title: A profile of patients with hyperparathyroidism undergoing lithium therapy for affective psychiatric disorders.
abstract: BACKGROUND
  Our objective was to evaluate whether lithium-induced hyperparathyroidism (LIHPT) is caused by single-gland versus multigland disease.
  
  
  METHODS
  Medical records of 7 patients who underwent parathyroidectomy for LIHPT were reviewed.
  
  
  RESULTS
  The mean preoperative calcium was 11.1 ± 0.7 mg/dL. Six of 7 patients were rendered eucalcemic with surgery. Of the 6 patients successfully treated with surgery, 4 had single-gland disease, 1 had double adenomas, and 1 had 4-gland hyperplasia. Intraoperative intact serum parathyroid hormone (iPTH) accurately predicted resolution of hyperparathyroidism in 6 of 7 patients. One patient then subsequently developed persistent hyperparathyroidism refractory to further surgery. Localization studies defined the extent of disease in 5 of 7 patients.
  
  
  CONCLUSIONS
  LIHPT presents with a spectrum of disease ranging from single-gland to multigland disease. The utility of preoperative localization studies and intraoperative iPTH in this population is uncertain. Bilateral exploration may be best to achieve a resolution of LIHPT.
authors.affiliation: Endocrine Surgery Section, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.forename: Alan P
authors.initials: AP
authors.lastname: Dackiw
authors.forename: Haytham
authors.initials: H
authors.lastname: Alabbas
authors.forename: Obai
authors.initials: O
authors.lastname: Abdullah
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Tufaro
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006965:Hyperplasia; D008094:Lithium / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy; D010280:Parathyroid Glands / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D014150:Antipsychotic Agents; D008094:Lithium; D002118:Calcium