A Prospective Study of Hyperparathyroidism in Individuals Exposed to Radiation in Childhood
- Joel Cohen, MD;
- Theresa C. Gierlowski, MPM;
- Arthur B. Schneider, MD, PhD
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)
Footnotes
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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).
