title: Intact parathyroid hormone measurement at 24 hours after thyroid surgery as predictor of parathyroid function at long term.
abstract: BACKGROUND
  There is no consensus about the usefulness of postoperative intact parathyroid hormone (iPTH) determination to predict permanent hypoparathyroidism (pHPP). We evaluated the value of calcium (Ca2+) and iPTH concentration at 24 hours after total thyroidectomy (TT) for predicting pHPP.
  
  
  METHODS
  Ca2+ and iPTH levels from 70 consecutive patients who underwent TT were measured at 24 hours and 6 months after TT.
  
  
  RESULTS
  Five patients (7.1%) developed pHPP. An iPTH concentration ≤5.8 pg/mL at 24 hours after TT identified patients at risk for pHPP (sensitivity, 100%; specificity, 81.5%), but it was not accurate enough to predict its development (positive predictive value, 30%). Conversely, an iPTH level >5.8 pg/mL predicted normal parathyroid function at 6 months (negative predictive value, 100%). Compared with iPTH, a postoperative Ca2+ level ≤1.95 mmol/L was 60% sensitive and 78.5% specific to predict pHPP.
  
  
  CONCLUSIONS
  An iPTH concentration >5.8 pg/mL on the first postoperative day rules out pHPP with much better diagnostic accuracy than Ca2+. Postoperative iPTH could be helpful in identifying patients at risk for developing pHPP.
authors.affiliation: Endocrinology and Nutrition Service, Germans Trias i Pujol University Hospital, Department of Medicine, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain. Electronic address: mtjulian.germanstrias@gencat.cat.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Julián
authors.forename: Jose María
authors.initials: JM
authors.lastname: Balibrea
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Granada
authors.forename: Pau
authors.initials: P
authors.lastname: Moreno
authors.forename: Antonio
authors.initials: A
authors.lastname: Alastrué
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
authors.forename: Anna
authors.initials: A
authors.lastname: Lucas
mesh_terms: D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013965:Thyroidectomy; D013997:Time Factors
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium
keywords: Permanent hypoparathyroidism; Postoperative hypocalcemia; Total thyroidectomy