title: Study of intact (1-84) parathyroid hormone secretion in patients undergoing parathyroidectomy.
abstract: Patterns of intact (1-84) parathyroid hormone (intact PTH) elimination and subsequent recovery of parathyroid function were studied in 12 patients undergoing parathyroidectomy. Nine patients had primary hyperparathyroidism (HPT), with single gland disease in 6 and multiple gland disease in 3. Two patients had subtotal parathyroidectomy for HPT secondary to chronic renal failure and 1 underwent excision of a hyperfunctioning parathyroid autograft. Using a sensitive 2-site immunochemiluminometric assay, serum intact PTH levels were measured preoperatively, intraoperatively, and postoperatively. A dual phase pattern of hormone clearance was found in 10 of the 12 patients, including the patient undergoing autograft excision. A monoexponential clearance pattern was seen in the remaining 2 patients, both of whom had subtotal parathyroidectomies for multiple gland disease. In the patients with primary HPT due to single gland disease, the early phase of intact PTH clearance had a half-life (T1/2) of 3.3 (+/- standard deviation 0.9) minutes and a late T1/2 of 96.4 (+/- standard deviation 92.7) minutes. Calculation of decay curves and half-lives for the patients undergoing subtotal parathyroidectomy was more difficult because of the inherent uncertainty in determining time zero. Nevertheless, in all but 2 patients, the clearance pattern was biexponential and the T1/2 measurements were very similar to those encountered in patients with single-gland disease. In the 2 patients with monoexponential clearance, the T1/2 figures were 86.7 minutes and 26.7 minutes, respectively. In the patients undergoing parathyroidectomy for primary HPT, levels of intact PTH were lowest at 1-3 hours after surgery, recovering to normal in the majority of patients by 18-40 hours.
authors.affiliation: Department of Biochemistry, Royal Perth Hospital, Western Australia.
authors.forename: C
authors.initials: C
authors.lastname: Davies
authors.forename: M J
authors.initials: MJ
authors.lastname: Demeure
authors.forename: A
authors.initials: A
authors.lastname: St John
authors.forename: A J
authors.initials: AJ
authors.lastname: Edis
mesh_terms: D006207:Half-Life; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D007120:Immunochemistry; D010279:Parathyroid Diseases / Q000601:surgery*; D010280:Parathyroid Glands / Q000502:physiology / Q000601:surgery*; D010281:Parathyroid Hormone / Q000378:metabolism*
chemical_list: D010281:Parathyroid Hormone