25-hydroxy vitamin D deficiency causes parathyroid incidentalomas

Langenbecks Arch Surg (2010) 395:919–924 DOI 10.1007/s00423-010-0692-4

ENDOCRINE SURGERY

25-hydroxy vitamin D deficiency causes parathyroid incidentalomas James Kirkby-Bott & Ziad El-Khatib & Benoit Soudan & Robert Caiazzo & Laurent Arnalsteen & Bruno Carnaille

Received: 20 June 2010 / Accepted: 5 July 2010 / Published online: 19 August 2010 # Springer-Verlag 2010

Abstract Purpose 25-OH D3 (D3) deficiency causes secondary hyperparathyroidism. Asymmetric gland hypertrophy may also lead to unnecessary parathyroid gland resection by mistaking these glands for parathyroid incidentalomas. We tested the hypothesis that D3 deficiency causes parathyroid gland hypertrophy. Method This is a prospective study of 100 consecutive patients undergoing total thyroidectomy. Pre-operative D3 measurement was made at first presentation and on the day after surgery. During thyroidectomy, the parathyroid glands were searched for and measured. Using an ellipsoid volume calculator, the gland volume was calculated. This was correlated with D3 and other possible confounding factors. Results Normal parathyroid volume is 25.1 mm3. Parathyroid gland size correlated with D3 levels, p30 ng/ml and those 30 mg/dl and 30 ng/ml the normal parathyroid gland volume is 25.1 mm3 (interquartile range (IQR)=25.1–33.5 mm3). Whilst in subjects with a vitamin D3