Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

21 February 2009

Stricter criteria increase the validity of a quick intraoperative parathyroid hormone assay in primary hyperparathyroidism

Gelsy Arianna LupoliABCDEF, Francesco FondericoBD, Annalisa PanicoBDEF, Michela Del PreteBF, Francesca MarcielloBF, Luciana GranieriB, Francesco MangusoC, Claudio MissoB, Luigi Antonio MarzanoAB, Giovanni LupoliADE

Med Sci Monit 2009; 15(3): CR111-116 :: ID: 869586


A "quick" intraoperative parathyroid hormone (PTH) (QPTH) assay evaluates parathyroid hypersecretion during parathyroidectomy. We investigated the likelihood of increasing surgical success rates by introducing stricter parameters in intraoperative PTH monitoring.
Material and Method
One hundred one patients with sporadic primary hyperparathyroidism were studied. Intraoperative plasma intact PTH (iPTH) levels were measured with a modified 2-site antibody immunochemiluminometric assay. iPTH values were determined before the manipulation of parathyroid tissue (t-10') and then 3 (t+3') and 10 (t+10') minutes after resection of the suspected pathologic parathyroid gland(s).
The median (interquartile range) baseline iPTH level was 259.6 (536) ng/L at t-10' and 64.1 (139.5) ng/L at t+10'. At t+3' and t+10', the median percentage decrease of iPTH from baseline was 56.1% and 77.3%, respectively. In 7 patients, the iPTH level decreased very slowly, and in patients with a double adenoma, an initial increase in the iPTH level occurred because of considerable manipulation during surgery. Despite a decrease of about 50% in iPTH level, persistent hyperparathyroidism was identified after a few months in 2 patients with a multiglandular pathologic condition in which a relatively larger parathyroid "masked" the hyperactivity of other parathyroid glands.
A QPTH is useful during parathyroidectomy. A decrease in the iPTH level of > or =70% from baseline indicates a successful operation and reduces the likelihood of false-positive results. The evaluation of more than 1 PTH level is required if multiglandular disease is suspected or excessive intraoperative manipulation occurs.

Keywords: Parathyroid Hormone - blood, Luminescent Measurements - methods, Intraoperative Care, Hyperparathyroidism, Primary - pathology, Bayes Theorem, Sensitivity and Specificity, Reproducibility of Results

Add Comment 0 Comments

998 7


01 November 2023 : Editorial  

Editorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is Declared

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville,

DOI: 10.12659/MSM.942960

Med Sci Monit 2023; 29:e942960


In Press

29 Nov 2023 : Laboratory Research  

CTRP13 Mitigates Endothelial Cell Ferroptosis via the AMPK/KLF4 Pathway: Implications for Atherosclerosis P...

Med Sci Monit In Press; DOI: 10.12659/MSM.942733  

28 Nov 2023 : Clinical Research  

Impact of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography on Therapeutic Decisions and ...

Med Sci Monit In Press; DOI: 10.12659/MSM.942122  

28 Nov 2023 : Clinical Research  

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children...

Med Sci Monit In Press; DOI: 10.12659/MSM.943031  

27 Nov 2023 : Clinical Research  

Comparison of Outcomes from Emergency Admissions to a Major Trauma Center in Turkey of 1646 Elderly Patient...

Med Sci Monit In Press; DOI: 10.12659/MSM.942916  

Most Viewed Current Articles

13 Nov 2021 : Clinical Research  

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

DOI :10.12659/MSM.932788

Med Sci Monit 2021; 27:e932788


30 Dec 2021 : Clinical Research  

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...

DOI :10.12659/MSM.935379

Med Sci Monit 2021; 27:e935379


14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990


08 Mar 2022 : Review article  

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...

DOI :10.12659/MSM.936292

Med Sci Monit 2022; 28:e936292


Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750