It appears unnecessary to perform surgery on patients who have the mild variant of the disease PHPT, where the level of calcium in the blood is only slightly higher than usual.
The disease PHPT primarily affects women after menopause. Most people with mild PHPT had good health over a ten-year period, regardless of whether or not the overactive gland had been removed. Illustration image: Colourbox.com
Primary hyperparathyroidism (PHPT) is a disease that causes an increase in the level of calcium in the blood. Calcium is an important mineral in the body, of which there should be neither too much nor too little. Persons who have mild PHPT only have a minor elevation of calcium levels and usually do not have any symptoms.
Four small glands in the neck, called parathyroid, regulate the level of calcium in the blood. In people who have PHPT, one of more of these glands are overactive.
The parathyroid glands secrete the parathyroid hormone PTH. This hormone ensures that calcium is moved from the skeleton to the bloodstream. An overactive gland secretes too much of the hormone, which leads to higher calcium levels.
Common treatment of PHPT has been to remove overactive glands through surgery. The aim has been to reduce the risk of early death and of potentially getting other diseases because of the elevated calcium levels.
However, researchers in Norway, Sweden and Denmark have found that it is not necessary to perform surgery on patients who have the mild variant of the disease, where the calcium level is only slightly higher than usual.
- Our study suggests that it is safe not to remove the overactive glands in patients with mild PHPT, at least over a ten-year perspective, Mikkel Pretorius says.
He is a PhD candidate at the Institute of Clinical Medicine at UiO and senior physician at the Department of Endocrinology, Morbid Obesity and Preventive Medicine at Oslo University Hospital.
Good outcomes for patients who had surgery and patients who did not have surgery
In the study, Pretorius and colleagues found out that the vast majority of people with mild PHPT had good health over a ten-year period, regardless of whether or not the overactive gland had been removed.
A few patients with mild PHPT developed other diseases and complications, and a few died during the 10 years duration of the study. This seems, however, unrelated to whether or not the patients underwent surgery. There were no differences on these measures between the two groups.
- Our study shows that the health of patients who did not have surgery was just as good as the health of patients who did have surgery, Jens Bollerslev says.
He is Adjunct Professor at the Institute of Clinical Medicine, UiO and a senior physician at Oslo University Hospital. Professor Bollerslev led the study.
