Hyperparathyroidism: intraoperative PTH cutoff best predicts success

  • Claflin J & al.
  • Surgery
  • 08.04.2019

  • von Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • After parathyroidectomy for primary hyperparathyroidism, intraoperative parathyroid hormone (IOPTH) levels ≤40 pg/mL are associated with lower persistence rates compared with the traditional measure of ≥50% reduction.

Why this matters

  • The optimal criteria for using IOPTH levels to predict normocalcemia are unclear.

Key results

  • 2.5% of patients experienced persistent hyperparathyroidism after surgery.
  • Patients with
  • Patients with IOPTH >65 pg/mL had a higher persistence rate than patients with IOPTH
  • Patients with IOPTH 40-65 pg/mL had a higher persistence rate than patients with IOPTH ≤40 pg/mL (3.4% vs 1.2%; OR, 4.2; P<.001>

Study design

  • 2654 patients with primary hyperparathyroidism who underwent parathyroidectomy were analyzed for associations between IOPTH and persistence rates.
  • Funding: None disclosed.

Limitations

  • Retrospective study.