Hyperparathyroidism in persons treated with X-rays for tuberculous cervical adenitis

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Tuberculous adenitis was historically treated with radiation therapy.
• Long-term effects of radiation exposure on endocrine glands are not fully understood.
• Hyperparathyroidism (HPT) is a condition affecting parathyroid glands.

Purpose of the Study:

• To investigate the incidence of hyperparathyroidism (HPT) in patients treated with x-rays for tuberculous adenitis.
• To determine if there is a correlation between radiation dose and HPT development.

Main Methods:

• Follow-up examinations of 100 patients treated between 1930-1946.
• Neck explorations for hypercalcemia and HPT symptoms.
• Fine needle aspiration for suspected thyroid malignancy.
• Dosimetry assessment of radiation exposure to parathyroid glands.

Main Results:

• Eleven patients developed parathyroid adenoma or hyperplasia.
• Four additional patients presented with asymptomatic hypercalcemia.
• A dose-response relationship was observed; HPT occurred in 4/6 patients receiving >1,200 rads.
• No HPT cases were recorded below 300 rads.

Conclusions:

• Radiation therapy for tuberculous adenitis is associated with an increased incidence of hyperparathyroidism (HPT).
• Higher radiation doses correlate with a greater risk of developing HPT.
• A cause-and-effect relationship between radiation exposure and HPT is suggested.