Role of preoperative intact parathyroid hormone levels in predicting the likelihood of multiglandular disease in primary hyperparathyroidism.
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.
Kandil
Emad
E
Division of Endocrine and Oncological Surgery, Department of Surgery, Tulane University Medical Center, New Orleans, Louisiana, USA.
Carson
Kathryn A
KA
Tufaro
Anthony P
AP
Abdullah
Obai
O
Alabbas
Haytham
H
Dackiw
Alan P
AP
Tufano
Ralph P
RP
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
D010281:Parathyroid Hormone