Persistent elevated serum levels of intact parathyroid hormone after operation for sporadic parathyroid adenoma: Evidence of detrimental effects of severe parathyroid disease

Significance of Rebounding Parathyroid Hormone Levels During Parathyroidectomy

“…The incidence of this phenomenon ranges from 12 to 43% of cases (19), and these patients tend to be older, deficient in Vitamin D, and have biochemical markers of more severe hyperparathyroidism (20)(21)(22)(23)(24). Similar to this study, our group has previously shown that recurrence is higher in the subset of patients who display elevations in PTH postoperatively (24).…”

Persistent Parathyroid Hormone Elevation Following Curative Parathyroidectomy for Primary Hyperparathyroidism

“…These findings confirm the results of other series where persistent elevation of postoperative PTH levels occurred in 11% to 40% of patients ( Table 3). [1][2][3][4][5][6][7] The pathogenesis of this phenomenon remains unclear. Possible explanations include persistent or impending recurrent hyperparathyroidism, impaired renal function, and bone remineralization.…”

“…Other authors have suggested that it is more likely to occur in elderly patients with more severe or advanced hyperparathyroidism. [4][5][6] For this reason, we performed a multivariate analysis looking at age, sex, race, symptomatology, biochemical markers, and gland weight to identify variables that might be predictive of persistent postoperative PTH level elevation. In performing this analysis, we found that 85% of our patients had symptoms that could be attributed to hyperparathyroidism, including 47% with musculoskeletal symptoms.…”

Primärer Hyperparathyreoidismus

“…Für die Wahrscheinlichkeit des Auftre tens einer postoperativen Hyperparathy rinämie wurden mitunter der Schwere grad des primären HPT [1,12,20,27,30] und auch die Größe der Nebenschilddrü se verantwortlich gemacht. Ebenfalls soll das Alter der Patienten eine Rolle spielen [10,12].…”