What long-term monitoring is needed following treatment for primary hyperparathyroidism, and what is the treatment outcome?

Updated: Oct 02, 2018
  • Author: Lawrence Kim, MD, FACS, FACE; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Patients are seen 1-2 weeks postoperatively, and serum calcium, 25-hydroxyvitamin D levels, and parathyroid hormone levels are obtained. Parathyroid hormone levels may be elevated postoperatively in some patients, but if the serum calcium remains within the reference range, it does not indicate persistent disease in most patients. Many of these patients have vitamin D deficiency, and replacement may correct the elevated parathyroid hormone concentration. [30] Vitamin D deficiency is particularly common in patients with hyperparathyroidism. Many practitioners routinely add calcium and vitamin D supplementation postoperatively to help restore bone loss and supplement poor dietary intake.

After the immediate postoperative period, follow-up is limited to periodic determinations of serum calcium levels to detect the persistence or recurrence of disease or hypoparathyroidism.

In the previously mentioned study by Ejlsmark-Svensson et al, the investigators found that at 12-months postparathyroidectomy, quality of life scores had significantly improved in primary hyperparathyroidism patients who had suffered from either mild or moderate-severe hypercalcemia. [4]


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