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Persistent symptomatic improvement in the majority of patients undergoing parathyroidectomy for primary hyperparathyroidism



Parathyroidectomy for primary hyperparathyroidism (PHPT) is followed by a decrease in the severity of symptoms reported on the Pasieka’s parathyroid symptoms score (PPSS) and SF-36 questionnaires. Some argue that such benefits are short-lived. This study investigates the severity of symptoms at more than 12 months after parathyroidectomy.


A prospective database collected clinical/operative data on consecutive patients with PHPT. PPSS was calculated as the sum of the 13 parameters self-assessed using a visual analog scale. SF-36(v2) was analyzed using commercially available software (QualityMetric Inc., Lincoln, USA).


Over 3-year interval, 166 patients (119 F/47 M, age 15–89 years) were operated for with PHPT (Ca 2.90 ± 0.25 mmol/L, PTH 21.64 ± 23.05 pmol/L). Their preoperative PPSS ranged 0–1,260 (median 413) and did not correlate with the severity of hypercalcemia. One hundred and seven patients responded when contacted by post at 18 ± 6 months postoperatively. Their postoperative PPSS was significantly lower (398 ± 226 to 231 ± 203, p < 0.001) and in 55 of 107 patients the severity of symptoms reduced by at least 50%. Most significant improvements were for mood (36 ± 33 vs. 16 ± 23), weakness/tiredness (37 ± 32 vs. 17 ± 23), irritability (35 ± 31 vs. 17 ± 21), and thirst (37 ± 32 vs. 18 ± 25; p < 0.0001). Physical and mental component scores of SF-36 questionnaire improved in patients whose PPSS decreased postoperatively.


Symptomatic benefits persist for at least 1 year after parathyroidectomy in the majority of patients with PHPT.

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Correspondence to Radu Mihai.

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Gopinath, P., Sadler, G.P. & Mihai, R. Persistent symptomatic improvement in the majority of patients undergoing parathyroidectomy for primary hyperparathyroidism. Langenbecks Arch Surg 395, 941–946 (2010).

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  • Primary hyperparathyroidism
  • Parathyroidectomy
  • Symptoms score
  • SF-36