PMID- 15606374
OWN - NLM
STAT- MEDLINE
DCOM- 20050214
LR  - 20131121
IS  - 0954-6820 (Print)
IS  - 0954-6820 (Linking)
VI  - 257
IP  - 1
DP  - 2005 Jan
TI  - Parathyroid surgery in familial hyperparathyroid disorders.
PG  - 27-37
AB  - The management of hyperparathyroidism (HPT) in the setting of familial HPT 
      differs between the specific syndromes and is generally complex because of the 
      underlying disease, which predisposes patients to persistent and recurrent HPT. 
      The basic principles of surgery include achieving and maintaining normocalcaemia 
      for the longest time possible, avoiding both iatrogenic hypocalcaemia and 
      operative complications, and facilitating future surgery for recurrent disease. 
      Multiple endocrine neoplasia type 1 (MEN1) is treated with either subtotal 
      parathyroidectomy or total parathyroidectomy with immediate heterotopic 
      autotransplantation of parathyroid tissue. MEN2A, familial isolated HPT and 
      HPT-associated with the hyperparathyroidism-jaw tumour (HPT-JT) syndrome 
      typically can be treated with parathyroidectomy, i.e. subtotal or less. The 
      increased risk of parathyroid cancer in HPT-JT requires special attention. 
      Parathyroid surgery in familial HPT syndromes in the setting of underlying 
      mutations in the calcium receptor (CASR) gene involves radical subtotal 
      parathyroidectomy. Intraoperative parathyroid hormone (PTH) measurements may help 
      guide the extent of parathyroid resection, particularly in the case of multigland 
      HPT. The vast majority of patients with familial HPT who require surgery are best 
      served with bilateral cervical explorations. However, minimally invasive 
      parathyroidectomy (MIP) techniques that have become routine for sporadic HPT at 
      selected institutions may be extrapolated to a subset of cases of familial HPT.
FAU - Carling, T
AU  - Carling T
AD  - Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
FAU - Udelsman, R
AU  - Udelsman R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
RN  - 0 (Parathyroid Hormone)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Calcium/blood
MH  - Humans
MH  - Hyperparathyroidism/blood/*genetics/*surgery
MH  - Multiple Endocrine Neoplasia/blood/*surgery
MH  - Multiple Endocrine Neoplasia Type 1/blood/surgery
MH  - Multiple Endocrine Neoplasia Type 2a/blood/surgery
MH  - Parathyroid Glands/*surgery
MH  - Parathyroid Hormone/blood
MH  - Parathyroidectomy/methods
MH  - Preoperative Care/methods
MH  - Recurrence
MH  - Reoperation
RF  - 59
EDAT- 2004/12/21 09:00
MHDA- 2005/02/16 09:00
CRDT- 2004/12/21 09:00
PHST- 2004/12/21 09:00 [pubmed]
PHST- 2005/02/16 09:00 [medline]
PHST- 2004/12/21 09:00 [entrez]
AID - JIM1428 [pii]
AID - 10.1111/j.1365-2796.2004.01428.x [doi]
PST - ppublish
SO  - J Intern Med. 2005 Jan;257(1):27-37. doi: 10.1111/j.1365-2796.2004.01428.x.