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Head & neck · 2009

Elevated parathyroid hormone levels after parathyroidectomy for primary hyperparathyroidism.

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Mizrachi Aviram, Gilat Hanna, Bachar Gideon, Feinmesser Raphael, Shpitzer Thomas

Аннотация

BACKGROUND: Curative parathyroidectomy is associated with elevated levels of parathyroid hormone (PTH) with eucalcemia. This study sought to determine the frequency, clinical significance, and risk factors of this finding.

METHODS: Seventy-six consecutive patients surgically treated for primary hyperparathyroidism due to a single parathyroid adenoma in 2006 to 2007 were monitored for 1 month postoperatively; those with elevated PTH levels (>70 pg/mL) were monitored for 18 months.

RESULTS: Nineteen patients (25%) had high postoperative PTH levels with normal calcium levels. Compared with the remaining patients, this group had a significantly higher average preoperative PTH level (224.89 vs 156.86 pg/mL) and a lesser intraoperative decrease in PTH.

CONCLUSIONS: About 25% of eucalcemic patients may have elevated PTH levels after parathyroidectomy. A high preoperative PTH level (>225 pg/mL) may predict a persistently high postoperative level. Evaluation of blood and urine calcium, bone density, and cardiac function should be considered in affected patients.

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