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Updated: Jun 2, 2026

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Published on: January 28, 2012
A profile of patients with hyperparathyroidism undergoing lithium therapy for affective psychiatric disorders
Emad Kandil1, Alan P Dackiw, Haytham Alabbas
1Endocrine Surgery Section, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Background:
Our objective was to evaluate whether lithium-induced hyperparathyroidism (LIHPT) is caused by single-gland versus multigland disease.
Methods:
Medical records of 7 patients who underwent parathyroidectomy for LIHPT were reviewed.
Results:
The mean preoperative calcium was 11.1 ± 0.7 mg/dL. Six of 7 patients were rendered eucalcemic with surgery. Of the 6 patients successfully treated with surgery, 4 had single-gland disease, 1 had double adenomas, and 1 had 4-gland hyperplasia. Intraoperative intact serum parathyroid hormone (iPTH) accurately predicted resolution of hyperparathyroidism in 6 of 7 patients. One patient then subsequently developed persistent hyperparathyroidism refractory to further surgery. Localization studies defined the extent of disease in 5 of 7 patients.
Conclusion:
LIHPT presents with a spectrum of disease ranging from single-gland to multigland disease. The utility of preoperative localization studies and intraoperative iPTH in this population is uncertain. Bilateral exploration may be best to achieve a resolution of LIHPT.
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