title: [Relationship between parathormone concentration during surgery and the post-operative outcome of primary hyperparathyroidism].
abstract: BACKGROUND
  The relationship between the intra-operative concentration of parathyroid hormone (IOPTH) and the long-term outcome of patients intervened due to primary hyperparathyroidism (PHPT).
  
  
  METHODS
  A prospective observational study was performed with 120 patients. Three determinations were made of PTH in blood: baseline, when the diseases gland was located, and 10 minutes after its extirpation. The calcium, PTH and vitamin D (25-OH-D3) levels were measured during follow up.
  
  
  RESULTS
  A decrease in IOPTH > 50% was observed in 96 (80%) patients, and the post-extirpation value returned to the normal range (Group I), in 18 (15%) a decrease of > 50% but the final value remained higher than normal (Group II) and in 6 (5%) the decrease was<50% (Group III). Persistent PHPT was detected during follow up in 6 patients (5%): one in Group I (1%), 3 (16.7%) in II and 2 (33.3%) in group III (P<.001). The risk of persistent PHPT was higher in Group II (odds ratio: 19; 95% CI: 1.85-194) and in Group III (odds ratio: 47; 95% CI: 3.53-639). There were no cases of recurrent PHPT. A normal calcium with an increased PTH was detected in 20 patients of Group I (20.8%), 11 (61.1%) in II and 3 (50%) in III (P<.001). These patients had a lower concentration of post-operative vitamin D (17 ng/ml, range: 24; compared to 28 ng/ml, range: 21) (P=.008) and higher frequency of hypovitaminosis D (70.6% compared to 26.2%) (P>.001).
  
  
  CONCLUSIONS
  The risk of persistent PHPT is higher when the IOPTH decreases more than 50% but still remains high.
authors.affiliation: Cirugía General, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Madrid, España. mdiez.hupa@salud.madrid.org
authors.forename: Manuel
authors.initials: M
authors.lastname: Díez
authors.forename: Tomás
authors.initials: T
authors.lastname: Ratia
authors.forename: María José
authors.initials: MJ
authors.lastname: Medrano
authors.forename: José María
authors.initials: JM
authors.lastname: Mugüerza
authors.forename: M Rosario
authors.initials: MR
authors.lastname: San Román
authors.forename: Carlos
authors.initials: C
authors.lastname: Medina
authors.forename: Angel
authors.initials: A
authors.lastname: Rodríguez
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Sánchez-Seco
authors.forename: Cristina
authors.initials: C
authors.lastname: Vera
authors.forename: Raúl
authors.initials: R
authors.lastname: Díaz
authors.forename: Pilar
authors.initials: P
authors.lastname: Franco
authors.forename: Javier
authors.initials: J
authors.lastname: Granell
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone