HYPERPARATHYROIDISM;
THE ROLE OF RADIATION EXPOSURE
Head and
neck irradiation has been associated with primary hyperparathyroidism (PHPT)
with a latency period from exposure to disease expression of about 20 – 40 years.
This association was seen in populations with environmental radiation exposure
such as Hiroshima and the nuclear power plant accident in Chernobyl, as well as
patients who received radiation for benign or malignant conditions (e.g., acne,
thymic irradiation, mantle irradiation [for lymphoma]). The relative risk (RR)
for the development of PHPT from radiation exposure is dose dependent, RR = 5 –
10 at 1 Gy. The probability of PHPT at this degree of exposure is still low,
being less than 1 % at 35 years and close to 5 % at 50 years of follow-up.
Studies have shown that prior radiation exposure does not increase the chance
of parathyroid hyperplasia versus single-gland disease, and a minimally invasive
operative approach is still an option.
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