Abstract
Background. The treatment of patients with asymptomatic primary hyperparathyroidism remains controversial
despite a National Institutes of Health consensus statement. This statement also recommended
a randomized clinical trial because none exists to address this issue. Methods. Informed consent was obtained from 53 asymptomatic patients with confirmed asymptomatic
primary hyperparathyroidism who participated in this randomized trial of parathyroidectomy
versus observation. Patients completed the SF-36 Health Survey, an instrument that
measures wellness, every 6 months for 2 years. Average annual changes were compared.
Results. Fifty-three patients (42 female, 11 male) with asymptomatic, mild (serum calcium
level, 10.1-11.5 mg/dL) asymptomatic primary hyperparathyroidism who agreed to participate
were randomized into either a surgical group or an observation group. The mean calcium
level was 10.31 mg/dL. The only demographic difference between groups was age, with
the operative group being older (66.7 vs 62.6 years; P <.03). The scores on 2 of the 9 domains of the SF-36 were significantly different
(P <.007 and <.012, respectively); both favored the operative group. Conclusions. Improved function is seen after parathyroidectomy when compared with patients who
did not undergo operation. This study supports surgical management of mild primary
hyperparathyroidism at the time of diagnosis because many patients have reversible
nonclassic symptoms of the disease. (Surgery 2000;128:1013-21.)
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Article info
Footnotes
*Supported by National Institutes of Health grant DK 43858.
**Reprint requests: Gary B. Talpos, MD, Department of Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202.
★Surgery 2000;128:1013-21.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
