title: [Usefulness of intraoperative PTH measurement in primary and secondary hyperparathyroidism: experience with 109 patients].
abstract: BACKGROUND
  Intraoperative parathyroid hormone measurement (IO-PTH) was first described in 1988 and it's potentially useful in predicting cure after parathyroidectomy. The aim of this study was to evaluate IO-PTH decay profile and the utility of this procedure in predicting cure in primary (PHH) and secondary (SHH) hyperparathyroidism due to renal disease.
  
  
  METHODS
  109 patients were evaluated from 06/2000 to 12/2004. 33 had PHH and 76 SHH (52 in dialysis, 24 with renal graft). IO-PTH was measured at times 0 (before resection), 10, 20 minutes after parathyroidectomy using immunometric assay (Elecsys-PTH/Immunoassay-Roche). Time necessary to perform assay: 10 minutes.
  
  
  RESULTS
  HPP patients: IO-PTH average decrease 79.2% from basal levels after 10 minutes. HPS: IO-PTH average decrease 85.8% and 87.6% after 10 minutes in dialysis and renal graft patients respectively. All patients were cured, except 2 (1 PHH, 1 SHH), because of a double adenoma and ectopic (mediastinal) parathyroid respectively. Failure in IO-PTH decrease was observed in both.
  
  
  CONCLUSIONS
  IO-PTH measurement is useful in improving surgical success rates in PHH and SHH.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP. moniqueohe@uol.com.br
authors.forename: Monique Nakayama
authors.initials: MN
authors.lastname: Ohe
authors.forename: Rodrigo Oliveira
authors.initials: RO
authors.lastname: Santos
authors.forename: Ilda Shizue
authors.initials: IS
authors.lastname: Kunii
authors.forename: Márcio
authors.initials: M
authors.lastname: Abrahão
authors.forename: Onivaldo
authors.initials: O
authors.lastname: Cervantes
authors.forename: Aluízio Barbosa
authors.initials: AB
authors.lastname: Carvalho
authors.forename: Marise
authors.initials: M
authors.lastname: Lazaretti-Castro
authors.forename: José Gilberto H
authors.initials: JG
authors.lastname: Vieira
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D007118:Immunoassay / Q000379:methods; D016030:Kidney Transplantation; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011877:Radionuclide Imaging; D006435:Renal Dialysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone