[Diagnosis and localization of primary hyperparathyroidism].
The diagnostic value of pre-operative laboratory tests and current imaging methods was evaluated in a series of 65 patients operated upon for primary hyperparathyroidism. Among laboratory tests, nephrogenous cyclic AMP and PTH serum levels had sensitivities of 100% and 71.7% respectively. Total urinary cyclic AMP and bone biopsy were much less reliable. Imaging procedures were mainly real-time ultrasonography and thallium-technetium substraction scintigraphy with sensitivities of 50.8% and 46.7% and specificities of 86.3 and 76.3% respectively. Failure of cervical exploration occurred in only one case and was attributed to an incorrect diagnosis (1.5%). Thus the selective use of these preoperative investigations may be envisaged in the following cases: hypercalcemic crises, highly probable PHP, uncertain PHP and in secondary surgical exploration.
Mellière
D
D
Service de Chirurgie vasculaire et endocrinienne, CHU Henri Mondor, Créteil.
Kassab
M
M
Becquemin
J P
JP
Etienne
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000242:Cyclic AMP / Q000097:blood; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D014463:Ultrasonography
D010281:Parathyroid Hormone; D000242:Cyclic AMP
Diagnostic et localisation des hyperparathyroïdies primaires.