Hyperparathyroidism in persons treated with x-rays for tuberculous cervical adenitis

Abstract

Follow-up examinations of one hundred persons treated with x-rays for tuberculous adenitis between 1930 and 1946 have been carried out to determine if there is an increased incidence of hyperparathyroidism (HPT) after radiation exposure. Neck explorations were done in patients with hypercalcemia and signs and symptoms compatible with HPT. Individuals with thyroid masses were also operated upon when examination of fine needle specimens gave suspicions of malignancy. Eleven subjects were found to have developed parathyroid adenoma or hyperplasia. Four other individuals have hypercalcaemia but are asymptomatic. The mean absorbed dose in the parthyroid glands varied between 75 and 2,200 rads. Six individuals received more than 1,200 rads; four of them later developed HPT, while no HPT occurred below a dose of 300 rads. The high incidence of HPT among patients who had been heavily exposed to radiation suggests a cause and effect relationship between radiation treatment and development of HPT.

Association between primary hyperparathyroidism and previous irradiation

“…The radiation dose of our patients also appears similar to that of other investigators' patients [ 11,131, a]-though Tisell et a1 [12] suggested that primary hyperparathyroidism was more frequent among patients who had been heavily exposed to radiation. The radiation dose of our patients also appears similar to that of other investigators' patients [ 11,131, a]-though Tisell et a1 [12] suggested that primary hyperparathyroidism was more frequent among patients who had been heavily exposed to radiation.…”

Multiple endocrine neoplasia type 1 polymorphism D418D is associated with sporadic primary hyperparathyroidism

“…21,22 Recently, polymorphisms in the VDR gene were shown to predispose to pHPT, so far representing the only known genetic risk factor for the disease. 20 Parathyroid adenomas are mainly monoclonal tumors, 23 which arise from a single precursor cell with an acquired growth advantage compared with the surrounding tissue.…”

Increased Risk of Malignant Diseases After Surgery for Primary Hyperparathyroidism

“…A history of radiation therapy of the neck was noted in the hospital records of six patients. Such therapy is a well known risk factor for both thyroid cancer (34)(35)(36)(37) and hyperparathyroidism (38)(39)(40)(41)(42)(43). Since in all cases, several years elapsed between radiation therapy and manifestations of the neck tumor, it is possible that more patients with a combination of parathyroid adenoma and thyroid carcinoma may have had such therapy over the neck as children.…”