Post-surgical follow-up of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1

• Main Authors: Flavia L. Coutinho, Delmar M. Lourenco Jr., Rodrigo A. Toledo, Fabio L. M. Montenegro, Sergio P. A. Toledo
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP 2012-01-01
• Series: Clinics
• Subjects: Primary Hyperparathyroidism; MEN1; Bone Mineral Density; Parathyroid Hormone; Total Parathyroidectomy
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012001300028

The bone mineral density increments in patients with sporadic primary hyperparathyroidism after parathyroidectomy have been studied by several investigators, but few have investigated this topic in primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Further, as far as we know, only two studies have consistently evaluated bone mineral density values after parathyroidectomy in cases of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Here we revised the impact of parathyroidectomy (particularly total parathyroidectomy followed by autologous parathyroid implant into the forearm) on bone mineral density values in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Significant increases in bone mineral density in the lumbar spine and femoral neck values were found, although no short-term (15 months) improvement in bone mineral density at the proximal third of the distal radius was observed. Additionally, short-term and medium-term calcium and parathyroid hormone values after parathyroidectomy in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 are discussed. In most cases, this surgical approach was able to restore normal calcium/parathyroid hormone levels and ultimately lead to discontinuation of calcium and calcitriol supplementation.