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Joel Cohen, MD; Theresa C. Gierlowski, MPM; Arthur B. Schneider, MD, PhD

JAMA. 1990;264(5):581-584.

Abstract
To determine the effects of childhood irradiation on the parathyroid glands, a cohort of 4297 patients who received radiation to the tonsils before the age of 16 years has been followed-up prospectively. Among the 2923 patients who were located and provided information, 32 patients developed clinical hyperparathyroidism. The incidence of clinical hyperparathyroidism was 18.7 per 100 000 person-years below the age of 40 years and 171 per 100 000 person-years in the age range of 40 to 60 years. This represents a 2.9-fold (95% confidence interval, 1.6 to 4.3) and 2.5-fold (95% confidence interval, 1.1 to 3.9) increase in the incidence of hyperparathyroidism compared with that among the general population. In addition, 31% of the patients who developed hyperparathyroidism also developed thyroid cancer, which is higher than the 11.2% prevalence of thyroid cancer in the patients who received radiation therapy who did not develop parathyroid tumors. Patients with a history of head and neck irradiation should have their parathyroid glands evaluated on a regular basis.

(JAMA. 1990;264:581-584)

Author Affiliations
From the Division of Endocrinology and Metabolism, Michael Reese Hospital and Medical Center, University of illinois College of Medicine, Chicago.

Footnotes
Reprint requests to the Division of Endocrinology and Metabolism, Michael Reese Hospital and Medical Center, Lake Shore Drive at 31st Street, Chicago, IL 60616 (Dr Schneider).

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