Intraoperative Parathyroid Hormone is a Valuable Indicator of Long Term Cure in Primary Hyperparathyroidism

Florbela Ferreira, Paula Font, Deolinda Madureira, Jorge Rosa Santos, Valeriano Leite

Abstract


Background: The use of intraoperative parathyroid hormone (ioPTH) during surgery for primary hyperparathyroidism (PHPT) has become widely available as a tool to monitor the success of the procedure. The aim of our study was to correlate the decrease of ioPTH with long term outcome in patients with PHPT.

Methods: During a 10 year period, in 137 consecutive patients with PHPT, serum PTH was measured during surgery at baseline and 5, 10 and 20 minutes after excision of the suspected parathyroid gland. Surgery was considered successful if a 50% drop in ioPTH was observed after 10 minutes. Two groups were defined - with normal (I) and above normal (II) PTH after 10 minutes. Calcium and PTH were monitored at 1.5, 3, 6 and 12 months of follow-up.

Results: Group I had significantly lower median weight of glands (1.4 vs 3.0 g), maximum pre-operative calcium (11.1 vs 11.7 mg/dL) and ioPTH at 10 minutes (30.1 vs 124.9 pg/mL) than group II - P < 0.05. Serum PTH levels at 3 and 6 months of follow-up were also significantly lower in group I than group II (55.0 vs 124.5 pg/mL and 55.9 vs 83.1 pg/mL, respectively) - P < 0.05. At 6 months, 74.3% of the patients in group I presented normal calcium and PTH, whereas in group II normal calcium and high PTH was the predominant pattern (59.1%) - P = 0.01.

Conclusions: Obtaining normalization of ioPTH during surgery is important in addition to the classic criterion of 50% decrease from baseline to predict cure of PHPT.




J Endocrinol Metab. 2013;3(4-5):98-104
doi: https://doi.org/10.4021/jem189w


Keywords


Hyperparathyroidism; Cure; Intraoperative; Parathyroid hormone

Full Text: HTML PDF
 

Browse  Journals  

 

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

 

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

 

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

 

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

 

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 
       
 

Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jofem.org   editorial contact: editor@jofem.org    elmer.editorial2@hotmail.com
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.


Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.