Elevated parathyroid hormone levels after parathyroidectomy for primary hyperparathyroidism.
BACKGROUND
Curative parathyroidectomy is associated with elevated levels of parathyroid hormone (PTH) with eucalcemia. This study sought to determine the frequency, clinical significance, and risk factors of this finding.


METHODS
Seventy-six consecutive patients surgically treated for primary hyperparathyroidism due to a single parathyroid adenoma in 2006 to 2007 were monitored for 1 month postoperatively; those with elevated PTH levels (>70 pg/mL) were monitored for 18 months.


RESULTS
Nineteen patients (25%) had high postoperative PTH levels with normal calcium levels. Compared with the remaining patients, this group had a significantly higher average preoperative PTH level (224.89 vs 156.86 pg/mL) and a lesser intraoperative decrease in PTH.


CONCLUSIONS
About 25% of eucalcemic patients may have elevated PTH levels after parathyroidectomy. A high preoperative PTH level (>225 pg/mL) may predict a persistently high postoperative level. Evaluation of blood and urine calcium, bone density, and cardiac function should be considered in affected patients.
Mizrachi
Aviram
A
Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gilat
Hanna
H
Bachar
Gideon
G
Feinmesser
Raphael
R
Shpitzer
Thomas
T
D000236:Adenoma / Q000097:blood / Q000473:pathology / Q000601:surgery; D002118:Calcium / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D010281:Parathyroid Hormone; D002118:Calcium