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Related Experiment Videos

Persistent or recurrent hyperparathyroidism in patients with double adenomas

S Tezelman1, W Shen, A E Siperstein

  • 1Surgical Services of UCSF/Mount Zion 94115, USA.

Surgery
|December 1, 1995
PubMed
Summary

Double adenomas (DA) in persistent or recurrent hyperparathyroidism present differently than hyperplasia. Patients with DA are older and experience distinct symptoms, but both conditions are effectively treated with surgery.

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Area of Science:

  • Endocrinology
  • Surgical Pathology

Background:

  • Investigating whether double adenomas (DA) represent a distinct clinical entity or variations of hyperplastic parathyroid glands.
  • Differentiating patients with persistent or recurrent hyperparathyroidism due to DA from those with hyperplasia based on clinical profiles and treatment responses.

Purpose of the Study:

  • To determine if patients with persistent or recurrent hyperparathyroidism and double adenomas (DA) differ clinically or in treatment outcomes compared to patients with parathyroid hyperplasia.

Main Methods:

  • A cohort of 37 patients with persistent (11) or recurrent hyperparathyroidism (26) treated between 1982 and 1993.
  • Categorization into 21 patients with DA (defined as two abnormal and two normal glands) and 16 with hyperplasia.

Main Results:

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  • DA patients were older and exhibited more muscle weakness, neuropsychiatric issues, constipation, and weight loss (p < 0.001).
  • Nephrolithiasis was more prevalent in hyperplasia patients (p < 0.001).
  • Preoperative serum calcium levels were similar, but parathyroid hormone levels varied; no recurrences were observed in either group post-treatment.

Conclusions:

  • Patients with DA causing persistent or recurrent hyperparathyroidism are older and present with distinct clinical manifestations.
  • Resection of the second adenoma effectively cures DA, supporting DA and hyperplasia as separate entities.