Impact of 25-Hydroxyvitamin D Deficiency on Perioperative Parathyroid Hormone Kinetics and Results in Patients with Primary Hyperparathyroidism

The Impact of Vitamin D Status on Preoperative Ultrasound Findings and Parathyroidectomy Outcomes in Patients With Primary Hyperparathyroidism

“…As vitamin D deficiency is a stimulus for parathyroid hyperplasia and parathyroid tumour weight is the most reliable indicator of parathyroid cell mass, our patients who were vitamin D deficient or insufficient had the largest mean gland weight both in SGD and MGD and vitamin D sufficient patients had the smallest size glands. These findings echo with results from previous work by other authors [9,13,19]. We also noticed an inverse association between serum 25(OH)D3 levels and gland weight after resection especially in SGD which would be relevant in the management of PHPT as this would strongly add to the growing body of evidence whether vitamin D deficiency or insufficiency should be corrected routinely to reduce adenoma weight and disease severity before undertaking parathyroidectomy.…”

Letter to the Editor: 25-Hydroxyvitamin D Status does not Affect Intraoperative Parathyroid Hormone Dynamics in Patients with Primary Hyperparathyroidism

“…The impact of vitamin D deficiency on the kinetics of parathormone (PTH) secretion and utility of intraoperative PTH (ioPTH) in predicting complete tumor-excision is always been a concern, especially in vitamin-D-deficient areas. 2 We agree with authors, that concurrent vitamin D deficiency and primary hyperparathyroidism leads to increased gland weight; however, being from a vitamin-D-deficient endemic area, we observed relatively more severe bone complaints, with significant proportion presenting with brown tumors or fragility fractures, the serum alkalinephosphatase (ALP) and PTH levels significantly higher, and predominantly female involvement in deficient than sufficient group.…”

Current evidence for recommendation of surgery, medical treatment and vitamin D repletion in mild primary hyperparathyroidism

“…They suggested empirical postoperative calcium supplementation to patients with a low preoperative 25OHD. A later study confirmed that patients with a preoperative VitD deficiency (25OHD !62.5 pmol/l) had higher postoperative PTH levels (70).…”