title: Early prediction of postthyroidectomy hypocalcemia by one single iPTH measurement.
abstract: BACKGROUND
  We prospectively evaluated the possibility to make an early prediction of postthyroidectomy hypocalcemia by postoperative intact parathyroid hormone (iPTH) measurements.
  
  
  METHODS
  Fifty-three consecutive patients who underwent bilateral thyroid resection were included; iPTH was measured preoperatively, at the end of the surgical procedure, and at 2, 4, 6, 24, and 48 hours after the operation. Patients who had hypocalcemia (serum total calcium, <8.0 mg/dL) were compared with normocalcemic patients.
  
  
  RESULTS
  Sixteen patients experienced hypocalcemia. Six patients experienced symptoms. No significant difference was found between hypocalcemic and normocalcemic patients concerning demographic, pathologic, and preoperative laboratory data, surgical procedure, and intraoperative findings. Postoperative iPTH levels were reduced in hypocalcemic patients at the end of the procedure and at 2, 4, 6, 24, and 48 hours after the operation ( P < .001). IPTH levels below the normal range (<10 pg/mL) at 4 and 6 hours after the operation correctly predicted postoperative hypocalcemia and symptoms in all but 1 patient with a self-limiting, asymptomatic hypocalcemia (serum calcium concentration, 7.8 mg/dL) (specificity, 100%; sensitivity, 94%; overall accuracy, 98%).
  
  
  CONCLUSIONS
  One single iPTH measurement reliably can predict, early after thyroidectomy, which patients are prone to clinically relevant postoperative hypocalcemia and necessitate supplementation treatment and which patients are eligible for a safe early discharge.
authors.affiliation: Division of Endocrine Surgery, Department of Surgery, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy.
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Marco
authors.initials: M
authors.lastname: Raffaelli
authors.forename: Pietro
authors.initials: P
authors.lastname: Princi
authors.forename: Stefano
authors.initials: S
authors.lastname: Santini
authors.forename: Mauro
authors.initials: M
authors.lastname: Boscherini
authors.forename: Carmela
authors.initials: C
authors.lastname: De Crea
authors.forename: Emanuela
authors.initials: E
authors.lastname: Traini
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: D'Amore
authors.forename: Cinzia
authors.initials: C
authors.lastname: Carrozza
authors.forename: Cecilia
authors.initials: C
authors.lastname: Zuppi
authors.forename: Rocco
authors.initials: R
authors.lastname: Bellantone
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: D010281:Parathyroid Hormone