Timing of symptom improvement after parathyroidectomy for primary hyperparathyroidism.
BACKGROUND
The timing of symptom improvement after parathyroidectomy for primary hyperparathyroidism (PHPT) has not been well characterized.


METHODS
This prospective study involved administering a questionnaire to patients with PHPT who underwent curative parathyroidectomy over an 11-month period. The questionnaire evaluated the frequency of 18 symptoms of PHPT on a 5-point Likert scale and was administered preoperatively and 1 week, 6 weeks, and 6 months postoperatively.


RESULTS
Of 197 eligible patients, 132 (67%) participated in the study. The questionnaires were completed at a rate of 91%, 92%, and 86% at 1 week, 6 weeks, and 6 months postoperatively, respectively. The most commonly reported preoperative symptoms were fatigue (98%), muscle aches (89%), and bone/joint pain (87%). Improvement in symptom severity occurred across all symptoms and was separated into three categories based on the timing of improvement. Fatigue and bone/joint pain demonstrated "Immediate Improvement" (>50% of patients reporting improvement by post-operative week 1), whereas the majority of symptoms showed peak improvement at 6 weeks ("Delayed Improvement"). Symptoms categorized as "Continuous Improvement" were those showing progressive improvement up to 6 months postoperatively (polydipsia, headaches, and nausea/vomiting).


CONCLUSIONS
Symptom improvement was most prominent 6 weeks postparathyroidectomy, although some symptoms showed continued improvement at 6 months.
Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI.
Sara E
SE
Murray
Priya R
PR
Pathak
David S
DS
Pontes
David F
DF
Schneider
Sarah C
SC
Schaefer
Herbert
H
Chen
Rebecca S
RS
Sippel
D000236:Adenoma / Q000503:physiopathology / Q000601:surgery; D015331:Cohort Studies; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D016105:Parathyroidectomy; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome