Hyperparathyroidism: 30% of patients have persistent PTH elevation after surgery

  • Caldwell M & al.
  • J Clin Endocrinol Metab
  • 12.06.2019

  • von Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • 30% of patients with hyperparathyroidism who underwent parathyroidectomy experienced persistently elevated parathyroid hormone (PTH) in a follow-up study at a tertiary hospital.

Why this matters

  • The number of parathyroidectomy procedures is increasing over time, necessitating better understanding of patients who continue to have elevated PTH.

Key results

  • 97% of patients had normalized calcium after surgery.
  • 30% of patients had persistently elevated PTH after surgery.
  • Persistently elevated PTH was not significantly associated with sex, age, BMI, or gland weight.
  • Patients with persistently elevated PTH had lower presurgery vitamin D levels (26.1 vs 35.6 ng/mL; P=.019) and higher presurgery PTH levels (156.5 vs 102.5 pg/mL; P<.001 compared with patients normalized pth.>
  • Presurgery calcium was inversely associated with postsurgery PTH (P=.002).

Study design

  • 407 patients who underwent parathyroidectomy for primary hyperparathyroidism from the Carolina Data Warehouse were included.
    • 144 had PTH measurements within 3-18 months of surgery.
  • Funding: National Center for Advancing Translational Sciences.

Limitations

  • Retrospective study design.