Lithium-associated
hyperparathyroidism
Prevalence, Pathophysiology, Management
ADRIAN MEEHAN
Medical Science with a specialisation in Surgery
Örebro Studies in Medicine 174 I
ÖREBRO 2018 2018AD
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adrian d. meehan (1973) graduated with an M.A. (Hons) from Edinburgh University in 1995 before doing a one-year post-graduate certificate in education at Glasgow University. After a number of years teaching, both in Scotland and Sweden, he completed his medical degree in 2010 from Gothenburg University, Sweden. He completed his residency in Geriatric Medicine at the University Hospital in Örebro between 2012-2017. He is currently working as a Geriatrician at Örebro University Hospital. He registered as a doctoral student at Örebro University in 2012 under the supervision of Dr. Göran Wallin, Professor in Surgery, also at Örebro University Hospital, and the co-supervision of emeritus Professor of Surgery Johannes Järhult, Ryhov Hospital, Jönköping.
Lithium is a so-called mood stabiliser and has been used in the treatment of bipolar disorders, earlier termed manic depression, for almost seven decades. Lithium is still regarded as the gold standard in therapeutic alternatives. There are, however, several well-known side-effects, including potentially effecting the thyroid gland and kidneys. Less well-known or understood is its effect on the parathyroid glands. Lithium-associated hyperparathyroidism (LHPT) is an ill-defined and somewhat indistinct endocrinopathy. Despite an ever increasing, though currently relatively limited, body of descriptive literature, there remains a good deal of controversy as to its prevalence and pathohis-tological background, thereby leading to clear difficulties in establishing recommendations for adequate management of the condition. The studies in this thesis confirm that LHPT is very common, that it has biochemical and pathophysiological characteristics which differ from primary hyperparathy-roidism (the common form of pathological over-stimulation of the parathyroid glands in non-lithium users), and that current surgical management of LHPT may not be adequate. Details are also provided of an on-going randomised study aimed at evaluating the surgical management of LHPT.
issn 1652-4063 isbn 978-91-7529-234-2
