Quality of life in patients with primary hyperparathyroidism

Abstract

The clinical picture of primary hyperparathyroidism (PHPT) has changed over the last three decades and many asymptomatic patients are now diagnosed through the unexpected finding of high serum calcium levels. However, though not yet considered as typical features of the disease and therefore not included in the guidelines for surgery, many data are available on neuropsycological manifestations and their impact on quality of life in asymptomatic patients. PHPT patients indeed show early experience nonspecific symptoms, such as weakness, depression, sleep disturbance, memory loss and anxiety. Although the underlining mechanisms have not been still identified, the prevalence of psychiatric and cognitive deficits has been investigated in many studies, as well as the possible association with quality of life and well-being improvement after surgery. This article aims to review the current knowledge on quality of life in PHPT patients before and after surgery and the possible clinical implications of these findings.

Keywords::

• asymptomatic
• cognition
• parathyroidectomy
• primary hyperparathyroidism
• psychological
• quality of life

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The overall recent available evidence further characterize the nature of the neuropsychiatric, even subclinical, symptoms associated with PHPT and their effect on quality of life.

• Additionally, some data support the hypothesis of a beneficial effect of parathyroidectomy on quality of life and psychological functioning, even if different domains of both cognition and metal status showed an improvement in the different reports.

• Primary hyperparathyroidism therefore appears to be an endocrine disorder with multiorgan complications, whose definition and management are definitely warranted.