PMID- 10522858
OWN - NLM
STAT- MEDLINE
DCOM- 19991110
LR  - 20190704
IS  - 0004-0010 (Print)
IS  - 0004-0010 (Linking)
VI  - 134
IP  - 10
DP  - 1999 Oct
TI  - Osteoporosis in multiple endocrine neoplasia type 1: severity, clinical 
      significance, relationship to primary hyperparathyroidism, and response to 
      parathyroidectomy.
PG  - 1119-23
AB  - BACKGROUND: Sporadic primary hyperparathyroidism (PHPT) occurs most frequently in 
      postmenopausal women. Multiple endocrine neoplasia type 1 (MEN 1) is an 
      autosomal-dominant disease in which mild to moderate PHPT develops in most gene 
      carriers by 20 years of age. Primary hyperparathyroidism associated with MEN 1 is 
      typically recurrent, despite initially successful subtotal parathyroidectomy. 
      Osteoporosis is considered a complication of sporadic PHPT and an indication for 
      parathyroidectomy. In the setting of MEN 1, however, the relationship of bone 
      mass to PHPT, fracture risk, and parathyroidectomy is unknown. HYPOTHESIS: 
      Parathyroidectomy improves bone mineral density for patients with primary 
      hyperparathyroidism in the setting of MEN 1. DESIGN: Case series. SETTING: 
      Tertiary referral center. PATIENTS: Twenty-nine women with MEN 1 belonging to a 
      single family with a history of MEN 1. INTERVENTIONS: Parathyroidectomy. MAIN 
      OUTCOME MEASURES: Bone mineral density (BMD) and history of skeletal fracture. 
      RESULTS: Osteopenia and osteoporosis were diagnosed in 41% and 45% of patients, 
      respectively. Forty-four percent of patients with uncontrolled PHPT had severe 
      osteopenia (T score, <-2.0) by 35 years of age. Reduction in BMD was greatest at 
      the femoral neck. Reduced BMD was associated with an increased likelihood of 
      skeletal fracture (P = .05). Patients with uncontrolled PHPT had lower femoral 
      neck and lumbar spine BMDs than those in whom PHPT was controlled by 
      parathyroidectomy (P = .005 and .02, respectively). Successful parathyroidectomy 
      improved femoral neck and lumbar spine BMDs by a mean +/- SEM of 5.2% +/- 2.5% 
      and 3.2% +/- 2.9%, respectively. CONCLUSIONS: Osteoporosis is a frequent and 
      early complication of PHPT in MEN 1. Despite difficulty in achieving a cure of 
      PHPT in MEN 1, parathyroidectomy has an important role in the optimization of BMD 
      for patients with MEN 1.
FAU - Burgess, J R
AU  - Burgess JR
AD  - Department of Diabetes, Royal Hobart Hospital, Australia. 
      jburges@postoffice.utas.edu.au
FAU - David, R
AU  - David R
FAU - Greenaway, T M
AU  - Greenaway TM
FAU - Parameswaran, V
AU  - Parameswaran V
FAU - Shepherd, J J
AU  - Shepherd JJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/*etiology/*surgery
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*complications
MH  - Osteoporosis/*etiology/*prevention & control
MH  - *Parathyroidectomy
MH  - Severity of Illness Index
EDAT- 1999/10/16 00:00
MHDA- 1999/10/16 00:01
CRDT- 1999/10/16 00:00
PHST- 1999/10/16 00:00 [pubmed]
PHST- 1999/10/16 00:01 [medline]
PHST- 1999/10/16 00:00 [entrez]
AID - 10.1001/archsurg.134.10.1119 [doi]
PST - ppublish
SO  - Arch Surg. 1999 Oct;134(10):1119-23. doi: 10.1001/archsurg.134.10.1119.