Primary hyperparathyroidism after radioactive iodine therapy: Is it a distinct clinical entity? |
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Institution: | 1. University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, 44106, USA;2. Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH, 44195, USA;3. MetroHealth Medical Center, 2500 MetroHealth Dr., Cleveland, OH, 44109, USA;1. Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama;2. Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire |
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Abstract: | BackgroundRadioactive iodine (RAI) treatment is considered a rare cause of primary hyperparathyroidism (pHPT).MethodA multi-institutional retrospective review of patients with pHPT who underwent parathyroidectomy from 1990 to 2020 was completed to evaluate the prevalence and latency time for development of RAI-associated pHPT and determine clinical differences in pHPT patients with or without prior RAI treatment.Results1929 patients with sporadic pHPT underwent parathyroidectomy; 48 (2.5%) had prior RAI treatment and 1881 (97.5%) did not. RAI treatment was for thyrotoxicosis in 43 (90%) patients. Average latency was 24 years (3–59 years) and inversely correlated with age. Patients with prior RAI treatment had lower preoperative calcium and PTH levels (p < 0.0001). No significant differences were observed in age, symptoms, pathology, ectopic glands and cure rate.ConclusionRAI is a potential causative factor for pHPT, accounting for 2.5% of sporadic pHPT. RAI-associated pHPT may be a less severe form of sporadic pHPT and latency inversely correlates with age. |
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Keywords: | Radioiodine RAI Primary hyperparathyroidism Radioiodine-associated hyperparathyroidism |
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