title: Screening for Hyperparathyroidism by Measurement of Calcium in Patients Undergoing Thyroid Surgery: A Prospective Study.
abstract: This study screened for asymptomatic primary hyperparathyroidism (PHPT) by measuring calcium (Ca) before thyroid surgery. The study was prospective. A total of 676 patients without a suspicion of PHPT were studied. PHPT was defined as elevated Ca (in 2 measurements) in the presence of PTH>25 pg/ml and in the absence of hypocalciuria. PHPT was diagnosed in 5 patients (0.74%), all of them women. One of the 5 patients with PHPT had no indication for parathyroidectomy (PTx) according to current guidelines. Parathyroid adenoma was easily identified during perioperative assessment of thyroid surgery in 3 patients. In the other 2 patients (0.3%), localization of the adenoma required specific exploration, which was only performed because of the preoperative diagnosis of PHPT. Normalization of Ca and PTH was achieved in all 5 patients. In conclusion, in patients without a clinical or ultrasonographic suspicion of PHPT, approximately 300 individuals should be screened before thyroid surgery to avoid one reoperation (PTx) due to PHPT, which does not seem to be cost-effective.
authors: Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors: P W
authors: PW
authors: Rosário
authors: Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors: G F
authors: GF
authors: Mourão
authors: Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors: M R
authors: MR
authors: Calsolari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D013961:Thyroid Gland / Q000601:surgery*; D013965:Thyroidectomy; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002118:Calcium