Evidence map›Paper›PMID 42606582›Full record

SynthesisLangenbeck's archives of surgery2026

Lithium-associated hyperparathyroidism: a systematic review of prevalence and surgical outcomes.

Reza Alidousti Shahraki, Adrian D Meehan, Göran Wallin, Kosmas Daskalakis

Abstract readSystematic Review
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Reza Alidousti ShahrakiFaculty of Medicine and Health, Department of Surgery, Örebro University, Örebro, Sweden.
Adrian D MeehanFaculty of Medicine and Health, Department of Orthopaedic Surgery, Örebro University, Örebro, Sweden.
Göran WallinFaculty of Medicine and Health, Department of Surgery, Örebro University, Örebro, Sweden.
Kosmas DaskalakisFaculty of Medicine and Health, Department of Surgery, Örebro University, Örebro, Sweden. kosmas.daskalakis@oru.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLithium remains one of the most effective maintenance treatments for bipolar disorder. However, disturbances in calcium homeostasis including hypercalcemia and lithium-associated hyperparathyroidism (LHPT) have increasingly been recognized as endocrine complications of chronic lithium therapy. The prevalence, pathophysiology, and optimal surgical management of LHPT remain incompletely defined. This systematic review aims to synthesize the available evidence on prevalence, pathophysiology, and surgical outcomes in LHPT.

methodsWe conducted a systematic review according to PRISMA guidelines. Five databases (MEDLINE, Embase, Cochrane Library, Web of Science, and PsycINFO) were searched. Studies reporting hypercalcemia or hyperparathyroidism in adult patients receiving lithium therapy were eligible for inclusion. Surgical case series reporting parathyroidectomy in LHPT were analyzed separately.

resultsA total of 5,483 records were identified, of which 125 studies met the inclusion criteria. Hypercalcemia occurred in 7.2% (423/5,853) and HPT was confirmed in 4.8% (156/3,239) of lithium-treated patients. Multiglandular disease was identified in 25-83% of surgical cases, substantially higher than the 15-20% observed in sporadic HPT. Bilateral neck exploration was performed in the majority of surgical series. Postoperative cure rates ranged from 58% to 100%, with recurrence rates of approximately 16% at 10 years.

conclusionLHPT represents a clinically significant endocrine complication characterized by heterogeneous pathological patterns. The elevated prevalence of multiglandular disease has important implications for surgical planning. Given the high proportion of multiglandular involvement, surgeons should maintain a low threshold for bilateral neck exploration, particularly in patients with prolonged lithium exposure or intraoperative findings suggestive of multiple gland involvement.

Indexed as

Bipolar DisorderHyperparathyroidismLithium CompoundsParathyroidectomyHumansHypercalcemiaPrevalenceTreatment OutcomeLithium CompoundsBipolar disorderCalcium homeostasisHypercalcemiaHyperparathyroidismLithiumMultiglandular diseaseParathyroidectomy

Identifiers

PMID42606582
PMCPMC13481389

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.