[Usefulness of intraoperative PTH measurement in primary and secondary hyperparathyroidism: experience with 109 patients].
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.
Ohe
Monique Nakayama
MN
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP. moniqueohe@uol.com.br
Santos
Rodrigo Oliveira
RO
Kunii
Ilda Shizue
IS
Abrahão
Márcio
M
Cervantes
Onivaldo
O
Carvalho
Aluízio Barbosa
AB
Lazaretti-Castro
Marise
M
Vieira
José Gilberto H
JG
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
D010281:Parathyroid Hormone