title: Hyperparathyroidism associated with thyroid pathology.
abstract: BACKGROUND
  The pathological association between thyroid and parathyroid gland disease is here discussed. The multiphase analyzer has revealed a new type of subclinical primary hyperparathyroidism (HPP) and the role of surgery in these cases is not clear.
  
  
  METHODS
  This is a prospective study of all cases of thyroid disease in association with parathyroid disease treated surgically in our Institute from July 1999 to June 2001.
  
  
  RESULTS
  Of the 221 thyroidectomies carried out, 29 patients had an elevated preoperative serum level of parathyroid hormone (PTH). An ultrasonography examination was performed on all patients and a preoperative scanning with 99Tc-MIBI on 11 of 29 patients. We examined intraoperatively 19 cases of HPP (14 parathyroid adenoma, 5 hyperplasia). In 10 cases we observed a normal size of the parathyroid gland and we did not perform a parathyroidectomy.
  
  
  CONCLUSIONS
  All patients with elevated serum parathyroid hormone and serum calcium levels before thyroidectomy should be considered candidates also for surgery to the parathyroid glands. The pathological association between thyroid and parathyroid gland diseases is not rare. We must conduct an accurate neck exploration in all these cases.
authors.affiliation: Institute of General Surgery and Organ Transplant, University of Parma, Italy. paolofelisso@hotmail.com
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Arcuri
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Iapichino
authors.forename: Robuschi
authors.initials: R
authors.lastname: Giuseppe
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome