Highlights
- •2.5% of patients undergoing parathyroidectomy had radioactive iodine exposure.
- •The average latency to development of RAI-induced hyperparathyroidism is 24 years.
- •As age at the time of RAI treatment increases, the latency period decreases.
- •Follow-up serum calcium level every 3–5 years following RAI treatment is recommended.
Abstract
Background
Radioactive iodine (RAI) treatment is considered a rare cause of primary hyperparathyroidism
(pHPT).
Method
A multi-institutional retrospective review of patients with pHPT who underwent parathyroidectomy
from 1990 to 2020 was completed to evaluate the prevalence and latency time for development
of RAI-associated pHPT and determine clinical differences in pHPT patients with or
without prior RAI treatment.
Results
1929 patients with sporadic pHPT underwent parathyroidectomy; 48 (2.5%) had prior
RAI treatment and 1881 (97.5%) did not. RAI treatment was for thyrotoxicosis in 43
(90%) patients. Average latency was 24 years (3–59 years) and inversely correlated
with age. Patients with prior RAI treatment had lower preoperative calcium and PTH
levels (p < 0.0001). No significant differences were observed in age, symptoms, pathology,
ectopic glands and cure rate.
Conclusion
RAI is a potential causative factor for pHPT, accounting for 2.5% of sporadic pHPT.
RAI-associated pHPT may be a less severe form of sporadic pHPT and latency inversely
correlates with age.
Keywords
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Article info
Publication history
Published online: July 31, 2022
Accepted:
July 24,
2022
Received in revised form:
July 12,
2022
Received:
June 2,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
