Background. To assess the impact of surgery on preoperative symptoms in secondary (2°) and tertiary (3°) hyperparathyroidism (HPT) compared with primary (1°) HPT. Methods. Twenty-two patients with 2° HPT and 10 with 3° HPT were enrolled. Age-matched patients, 32 with 1° HPT and 32 with thyroid disease were enrolled for comparison. An outcome questionnaire documented symptoms expressed as the median symptom index score (MSIS) preoperatively and at days 7 and 3 and 12 months postoperatively. Results. Preoperatively, the MSIS for the groups with 3°, 2°, and 1° HPT and thyroid disease was 225, 572, 372, and 146, indicating that patients with HPT were more symptomatic than those in the thyroid group (P <.05). Patients with 1° HPT had a decrease in their MSIS at day 7 (195, P <.05) and at 3 and 12 months (159 and 156). Patients with 3° HPT also had a decrease in their MSIS over time. Patients with 2° HPT had a decrease in their MSIS at day 7 (469, P <.05); however, they remained more symptomatic at 3 and 12 months (410 and 355). Conclusions. Parathyroidectomy reduces many of the preoperative symptoms in HPT. Patients with 1° and 3° HPT have a similar resolution of their symptoms. Patients with 2° HPT have an improvement in many of their symptoms, although they remain more symptomatic at 1 year. (Surgery 2000;128:531-9.)
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*Reprint requests: Dr Janice L. Pasieka, Clinical Professor and Chief, Division of General Surgery, Foothills Medical Center, 1403 29th St NW, Calgary, Alberta, Canada, T2N 2T9.
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.