title: Role of preoperative intact parathyroid hormone levels in predicting the likelihood of multiglandular disease in primary hyperparathyroidism.
abstract: BACKGROUND
  Minimally invasive parathyroidectomy has become increasingly popular for the treatment of primary hyperparathyroidism, but is not a feasible option for multiglandular disease. It has been suggested that preoperative intact parathyroid hormone (iPTH) levels may predict multiglandular disease. We examined this hypothesis in patients who underwent surgical intervention for primary hyperparathyroidism at Johns Hopkins Medical Institutions.
  
  
  METHODS
  We retrospectively reviewed 502 consecutive patients with primary hyperparathyroidism who underwent parathyroidectomy. Multivariable logistic regression analysis assessed preoperative iPTH levels as a predictor of multiglandular disease and a positive sestamibi scan, after adjustment for age, sex, and race.
  
  
  RESULTS
  Preoperative iPTH levels were not significantly associated with a greater likelihood of multiglandular disease. However, sestamibi scan positivity was significantly more likely in patients with higher preoperative iPTH levels.
  
  
  CONCLUSIONS
  Preoperative iPTH levels are not helpful in predicting multiglandular disease and should not be used to exclude a minimally invasive parathyroidecotomy for patients with primary hyperparathyroidism. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.
authors.affiliation: Division of Endocrine and Oncological Surgery, Department of Surgery, Tulane University Medical Center, New Orleans, Louisiana, USA.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Carson
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Tufaro
authors.forename: Obai
authors.initials: O
authors.lastname: Abdullah
authors.forename: Haytham
authors.initials: H
authors.lastname: Alabbas
authors.forename: Alan P
authors.initials: AP
authors.lastname: Dackiw
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone