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Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study

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Abstract

Background

Thyroid disease and hyperparathyroidism are the most common endocrine disorders. The incidence of thyroid disease in patients with hyperparathyroidism ranges in the different series from 17 to 84%, and thyroid cancer occurs with an incidence ranging from 2 to 15%.

Aim

The aim of our study was to analyze the management of elderly patients with concomitant thyroid and parathyroid disease in order to define the best surgical therapeutic strategy and avoid reoperations associated with a higher risk of complications.

Methods

All consecutive patients (64 patients, age range 60–75 years), undergoing surgery for hyperparathyroidism, from January 2011 to June 2014, were retrospectively evaluated. Enrolled patients were divided into two study groups of patients affected by hyperparathyroidism with or without a concomitant thyroid disease.

Results

Out of 64 patients enrolled in our study (24 men, age range 60–75 years), affected by hyperparathyroidism, 34 had an associated thyroid disease and were treated with total thyroidectomy and parathyroidectomy. The group, who underwent parathyroidectomy associated with thyroidectomy, had no greater complications than the group receiving only parathyroidectomy.

Conclusions

Thyroid disease must be excluded in patients affected by hyperparathyroidism. It is difficult to determine whether hyperparathyroidism can be considered a risk factor for thyroid disease, but an accurate preoperative study is essential for a surgery able to treat both thyroid and parathyroid disease. In this way, we avoid the elderly patient, with associated morbidity and increased surgical risk, to undergo a reoperation for thyroid disease, burdened with major complications.

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Abbreviations

PHPT:

Primary hyperparathyroidism

QPTH:

Intraoperative parathyroid hormone assay

PH:

Parathyroid hormone

US:

Ultrasonography

CT:

Computer tomography

MEN:

Multiendocrine neoplasia

FNA:

Fine-needle aspiration biopsy

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Authors and Affiliations

  1. Department of Surgical Sciences, Policlinico Umberto I, “Sapienza” University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy

    Alessandra Panarese, Vito D’Andrea, Stefano Pontone, Pasqualino Favoriti, Daniele Pironi, Stefano Arcieri, Angelo Filippini & Salvatore Sorrenti

Authors
  1. Alessandra Panarese
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  2. Vito D’Andrea
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  3. Stefano Pontone
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  4. Pasqualino Favoriti
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  5. Daniele Pironi
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  6. Stefano Arcieri
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  7. Angelo Filippini
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  8. Salvatore Sorrenti
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Corresponding author

Correspondence to Alessandra Panarese.

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Conflict of interest

All authors listed have contributed sufficiently to the project to be included as authors, and to the best of our knowledge, no conflict of interest, financial or other exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Panarese, A., D’Andrea, V., Pontone, S. et al. Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study. Aging Clin Exp Res 29 (Suppl 1), 29–33 (2017). https://doi.org/10.1007/s40520-016-0665-8

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  • DOI: https://doi.org/10.1007/s40520-016-0665-8

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