Transient rise in intact parathyroid hormone concentration after surgery for primary hyperparathyroidism.
Two-site immunometric assays for determination of the level of intact parathyroid hormone (PTH) in serum have enabled detailed clinical studies of PTH secretion. Fifty-one patients with primary hyperparathyroidism were studied before surgery and 2 years after operation. PTH levels dropped to low values after operation. A rebound increase in PTH concentration occurred from 10 days to 3 months after surgery. Abnormally raised postoperative PTH concentrations were noted in 31 per cent of the patients, who had lower serum concentrations of ionized calcium (Ca2+) than the rest (P < 0.003). Before operation these patients had a more pronounced hyperparathyroidism than the others. At 2 years after surgery there was still a positive correlation between PTH concentrations before and after surgery (P < 0.001). The rebound increase in the level of PTH was a general phenomenon probably caused by low Ca2+ concentrations at the time of remineralization of bone. This phenomenon was transient. The positive correlation between preoperative and postoperative PTH concentrations shows that effects of hyperparathyroidism can remain for a long time after surgical cure.
Tisell
L E
LE
Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Jansson
S
S
Nilsson
B
B
Lundberg
P A
PA
Lindstedt
G
G
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000378:metabolism* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011184:Postoperative Period; D013997:Time Factors
D010281:Parathyroid Hormone; D003404:Creatinine; D000469:Alkaline Phosphatase; D002118:Calcium