Hyperparathyroidism following the atomic bombing in Nagasaki

Forty-three patients with hyperparathyroidism (HPT), including 20 atomic bomb survivors (46.5 per cent) were treated surgically in our institute during the last 19 years. The mean age of the patients at the time of atomic bomb exposure (AB*E) was 17.6 +/- 1.5 years. The mean latent interval between atomic bomb exposure and detection of HPT was 39.1 +/- 1.1 years. We compared the 20 AB*E patients with 23 patients who had a history of neither atomic bomb exposure nor therapeutic irradiation to the neck region (non-AB*E patients). It was determined that females were more prominently affected by HPT than males among AB*E patients. The parathyroid lesions in AB*E patients consisted of adenoma in 16 patients and hyperplasia in 4. A similar proportion of pathological lesions was also observed in non-AB*E patients. Thyroid lesions accompanied by HPT, however, were more often revealed in AB*E patients than in non-AB*E patients. The two most common lesions in AB*E patients were papillary carcinoma in 3 patients (15 per cent) and adenoma in 3 (15 per cent). These findings suggest that atomic bomb survivors may be at a greater risk of developing HPT with a high incidence of accompanying thyroid disease.