nor in occurrence of autonomous thyroid nodules. The peri-operative rise in TSH was preceded by a decrease in calcium.</p><p>CONCLUSION: Transient hyperthyroidism after parathyroid surgery is not infrequent. The condition seems to be self-limiting, since symptoms invariably subsided without treatment. Manipulation of the thyroid gland is most likely the major contributing factor to postoperative hyperthyroidism. However, it may not be the sole explanation, since our data suggest a more multifactorial scenario.</p>},
  author       = {Lindblom, P and Valdemarsson, S and Westerdahl, J and Tennvall, J and Bergenfelz, A},
  issn         = {1435-2443},
  keyword      = {Aged,Breast Neoplasms,Female,Humans,Hyperparathyroidism,Hyperthyroidism,Male,Parathyroidectomy,Postoperative Complications,Thyroid Hormones,Comparative Study,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {6},
  pages        = {75--568},
  publisher    = {Springer},
  series       = {Deutsche Zeitschrift für Chirurgie},
  title        = {Hyperthyroidism after surgery for primary hyperparathyroidism},
  volume       = {384},
  year         = {1999},
}