Background. To assess the impact of surgery on preoperative symptoms in secondary (2 degrees) and tertiary (3 degrees) hyperparathyroidism (HPT) compared with primary (1 degrees) HPI: Methods. Twenty-two patients with 2 degrees HPT and 10 with 3 degrees HPT were enrolled. Age-matched patients, 32 with 1 degrees HPT and 32 with thyroid disease were enrolled for comparison. Art outcome questionnaire documented symptoms expressed as the median symptom index score (MSIS) preoperatively and at days 7 and 3 and 12 months postoperatively. Results. Preoperatively, the MSIS for the groups with 3 degrees 2 degrees and 1 degrees HPT and thyroid disease was 225, 572, 372, and 146 indicating that patients with HPT were more symptomatic than those in the thyroid group (P <.05). Patients with 1 degrees HPT had a decrease in their MSIS at day 7 (195, P <.05) and at 3 and 12 months (159 and 156). Patients with 3 degrees HPT also had a decrease in their MSIS over time. Patients with 2 degrees HPT had a decrease in their MSIS at day 7 (469, P<.05); however, they remained more symptomatic at 3 and 12 months (410 and 355). Conclusions, Parathyroidectomy reduces many of the preoperative symptoms in HPT. Patients with 1 degrees and 3 degrees HPT have a similar resolution of their symptoms. Patients with 2 degrees HPT have an improvement in many of their symptoms, although they remain more symptomatic at 1 year.
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