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[Intraoperative intact parathyroid hormone determination as a predictive factor of hyperparathyroidism resolution].

Abstract：

INTRODUCTION:The objectives of this study were: a) to evaluate the effectiveness of intraoperative intact parathyroid hormone (PTHi) determination as a marker of hyperparathyroidism resolution; b) to establish the minimum number of blood samples required; and c) to determine whether cervical manipulation increases baseline PTHi levels. PATIENTS AND METHOD:We performed a prospective study in 45 patients. Three intraoperative blood PTHi determinations were performed: at baseline and at 10 and 25 minutes after excising the lesion. To analyze the effects of cervical manipulation, in 19 patients, 2 further determinations were made after 2 minutes of massage on both sides of the neck. A decrease of > 50% in PTHi values between postexeresis samples and the baseline sample (gradient > 50%) was used as diagnostic and therapeutic criteria and normalization of calcemia was used as a criteria for complete resolution. RESULTS:Whenever the lesion causing hyperparathyroidism was extirpated, PTHi levels decreased at 10 and 25 minutes after exeresis. This decrease was predictive of complete resolution when the gradient was > 50. Cervical manipulation (massage) did not increase PTHi values. In patients with complete resolution, blood calcium levels also returned to normal. CONCLUSIONS:1. Intraoperative PTHi determination with a gradient > 50 is an excellent prognostic marker of resolution. 2. Only 2 PTHi samples are required: one at baseline and another at 10 minutes after exeresis. 3. Preoperative cervical manipulation does not increase PTHi values.

journal_name

Cir Esp

journal_title

Cirugia espanola

authors

Gómez-Palacios A,Taibo MA,Gutiérrez MT,Gómez P,Gómez-Zabala J,Barrios B,Escobar A,Iturburu I

doi

10.1016/s0009-739x(06)70830-2

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

114-9

issue

2

eissn

0009-739X

issn

1578-147X

pii

13084665

journal_volume

79

pub_type

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