Primary hyperparathyroidism: intraoperative PTH-measurements.
BACKGROUND
With the development of rapid assays and intraoperative measurement of intact parathyroid hormone (PTH), new strategies in the handling of patients with primary hyperparathyroidism (pHPT) have evolved.


OBJECTIVE
The aim of our study was to illustrate the performance of the intraoperative PTH measurement as a predictor of successful cure.


METHODS
From September 1999 to April 2002 143 patients with pHPT underwent a parathyroid operation (bilateral neck exploration with identification of all parathyroid glands) with intraoperative measurements of plasma PTH (immediately prior to surgery (T0) and 5 minutes after gland excision (T5)). A positive test result was defined as plasma PTH values at T5 below 20% of T0 or a value in the normal range below 7.6 pmol/l. Hence T5 values above 20% of T0 and above 7.6 pmol/l were considered test negative.


RESULTS
122 patients (85%) were test positive and cured, 11 patients (8%) were test negative but cured, and 10 patients (7%) were test negative and not cured by the primary operation. Consequently, the sensitivity of the test was 0.92 and the specificity 1.00.


CONCLUSIONS
The rapid PTH test used is a reliable predictor of a successful outcome in pHPT patients undergoing parathyroid surgery.
Rolighed
L
L
Surgical Department L, Breast and Endocrine Section, Aarhus University Hospital, Denmark.
Heickendorff
L
L
Hessov
I
I
Garne
J P
JP
Rodt
S A
SA
Christiansen
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000601:surgery; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D016896:Treatment Outcome
D010281:Parathyroid Hormone