Hyperparathyroidism in the elderly patient.

Abstract:

:Primary hyperparathyroidism is a common metabolic bone disease and currently presents a significant management dilemma. Most of the patients have few relevant symptoms and surgical parathyroidectomy offers the prospect of cure with freedom from the risk of long-term complications or the need for a follow-up. However, there is a natural reluctance to subject elderly patients to an operation where the balance of advantage is less clear. Advances in parathyroid imaging resulting in a greater use of targeted or focused parathyroidectomy has opened the way for the inclusion of less fit patients into the potentially operable category. However, there is still debate about whether these newer imaging techniques are sufficiently helpful and cost effective to warrant their use in all patients who may need parathyroid surgery. This has stimulated a debate about the indications for parathyroidectomy in the elderly and whether advances in medical therapy, which offset the end organ effects of excess parathyroid hormone, are of sufficient benefit to counteract this trend towards greater surgical intervention. These considerations mean that it is not possible to consider the merits of pharmacological therapy for primary hyperparathyroidism without reviewing the relative merits of minimally invasive and conventional surgery.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Sims R,Ubhi C,Hosking D

doi

10.2165/00002512-200421150-00004

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

1013-24

issue

15

eissn

1170-229X

issn

1179-1969

pii

21154

journal_volume

21

pub_type

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