Transient Rise in Intact Parathyroid Hormone Concentration after Surgery for Parathyroid Adenoma

Ferrer-Ramirez, M. J.; Domingo, M. Arroyo; Solá, E. Izquierdo; Garzón, S. Pastor; Morillas, C. Ariño; Hernández, A. Mijares

doi:10.1016/s0194-59980300088-3

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Some authors followed patients for 1 to 2 years and noted that calcium and PTH were often elevated immediately after surgery with PTH remaining elevated for weeks to months afterward, depending on the preoperative clinical levels 55–59 . When patients had very high levels of PTH/Ca before surgery and had significant objective sequelae of pHPT such as ostepenia/osteoporosis and BUN/Cr changes, they took a significant longer time to normalize their PTH postoperatively than patients with mild or even asymptomatic pHPT 60 .…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003

Ruda

Hollenbeak

Stack

2005

Otolaryngol.--head neck surg.

697

424

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Section: Discussionmentioning

confidence: 99%

A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003

Ruda

Hollenbeak

Stack

2005

Otolaryngol.--head neck surg.

697

424

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“…Longterm hypercalcemic suppression of non-adenomatous parathyroid tissue causes the remaining parathyroid tissue to be unable to respond when calcium levels must be abruptly controlled postoperatively [4]. During this time, a decline in serum calcium can be observed [5].…”

Section: Introductionmentioning

confidence: 99%

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

TOPÇU

Tutan²,

Kartal³

et al. 2023

J CLIN MED KAZ

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Aim: In primary hyperparathyroidism patients, avoiding hypoparathyroidism and hypocalcemia after surgery is essential. We aimed to evaluate if the delta parathormone percent value (ΔPTH%) can identify patients with an increased risk of developing hypocalcemia after parathyroid surgery for primary hyperparathyroidism. Material and methods: Eighty patients with parathyroid adenomas who underwent single parathyroidectomy were analyzed, and demographical data, preoperative, and postoperative laboratory data were collected were included in the study. Postoperative hypocalcemia was defined as a corrected calcium value below 8.5 mg/dL calculated from the blood values taken on the first postoperative day. The ΔPTH value was calculated by finding the difference between the preoperative PTH value and the postoperative PTH value, and the percentage of ΔPTH was calculated by dividing the ΔPTH value by the preoperative PTH (ΔPTH = Preoperative PTH – Postoperative PTH, and ΔPTH% = ΔPTH / Preoperative PTH). Results: Postoperative hypocalcemia developed in 7.5% of the patients. Hypocalcemic patients had higher ΔPTH and ΔPTH% values. The selection of 130.95 ng/L as ΔPTH level cutoff level divided patients with and without postoperative hypocalcemia with 83.3% sensitivity and 62.2% specificity. As for ΔPTH%, a cut-off value of 71.4% had 100.0% sensitivity, 56.8% specificity, and a 16-fold increase in odds of postoperative hypocalcemia. Conclusion: ΔPTH and ΔPTH% values are helpful predictors of postoperative hypocalcemia after parathyroidectomy and can be used as a guiding tool.

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Predictive Factors for Postoperative Severe Hypocalcaemia after Parathyroidectomy for Primary Hyperparathyroidism

Crea

Pata

Casella

et al. 2012

The American Surgeon™

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Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia ( P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.

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Transient Rise in Intact Parathyroid Hormone Concentration after Surgery for Parathyroid Adenoma

Cited by 3 publications

References 14 publications

A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003

A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

Predictive Factors for Postoperative Severe Hypocalcaemia after Parathyroidectomy for Primary Hyperparathyroidism

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