{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:07:46Z","timestamp":1791295666639,"version":"4.1.0"},"reference-count":0,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2003,4,1]],"date-time":"2003-04-01T00:00:00Z","timestamp":1049155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2003,4]]},"abstract":"<jats:p>Abstract<\/jats:p><jats:p>Chronic lithium therapy in patients with affective psychiatric disorders has been implicated as the cause of hypercalcemia and primary hyperparathyroidism. Our objective was to evaluate whether primary hyperparathyroidism was caused by an adenoma or four\u2010gland hyperplasia. The medical records of 15 patients with affective psychiatric disorders who were treated with chronic lithium therapy from 1982 to 1997, all of whom were operated on for primary hyperparathyroidism, were reviewed. Data on age, symptoms, duration of lithium therapy, pre\u2010 and postoperative calcium levels, and parathyroid hormone levels were collected. Parathyroid histology for each patient was independently and blindly reviewed. The mean age was 58 \u00b1 10 years, the mean duration of lithium therapy 10.7 \u00b1 6 years, and the mean preoperative calcium level 11.7 \u00b1 0.5\u00a0mg\/dl. All patients underwent bilateral neck exploration with selective resection of enlarged glands. Of the 15 patients, 14 (92%) had adenomas (11 single, 3 double), and 1 (8%) had four\u2010gland hyperplasia. All patients were rendered eucalcemic, with a postoperative calcium level of 9.2 \u00b1 0.5\u00a0mg\/dl (<jats:italic>p<\/jats:italic> &lt; 0.005). All patients resumed their lithium therapy, with 1 of 15 patients developing recurrent hyperparathyroidism 2 years following the first operation; this patient required reexploration, at which time an adenoma was resected. In our experience hyperparathyroidism in patients who have undergone prolonged therapy with lithium is associated with a high incidence of parathyroid adenomas versus four\u2010gland hyperplasia. This suggests that lithium selectively stimulates growth of parathyroid adenomas in susceptible patients, who are best treated with adenoma excision rather than subtotal parathyroidectomy.<\/jats:p>","DOI":"10.1007\/s00268-002-6824-4","type":"journal-article","created":{"date-parts":[[2003,3,25]],"date-time":"2003-03-25T19:02:58Z","timestamp":1048618978000},"page":"486-488","source":"Crossref","is-referenced-by-count":83,"title":["Parathyroid Adenomas versus Four\u2010gland Hyperplasia as the Cause of Primary Hyperparathyroidism in Patients with Prolonged Lithium Therapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Samir S.","family":"Awad","sequence":"first","affiliation":[{"name":"Michael E. DeBakey Department of Surgery Baylor College of Medicine Houston Veterans Administration Medical Center, Surgical Service (112) 2002 Holcombe Boulevard 77030 Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judiann","family":"Miskulin","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Michigan Hospitals, Taubman 2920 1500 E. Medical Center Drive 48109 Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Michigan Hospitals, Taubman 2920 1500 E. Medical Center Drive 48109 Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,4]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-002-6824-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-002-6824-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-002-6824-4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:18:07Z","timestamp":1704989887000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-002-6824-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,4]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2003,4]]}},"alternative-id":["10.1007\/s00268-002-6824-4"],"URL":"https:\/\/doi.org\/10.1007\/s00268-002-6824-4","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,4]]}}}